Evaluation of the effects of computer-controlled and traditional local anesthesia on pain and anxiety in children with molar incisor hypomineralization

The aim of this study was to evaluate the effects of the computer-controlled local anesthesia system SleeperOne compared to conventional local anesthesia technique on pain and anxiety in children with molar incisor hypomineralization (MIH). The study included 28 patients aged 6-12 years with MIH and deep dentin caries in the first permanent molars. Prior to the study, all participants completed the Children's Fear Survey Schedule (CFSS-DS). Pulse rate, oxygen saturation (SpO2), and salivary cortisol levels were measured before anesthesia administration, after anesthesia, and following the treatment procedure. Additionally, pain and anxiety were assessed using the Wong Baker Faces Pain Rating Scale (WBS), Visual Analogue Scale (VAS) and Face, Legs, Arms, Cry, Consolability (FLACC) scale. Patients were initially classified according to sensitivity status, and the efficacy of the two anesthesia techniques was evaluated by comparing pain and anxiety scores post-treatment. No significant difference was observed between the two anesthesia methods in pre-treatment CFSS-DS scores, indicating a homogeneous distribution of anxiety levels among patients. No significant differences were found between conventional anesthesia and SleeperOne groups regarding WBS, VAS, FLACC, and SpO2 values at any time point; however, post-anesthesia pulse rates were significantly higher in the conventional anesthesia group. Furthermore, salivary cortisol levels were significantly lower in the SleeperOne group compared to the conventional anesthesia group. Post-treatment cortisol levels were significantly lower in the SleeperOne group for total values in patients with sensitivity and mandibular values in patients without sensitivity. Intraosseous anesthesia using SleeperOne is considered an effective and reliable alternative for the treatment of teeth affected by MIH. Moreover, salivary cortisol measurement was concluded to be a safe, objective, quantitative, and physiological method for assessing pain and anxiety. However, further studies with larger sample sizes are necessary to confirm these findings.