Effect of needle bevel type on pain perception in children during inferior alveolar nerve block anesthesia: randomized controlled clinical trial

Abstract

Background: The difficulty in providing optimal treatment has been related to patients’ fear of the discomfort that comes with anesthetic needle insertion. The main purpose of this study is to clinically assess the effect of needle bevel on patient’s perception of pain during inferior alveolar nerve block (IANB) anesthesia and evaluate the needle tip for mechanical deformation. Materials and methods: Sixty-six children 5–7 years old, who were indicated for IANB anesthesia, were selected from the outpatient clinic of Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University. Participants were randomly allocated into two groups according to the type of needle bevel used. Group I (n = 33) received INAB anesthesia using double scalpel blade bevel needle, while group II (n = 33) received the injection using conventional bevel needle. Pain reaction was evaluated subjectively using modified Maunuksela face pain scale (FPS) and objectively using Sensory, Eye, and Motor (SEM) scale. After the respective injections, the needles were prepared for microscopic examination. Results: The FPS and SEM showed significantly lower pain scores during IANB anesthesia with double scalpel blade bevel needle compared to the conventional bevel needle (p = 0.002, p = 0.003 respectively). No significant difference in mechanical angle deformation between the two needles was observed (p = 0.837). Conclusion: For IANB anesthesia, double scalpel blade bevel needle demonstrated significantly less injection pain. All dentalneedles demonstrated tip deformation after single use.