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Effect of Topical Anesthesia on Pain from Needle Insertion and Injection and Its Relationship with Anxiety in Patients Awaiting Apical Surgery: A Randomized Double-blind Clinical Trial

 Sin-Yeon Cho  ;  Euiseong Kim  ;  Sung-Ho Park  ;  Byoung-Duck Roh  ;  Chan-Young Lee  ;  Seung-Jong Lee  ;  Il-Young Jung 
 JOURNAL OF ENDODONTICS, Vol.43(3) : 364-369, 2017 
Journal Title
Issue Date
Adult ; Aged ; Anesthesia, Dental ; Anesthesia, Local* ; Anesthetics, Local/administration & dosage* ; Anxiety/etiology* ; Double-Blind Method ; Female ; Humans ; Injections/adverse effects ; Injections/psychology* ; Male ; Middle Aged ; Pain/etiology ; Pain/prevention & control ; Pain/psychology* ; Pain Measurement ; Surveys and Questionnaires ; Young Adult
Anxiety ; maxillary central incisors ; pain ; topical anesthesia
INTRODUCTION: We aimed to simultaneously investigate the effects of topical anesthesia on needle insertion and injection pain in the labial mucosa of the maxillary central incisors of patients awaiting apical surgery and to assess the relationship between patients' anxiety and pain scores.

METHODS: Forty-four patients scheduled for apical surgery of the maxillary anterior incisor or canine were included, and all completed the Modified Dental Anxiety Scale (MDAS) questionnaire. One piece of Xylocaine (AstraZeneca, Sodertalje, Sweden) gauze was applied to the right or left side of the labial vestibule below the central incisor according to a randomization process, and 1 piece of water gauze was applied to the contralateral side of the labial vestibule. Each piece of gauze remained in place for 2 minutes. The subjects were asked to rate their pain according to the numeric rating scale immediately after needle insertion and anesthetic solution injection.

RESULTS: Topical anesthetic application significantly reduced both insertion- and injection-related pain. Injection pain was significantly higher than insertion pain throughout the experiment. The difference in pain scores between the placebo and topical anesthetic groups was significantly greater for insertion pain than injection pain. The group with higher MDAS scores showed significantly higher pain scores, except for insertion pain reported by the topical anesthetic group, which did not show a significant difference between MDAS score groups.

CONCLUSIONS: The topical anesthetic was highly effective for both insertion and injection pain during infiltration anesthesia in the maxillary central incisors. Highly anxious patients reported higher pain scores; however, topical anesthetics reduced the effect of anxiety on increasing pain.
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2. College of Dentistry (치과대학) > Dept. of Conservative Dentistry (보존과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eui Seong(김의성) ORCID logo https://orcid.org/0000-0003-2126-4761
Roh, Byoung Duck(노병덕)
Park, Sung Ho(박성호) ORCID logo https://orcid.org/0000-0003-2171-235X
Lee, Seung Jong(이승종)
Lee, Chan Young(이찬영)
Jung, Il Young(정일영) ORCID logo https://orcid.org/0000-0001-8972-2664
Cho, Sin Yeon(조신연)
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