Effect of pre-cooling agent on intensity of pricking pain at intraoral injection site in adults: An experimental study.

OBJECTIVE: To determine the effect of pre-cooling agent on the intensity of pricking pain at the intraoral injection site in adult patients. METHODS: The in-vivo interventional study was conducted at the Department of Operative Dentistry, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, from September 2018 to August 2019, and comprised adult patients of either gender. The pricking pain perception during needle administration was assessed using split-mouth technique. Topical anaesthesia benzocaine gel was applied on the left side, which was treated as controls, for 1 min, while on the right side, which was treated as the experimental side, refrigerated cartridge was placed for 2 min. Infiltration anaesthesia was then administered on both sides. Pain perception ratings were measured through visual analogue scale. After profound anaesthesia was achieved, restorative treatment was performed under rubber dam isolation. Data was analysed using SPSS 24. RESULTS: Of the 152 subjects, 77(50.65%) were females and 75(49.34%) were males. The overall mean age was 35.97±8.669 years (range: 21-50 years). The effect of refrigerated cartridge was significant on the intensity of pricking pain at the intraoral injection site in patients aged 41-50 years, and in female patients aged 21-30 years (p<0.05), whereas its effect was non-significant in males aged 21-30 years and patients aged 31-40 years (p>0.05). CONCLUSIONS: Pre-cooling agent was found to be effective in decreasing pricking pain felt by patients.

Comparison of gingival biotype in smokeless tobacco users (Gutka and Paan) and non-tobacco users.

OBJECTIVE: To assess the gingival biotypes in smokeless tobacco (Gutka and Paan) users and compare it with non-tobacco users in Karachi sub-population using trans-gingival probing method (TRAN). METHODS: This in-vivo, cross sectional study was conducted in the department of Operative Dentistry from 20th February 2019 to 25th June 2019 Dow University of Health Sciences, Karachi after obtaining ethical approval from the Institutional review board of DUHS (Ref: IRB-1207/DUHS/Approval/2019/21). A total of 70 participants, 35 subjects currently using smokeless tobacco (Gutka and Paan) and 35 non-tobacco users from both genders were included in the study after taking informed consent. Gingival biotype was recorded using probe transparency method. Probing of the gingival sulcus was performed at the mid-buccal aspect of both maxillary incisors. Depending on the visibility of the underlying probe gingiva was categorized as thin or thick. RESULTS: Statistically significant differences in gingival biotype was observed of both groups (p=0.005). Males were recorded with a higher percentage of thick gingiva in both groups (81% in smokeless tobacco and 65% in non-tobacco) while in females thick gingiva was more prevalent in smokeless tobacco group (85.7%) whereas thin gingiva was noted in non-tobacco group (66.7%); although the results between genders was statistically insignificant. The comparison between different age groups, genders and both groups was statistically insignificant. CONCLUSIONS: Significant difference was observed between gingival biotype of smokeless tobacco and non-tobacco user groups. No statistically significant results were observed between genders and age groups.

Audiovisual Distraction: A Pricking Pain Reduction Modality among Ladies Receiving Intraoral Injections.

OBJECTIVE: To determine the effect of audiovisual distraction (AVD) using virtual reality device (bobo VRZ4-VRBOX) on intensity of pricking pain at the intraoral injection site among different age groups in ladies. STUDY DESIGN: Experimental study. PLACE AND DURATION OF STUDY: Department of Operative Dentistry, Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, during September 2018 to March 2019. METHODOLOGY: An in-vivo interventional study, using split-mouth technique was conducted in 50 lady patients of sample size of 50, to investigate pricking pain perception during needle insertion. Topical anesthesia (benzocaine gel) was applied on left side (control) for 1 minute without audiovisual distraction (AVD); whereas, on the experimental side (right), similar methodology was followed after topical anesthesia but with AVD via VR-Z4 video eyeglasses after the local anesthesia was administered. Patients' pain perception ratings were measured through visual analog scale (VAS). After profound anesthesia was achieved, restorative treatment was performed under rubber dam isolation. RESULTS: Audiovisual (AV) device was effective in decreasing the pricking pain sensed by the patients during infiltrate anesthesia; but the score remained within the same pain category. The effect of audiovisual distraction (AVD) using virtual reality device (VRZ4-VRBOX) was statistically insignificant on intensity of pricking pain at the intraoral injection site among different age groups in ladies. CONCLUSION: AV device is not dependent on age (21-50 years) in reducing the pricking pain. Pain is effectively reduced after the use of AV device, but this reduction is not statistically significant.