Topical Cryoanesthesia Versus Benzocaine in Pediatric Dentistry

Comparison of Topical Cryoanethesia and Benzocaine in Pain Perception During Mandibular Nerve Block in Pediatric Patients: A Randomized Controlled Clinical Trial

This clinical study tested and compared two ways (cold-base technique or "cryoanesthesia" and conventional benzocaine gel) to reduce pain from dental injections in children.

Researchers worked with 28 children between 6 and 12 years old who needed injections on both sides of the lower jaw for dental treatment. Each child received cryoanesthesia on one side and 20% benzocaine gel on the other side, in different appointments, and the team measured pain, behavior, heart rate, and blood oxygen levels.

Objective: To evaluate and compare pain perception during inferior alveolar nerve block puncture in pediatric patients using cryoanesthesia versus conventional topical benzocaine anesthesia.

Methods: A split-mouth randomized controlled clinical trial was conducted with 28 patients aged 6 to 12 years requiring bilateral inferior alveolar nerve blocks for bilateral lower arch dental treatment. Each participant received both anesthetic techniques in a randomized order on separate appointments, with treatment allocated to contralateral mandibular hemiarches. Primary and secondary outcome measures included pain intensity (Visual Analog Scale), heart rate, oxygen saturation, and behavioral response (FLACC scale).

Inclusion Criteria:

• Systemic health: No significant medical history or uncontrolled systemic disease.
• Bilateral dental pathology requiring treatment: At least two teeth (one per mandibular hemiarch) requiring bilateral inferior alveolar nerve blocks for restorative or endodontic treatment.
• Cooperation level: Frankl behavioral rating scale classification III or IV (positive or very positive).
• Informed consent/Child assent: Signed informed consent from parent or legal guardian; signed assent from participant (age-appropriate).

Exclusion Criteria:

• Acute dental emergency requiring immediate treatment.
• Known hypersensitivity or allergy to benzocaine or other local anesthetics.
• Known hypersensitivity to cold (cryophobia or cold urticaria).
• Significant dental anxiety or phobia precluding study participation.
• Developmental delay or behavioral disorders limiting communication or cooperation.
• Current use of medications affecting pain perception or hemodynamic parameters.