Clinical anesthetic effectiveness of intraoral mucoadhesive tablets of amitriptyline in healthy volunteers.

PURPOSE: Topical anesthetics are widely used in dentistry. One of their indications is to diminish the pain of the injection of anesthetics. Amitriptyline is a tricyclic antidepressant that provides local anesthetic effects by blocking the sodium channels. The present study was performed in an attempt to assess the anesthetic efficacy of an intraoral mucoadhesive tablet of amitriptyline. MATERIALS AND METHODS: The present study was performed as a randomized, double-blind, placebo-controlled, clinical trial of 25 healthy female volunteers. The mucoadhesive tablet was randomly placed for 15 minutes on the buccal mucogingival tissue adjacent to the root of the upper lateral incisor, and a placebo was placed on the other side. A 27-gauge needle was inserted to touch the alveolar periosteum of the designated site. The pain intensity associated with the stimulation was evaluated every 5 minutes after removing the mucoadhesive tablet using a visual analog pain scale and pain rating scoring methods. RESULTS: The difference between the amitriptyline and placebo groups was statistically significant 20, 25, 30, 35, and 40 minutes after placing the mucoadhesive tablet. Its mean onset and duration of action was 25 and 20 minutes, respectively (P<.05). CONCLUSIONS: To our knowledge, the present study represents an initial step toward achieving an efficient and safe anesthetic method. The intraoral mucoadhesive amitriptyline tablet proved to be a promising anesthetic device for manipulating pain in dental procedures. However, it should also be mentioned that to achieve high efficiency, it will be necessary to optimize the release profile.

A comparison between craniofacial templates of Iranian and western populations.

Templates are very useful tools for diagnosis of malocclusions. A number of templates have been provided for some populations in previous years. Since craniofacial characteristics of different ethnic groups are not the same, each population needs its own norms. The aim of this study was to provide orthodontic craniofacial templates for 8-16 year old Iranian boys and compare dentoskeletal features between Iranian and western populations. 3330 boys with the age range of 8-16 years were examined in Tehran, and 107 cases were finally chosen for the study and their lateral cephalograms were traced. Since there is no universal, consensus about the selection of one specific point or line for cephalometric superimposition, both the sella nasion (SN) and basion nasion (Ba-N) lines were chosen for this purpose. Based on both SN and Ba-N lines, a template was prepared for each age. Simple linear regression analysis was used to evaluate the angles and the multivariant regression analysis for evaluation of landmark vectors. Posterior cranial base, maxillary and mandibular lengths, upper and lower anterior facial heights (N-ANS and ANS-Me) and posterior facial height (S-Go) are greater in Iranian population. But anterior cranial base, height and inclination of the incisors and molar height are similar in two populations.

Bone formation with two types of grafting materials: a histologic and histomorphometric study.

BACKGROUND: Although autogenous bone grafts are considered the gold standard for bone regeneration, they have certain limitations, including patient morbidity at the harvest site. Synthetic bone substitutes have been developed to overcome some of these limitations. The present study aimed to compare the osteogenic properties of Straumann Bone Ceramic (SBC), which is a biphasic calcium phosphate, with Bio-Oss, an inorganic bovine bone material, in an animal model. METHODS: Thirteen rabbits were included in this study. In each rabbit, four 6.5-mm-diameter identical defects were prepared on the calvarium. One site was filled with Bio-Oss, the second site was treated with small-particle SBC, the third site was treated with large-particle SBC, and the fourth site was left as an untreated control. After 4 and 8 weeks, the animals were sacrificed, and histologic and histomorphometric examinations were performed. The data were analyzed using Friedman and multiple-comparison Mann-Whitney U tests. RESULTS: There were no statistically significant differences in the amount of bone fill between the four groups. L-SBC showed more inflammation and foreign-body reactions than the other bone substitutes. CONCLUSION: No statistically significant differences were found between groups. Further studies on this issue seem necessary.

Development of amitriptyline buccoadhesive tablets for management of pain in dental procedures.

Administration of lidocaine and nonsteroidal anti-inflammatory drugs (NSAIDs) as a routine procedure for relief of dental pains by and large is restricted due to some side effects. Amitriptyline (AM) has long been known to exert analgesic activity as a result of blocking the Na⁺ channels. The objective of the present investigation was to prepare suitable buccoadhesive tablets using cellulose derivatives in order to obtain new formulations containing AM to provide local analgesic action. The tablets were evaluated in terms of physical characteristics, mucoadhesion performance, drug release, and in vivo assessment of analgesic efficiency. Tablets containing higher amounts of high-viscosity hydroxypropylmethyl cellulose (HPMC-K4M) significantly demonstrated enhanced adhesive performances. On the other hand, presence of sodium carboxymethyl cellulose (NaCMC) in formulations including HPMC of lower-viscosity grade (HPMC-E5LV) provided further adhesiveness by increase in viscosity. Rate of drug release from HPMC-E5LV tablets was significantly higher than the HPMC-K4M tablets. Kinetically, patterns of AM release from the tablets fitted best to Higuchi model. Moreover, in a randomized double-blind trial, analgesic efficiency of the prepared bioadhesive tablets was revealed to be satisfactory. It is suggested that applying the topical AM mucoadhesive tablet containing the low amount of drug is a safe and promising alternative to relief the pain in the buccal region.