# Comparative Evaluation of Pain Perception Between Needleless Jet Infiltration Anaesthesia and Conventional Needle Anaesthesia for Maxillary Primary Molars in Children: A Systematic Review and Meta-Analysis

**Authors:** Utkarsha Kadam, Ritesh Kalaskar, Ashita R Kalaskar, Nidhi Sharma, Snehal Jagtap

PMC · DOI: 10.7759/cureus.100909 · 2026-01-06

## TL;DR

This study compares pain levels in children receiving needleless jet anesthesia (INJEX) versus traditional needle anesthesia for dental procedures, finding similar pain but higher child acceptance with the needleless option.

## Contribution

The study provides a systematic review and meta-analysis comparing pain perception and child acceptance of needleless jet infiltration versus conventional needle anesthesia in pediatric dentistry.

## Key findings

- Pain during injection and treatment with INJEX was not significantly different from conventional infiltration anesthesia.
- Needleless jet injection showed higher child acceptance and reduced postoperative pain.
- INJEX offers a child-friendly alternative that improves patient satisfaction and clinical efficiency.

## Abstract

The use of a syringe and needle for delivering local anaesthesia is known to provoke anxiety and apprehension in patients even before dental treatment begins. To overcome anxiety associated with needles, needleless jet infiltration anaesthesia using the INJEX® system (Pharma AG, Berlin, Germany) has been investigated. The present systematic review and meta-analysis aim to evaluate differences in pain perception among children administered INJEX and conventional infiltration anaesthesia.

A comprehensive literature search was conducted across multiple electronic databases for studies published up to December 31, 2023. Two reviewers independently screened and assessed the articles, and six studies were finally included based on predefined inclusion and exclusion criteria. The risk of bias in the selected randomised controlled trials was evaluated using the Risk of Bias 2 (RoB 2) tool.

Findings of this meta-analysis suggest that pain experienced during injection and treatment with INJEX was not significantly different from that associated with conventional infiltration anaesthesia. In paediatric dentistry, needleless jet injection could represent a preferable option to conventional local anaesthetic delivery, owing to its higher child acceptance and reduced postoperative pain.

Incorporating needleless jet injection (INJEX) into pediatric dental practice can improve patient acceptance by lowering pain and anxiety, ultimately leading to a more positive treatment experience. It offers a child-friendly alternative to conventional needle infiltration, enhancing overall clinical efficiency and patient satisfaction.

## Full-text entities

- **Diseases:** Pain (MESH:D010146), anxiety (MESH:D001007), postoperative pain (MESH:D010149)
- **Chemicals:** INJEX (-)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

5 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12874480/full.md

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Source: https://tomesphere.com/paper/PMC12874480