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The purpose of this study was to investigate the manufacturer's claims regarding a novel needleless intraligamentary local anesthesia injection device (Numbee, BioDent) to provide effective single tooth anesthesia. Investigators compared the Numbee with a traditional inferior alveolar nerve block (IANB) during a restorative procedure on mandibular teeth. A randomized, split-mouth design was conducted with 15 adult subjects receiving an IANB on one side and a Numbee injection on the same tooth type on the contralateral side. Subjects recorded injection pain using the Visual Analog Scale (VAS) and their preferred injection technique. Anesthesia was considered profound with 2 consecutive electric pulp tester readings of 80. If subjects became symptomatic during the restorative procedure, rescue anesthesia was administered. The difference in VAS scores for injection pain between the Numbee and the IANB was not significant (p = .078). For the IANB, the incidence of profound anesthesia was 46%, and required rescue anesthesia was 20%. For the Numbee, the incidence of profound anesthesia was 0%, and required rescue anesthesia was 60%. Subject preference was evenly split (50/50%) between the 2 techniques. The IANB outperformed the Numbee device for achieving profound anesthesia and requiring less rescue anesthesia.

Keywords: Needle-less syringe; Injection pain
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Copyright: © 2020 by the American Dental Society of Anesthesiology
Figure 1.
Figure 1.

Numbee packaging and the Numbee attached to BioDent's “Intraligamental Syringe” (intraligamentary, pen-style syringe).

Figure 2.
Figure 2.

Comparison of Numbee and periodontal ligament (PDL) injection. (a) Gingival sulcus is the target for a Numbee injection. (b) Numbee. (c) Dental needle. (d) PDL is the target for a traditional intraligamentary injection using a needle.

Figure 3.
Figure 3.

Intraligamentary injection with the Numbee in the mesial sulcus of tooth #28.

Figure 4.
Figure 4.

Boxplots demonstrating Visual Analog Scale (VAS) scores for injection pain comparing the Numbee (median, 33.0 mm; interquartile range [IQR], 39.9 mm) and the inferior alveolar nerve block (median, 44.0; IQR, 34.6). The difference in VAS scores for injection pain was not found to be statistically significant (p = .078).

Figure 5.
Figure 5.

Desired anesthetic effects for Numbee versus inferior alveolar nerve block. †No pain reported, and no rescue anesthesia needed during restorative procedure. ‡Profound anesthesia following electric pulp tester testing.

Contributor Notes

Address correspondence to Kraig S. Vandewalle, DDS, MS, Director of Dental Research, Advanced Education in General Dentistry Residency, 1615 Truemper Street, Joint Base San Antonio–Lackland, TX 78236; kraig.s.vandewalle.civ@mail.mil.
Received: Jul 01, 2019
Accepted: Apr 20, 2020