The goal of this clinical trial is to compare the effects of two local anesthesia techniques on pulp hemostasis time during pulpotomy treatment of mandibular primary molars in children aged 6-9 years.
The main questions it aims to answer are:
Does the local anesthesia technique affect the time required to achieve pulp hemostasis during pulpotomy? Are there differences between the two anesthesia techniques in terms of pain, heart rate, and oxygen saturation during treatment?
Researchers will compare conventional inferior alveolar nerve block anesthesia with computer-controlled intraosseous local anesthesia using the QuickSleeper 5 system to determine whether the anesthesia technique affects pulp hemostasis time and the secondary clinical outcomes.
Each participant will receive both anesthesia techniques in a randomized order using a split-mouth design. Participants will:
Receive conventional inferior alveolar nerve block anesthesia for pulpotomy treatment of one mandibular primary molar.
Receive computer-controlled intraosseous local anesthesia using the QuickSleeper 5 system for pulpotomy treatment of the contralateral mandibular primary molar at a separate treatment session.
Have pulp hemostasis time recorded during each pulpotomy procedure. Have pain, heart rate, and oxygen saturation assessed during the treatment procedures.
Children aged 6-9 years.
Presence of a pulpotomy indication in both mandibular primary second molars (teeth 75 and 85).
Systemically healthy children classified as ASA physical status I or II.
No known coagulation disorders.
Children with systemic health conditions classified as ASA physical status III or higher.
Known allergy or hypersensitivity to the local anesthetic agents or other dental materials used in the study.
Presence of a known coagulation disorder or use of analgesic, anti-inflammatory, antithrombotic, or antipyretic medications within the previous 7 days.
Presence of severe infection, pulp necrosis, advanced root resorption, or any other dental condition requiring a treatment approach other than pulpotomy in the mandibular primary second molars.
Crossover
Inferior Alveolar Nerve Block Anesthesia
Procedure/SurgeryConventional inferior alveolar nerve block anesthesia will be administered before pulpotomy treatment of the mandibular primary molar using a standard dental syringe and an articaine-based local anesthetic solution (Ultracain D-S Forte). After adequate anesthesia is achieved, pulpotomy will be performed according to the study protocol. Pulp hemostasis time will be recorded following removal of the coronal pulp tissue.
Computer-Controlled Intraosseous Anesthesia
Procedure/SurgeryComputer-controlled intraosseous local anesthesia will be administered using the QuickSleeper 5 system (Dental Hi-Tec, France) and an articaine-based local anesthetic solution (Ultracain D-S Forte) before pulpotomy treatment of the mandibular primary molar. After adequate anesthesia is achieved, pulpotomy will be performed according to the study protocol. Pulp hemostasis time will be recorded following removal of the coronal pulp tissue
Pulp Hemostasis Time
The time required to achieve pulp hemostasis following removal of the coronal pulp tissue during pulpotomy will be recorded for each treatment session. Hemostasis will be assessed using standardized sterile cotton pellets and categorized according to the time required to achieve bleeding control: ≤2 minutes, \>2 to 5 minutes, or failure to achieve hemostasis within 5 minutes.
Pain Intensity
Pain intensity will be assessed using the Wong-Baker FACES Pain Rating Scale. Participants will select the face that best represents their perceived pain. The scale ranges from 0 (no pain) to 10 (worst pain), with higher scores indicating greater pain intensity. Pain will be assessed after administration of local anesthesia and after completion of the pulpotomy procedure.
Heart Rate
Heart rate will be measured using a pulse oximeter and recorded as beats per minute (bpm) to evaluate physiological changes associated with the anesthesia and pulpotomy procedures.
Peripheral Oxygen Saturation (SpO₂)
Peripheral oxygen saturation (SpO₂) will be measured using a pulse oximeter and recorded as a percentage (%) to evaluate physiological changes associated with the anesthesia and pulpotomy procedures.
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