Neuromodulation as an Alternative to Local Anesthesia Injections in Pediatric Patients With MIH: A Split-Mouth Study

Molar incisor hypomineralization (MIH) often poses challenges in achieving effective anesthesia. The role of neuromodulation as a potential alternative to local anesthesia injections in managing MIH-affected teeth remains unexplored.

This study evaluated the efficacy of neuromodulation in providing pain relief during vital pulp therapy for MIH-affected permanent molars.

A triple-blind, randomized clinical trial in 35 children (70 M) aged 6-12 assessed pulpotomy pain management. Teeth were randomly assigned to neuromodulation (Synapse Dental Pain Eraser) for 3 min and mock injection (experimental group), or to conventional infiltration of local anesthesia preceded by inactive control probes (control). Pain was evaluated using the Sound, Eye, Motor (SEM) scale, along with anesthesia need, patient satisfaction, and anesthesia duration. Data were analyzed using independent t-tests with significance set at p < 0.05.

The experimental group reported higher no-pain scores (29%) compared to the control group (20%). Supplemental anesthesia was required in 11% of cases in the experimental group and 19% in the control group. Neither showed a statistically significant difference (p = 0.42 for pain scores; p = 0.36 for supplemental anesthesia).

Neuromodulation demonstrated comparable effectiveness to local anesthesia alone in managing pain during pulpotomy in MIH molars, and its use should be further studied.

ClinicalTrials.gov identifier: CTRI/2024/06/069004.