Efficacy of Tactile Method versus Visual Method to Define Needle Insertion Site of Inferior Alveolar Nerve Block for Pulpotomy in Children: A double-Blind, Randomized, Cross-over Study

Effective pain control is a prerequisite for successful child dental treatment.This study was designed to evaluate the efficacy of tactile versus visual method to define needle insertion point of IANB for pulpotomy in children.

In this double-Blind, cross-over, randomized clinical trial, 40 children (7-9 years old) requiring primary mandibular second molars pulpotomy were recruited. Study was performed in Zahedan Dental School at 2016. Children were randomly divided into two groups. Group I received IANB using tactile method in the right side in the first session, and using visual method in the left side in the second session. Group II received the visual method for the right and the tactile method for the left in two sessions respectively. Objective and subjective pains during injection were recorded using SEM and FIS, respectively. Reaction during cavity preparation; recorded by SEM, was evaluated as sign of anesthesia failure. Data were analyzed using the Mann-Whitney U, Wilcoxon Singed Rank and Fisher's Exact Tests at a significance level of 0.05. 

Regarding tactile method, comparing groups I and II showed no significant difference in any of the variables (P> 0.05). About visual method two groups showed a significant difference only in subjective pain (P= 0.013). In group I, visual method showed significant differences in objective and subjective pain versus tactile method (p < 0.05). In group II, no significant differences were found between the two methods in variables. Totally, all variables were significantly different in favor of visual method versus tactile method (p <0.05).

The visual method reduced objective and subjective pain and yielded superior anesthesia success compared to tactile method.