Comparação da percepção da dor durante instrumentação periodontal utilizando técnicas anestésicas convencionais e computadorizadas: estudo clínico randomizado

Abstract

The aim of this study was to evaluate the perception of pain during the application of computerized anesthesia compared to conventional anesthetic techniques using a carpule syringe in patients requiring non-surgical periodontal treatment. This was a controlled, randomized, double-blind, crossover, split-mouth clinical study with 61 volunteers, 32 women, and 29 men, aged over 18 years, with stage I periodontitis or more. Patients undergoing periodontal treatment were divided into three intervention groups (Conventional Anesthesia, Rapid Conventional Anesthesia and Computerized Anesthesia), which received a different anesthetic method with a one-week interval between interventions. Patients underwent a session of subgingival instrumentation with manual and ultrasonic instruments, according to the indication for treatment. Clinical parameters were assessed, such as dental and periodontal evaluations, as well as the degree of anxiety and pain perception of the anesthetic method. Pain intensity was analyzed using non-parametric tests (Friedman and Cochran’s Q tests). The variables related to the secondary outcomes were analyzed descriptively and inferentially (chi-square, t-test for paired measures, and ANOVA for repeated measures). Multiple linear and logistic regression models were used to determine variables that could interfere with pain. The results showed that computerized anesthesia generated lower pain intensity than rapid conventional anesthesia, but the results were similar between conventional anesthesias performed with a carpule syringe. Age, sex, severity of periodontal disease, and anxiety did not influence patient pain. Anesthetic techniques did not alter hemodynamic parameters. In the patients' opinions, all techniques were effective. We conclude that computerized anesthesia is less painful than rapid conventional anesthesia. Conventional anesthesia can be used for most patients; however, in patients with a high level of fear and anxiety, computerized anesthesia can provide a more comfortable experience and consequently improve patient compliance with periodontal treatment.