Local Anaesthetic Drug Administration in Dentistry Using Computer Assisted Anaesthetic Delivery System: A Systematic Review

BACKGROUND: Local anaesthetics play a key role in reducing pain and anxiety during dental treatment. However the disadvantage of using syringe and needle technique in the maxilla, proximal to the apices of the teeth is that it is painful and also leads to collateral anaesthesia. Hence this systematic review aims to identify whether computer assisted local anaesthetic delivery system could produce predictable results similar to conventional syringe needle technique and also eliminate the disadvantages. METHOD: Electronic databases were searched for eligible studies. A pre-tested data extraction form was created and following data were extracted from each eligible study: trial site, year, trial methods, participants, interventions and outcomes. A significant heterogeneity was seen in between the eligible studies. RESULTS: Six studies met the inclusion criteria and were included in the present review. One was cross-over and one split mouth, while others were parallel. Only one was open label and the rest were single blinded. Three studies were conducted in children while the rest in adults. The outcome measurement was directed to measure psychological attributes using visual analog scale, electric pulp testing and pain behaviour code. CONCLUSION: Unfortunately because of the clinical heterogeneity, meta-analysis could not be performed. Hence it is difficult to conclude that the computer assisted delivery is better than the conventional method, although it was found to perform better. Many high quality studies assessing the efficacy and cost-efficiency of various modes of administration are required to confirm the utility of computer assisted delivery systems.