Effect of Starpen Injection Device Versus Conventional Syringe During Anesthesia and Extraction of Primary Molars

Inclusion Criteria: * Children aged 6-8 years * Cooperative children ( rating 3 or 4 based on the Frankl behavior scale ) * Medically fit children (ASA I ) * Children mentally capable of communication * First dental visit * Patient requiring extraction of upper primary molars due to root caries , crown fractures, periapical disease and failed pulpotomies * No acute dental pain Exclusion Criteria: * Children with a behavioral management problem * Parental refusal of participation * Children with previous history of local anesthesia injection * Medically unfit children (other than ASA I ) * Uncooperative children ( other than Frankl 3,4) * Children under medications ( antibiotics and analgesics ) for the previous 48 hours that could alter the pain perception * Teeth that showed any signs of mobility , ankylosis or root resorption affecting more than one third the root * Acute dental pain