Syringe micro vibrator (SMV) a new device being introduced in dentistry to alleviate pain and anxiety of intraoral injections, and a comparative study with a similar device

Abstract

BackgroundNeurologically, it is proven that stimulation of larger diameter fibers - e.g. using appropriate coldness, warmth, rubbing, pressure or vibration- can close the neural "gate" so that the central perception of itch and pain is reduced. This fact is based upon "Gate-control" theory of Melzack and Wall.Presentation of the hypothesisSyringe Micro Vibrator is a new design being introduced for the first time in the field of Dentistry. This device is a promising breakthrough in pain and anxiety management and may deliver solution for clinicians plagued with patient pain phobia. It has an off-set rotating micro vibration creator with ultra high frequency and ultra low altitude that can be easily placed on any standard dental syringe and some disposable syringes. This device was registered as an invention in dentistry and received Iran National Patent number of 63765.Testing the hypothesisBy creating micro vibration, this device would be effective in reducing the pain and anxiety confronted with most types of intraoral injections as palatal, mandibular block, intraligamental and local infiltration. From the aspect of the patient pain management, this device contributes both physiologically (based on Gate Control Theory of pain) and psychologically (based on the device function as will be explained by dentist to the patient as a modern pain reducing technology). From the aspect of clinician, SMV motor provides vibrations with ultra high frequency to alleviate pain, but since it has ultra low vibration altitude, it has no adverse effect on the clinician dexterity and accuracy during injection and it does not interfere with pin point localization of injection site.Implications of the hypothesisUpon mounting on a conventional dental anesthesia injection syringe, SMV is switched on and the clinician then uses normal injection technique to administer the anesthetic. This device is not only a useful accessory device for ordinary patients, but also more useful for pediatric patients and those who have a phobia of intraoral injection or pain.

Clinical pain evaluation with intraoral vibration device during local anesthetic injections

“…Our study shows that the vibration device was an effective and simple tool to alleviate the clinical pain encountered during local anesthetic injection. Previous studies reported similar results of pain reduction on vibration counter stimulation during local anesthesia injections ( 8 , 14 ). The effectiveness in pain control could be explained with gate control theory of pain modulation.…”

Local anesthetics and advances in their administration – an overview

“…The brain is only able to perceive one type of sensation from one area in any given time, therefore, when using vibratory stimulation in local anesthesia, that sensation will reach the brain before the pain sensation. Many devices have been developed to take advantage of the 'Gate-control' theory, which suggests that when applying pressure and using vibration, the neural gate can be closed, thereby reducing the perception of itch and pain [23].…”

“…The vibrations reduce the size of this balloon effect by enhancing tissue infiltration of the anaesthetic solution. Also, the use of SMV eliminates the need and saves the time required for application and onset of topical anaesthetics [23].…”

“…A short needle is inserted into the pulp chamber Figure 4. Vibraject system [23] and into the root canal. A small amount of anaesthetic (0.2-0.3mL) is injected.…”

Advances in dental local anesthesia techniques and devices: An update

“…A nasal spray[51] has shown to anesthetize maxillary anterior six teeth is set to be tested in an FDA Phase 3 trial, which will assess the spray's effectiveness compared to the current “gold standard” treatment - painful anesthesia injections. Syringe micro vibrator (SMV),[52] a new device being introduced in dentistry to alleviate pain and anxiety of intraoral injections.…”