The application of digital techniques in prosthetics is extremely useful in optimising clinical and laboratory times, thus accelerating and improving the entire restoration workflow. This is a clear benefit for the clinician, but also promotes patient acceptance and compliance.
Pain control is a fundamental requirement in most of the common dental treatments; in this sense, it is important to stress that a prosthetic rehabilitation (on natural teeth) or implant prosthesis is different from other procedures because it is spread on different appointments. The cumulative discomfort, resulting from conventional anaesthesia injections in each appointment, especially in the fastest ones – but not worthy of an effective anaesthesia regimen – can, therefore, be considerable.
Computer-controlled delivery systems for anaesthesia (CCLAD) have been proposed as a useful option to minimise the problem in question. These instruments are based on the rationality of continuous positive pressure, i.e. the administration of a slow but constant flow of anaesthetic solution, with the computer compensating for the variation in resistance provided by the tissues. This favours the rapid onset of effective anaesthesia at the cost of an almost imperceptible injection procedure. The method is versatile as it allows the implementation of the main techniques of nerve block and to work, if necessary, on more than one dental element, both in the upper arch (e.g. using the AMSA technique) and in the lower arch.
With this in mind, Yenisey compared the CCLAD method with conventional prosthetic injection anaesthesia (prosthodontics); the results were published a few years ago in the Journal of Applied Oral Science.
The author enlisted 16 patients, of whom 3/4 were women, all targeted for prosthetic rehabilitation, involving both maxillary arches. The study followed a split-mouth design, with the patient blindfolded and unaware of the type of method chosen, (1) the classic one or (2) a computer-guided AMSA, respectively (1) already tested and (2) never tested in the past.
At the end of the treatment – (ins) insertion of the needle + (of) administration of the anaesthetic solution + (pre) preparation of the tooth – the subject was questioned through a verbal rating scale (VRS) in five points on the pain perceived in the 3 phases indicated.
Net of a comparable efficacy during the actual treatment (no significant differences were found regarding the pain stimulation during the preparation), the author indicates CCLAD as the preferable method as it is significantly more comfortable in the two preliminary phases.