RESUMEN
The efficacy of a topical anesthetic on pain and unpleasantness provoked by scaling of gingival pockets was investigated in 20 patients with mild chronic periodontitis. A eutectic mixture of local anesthetics (EMLA) and a placebo cream, both occluded by Orahesive Oral Bandages, were applied in a balanced, randomized, double-blind, split-mouth design, which enabled within-subject comparison of the anesthetic and the placebo in the upper and the lower jaw. Pretreatment interviews showed that approximately two-thirds of the patients considered gingival scaling to be associated with some degree of pain and unpleasantness. Pain intensity and unpleasantness were evaluated on 100-mm visual analog scales (VAS). Application of EMLA reduced both pain intensity and unpleasantness significantly compared to placebo cream. Median reductions in VAS pain intensity in the upper and lower jaw were 58.9% and 61.9%, and corresponding reductions in VAS unpleasantness were 31.9% and 25.6%, respectively. Generally, the patients accepted the anesthetic procedure well. The residual perception of pain and unpleasantness following topical anesthesia may be dependent on activation of nonanesthetized nociceptive fibers in the tooth pulp. However, the present study clearly demonstrates the efficacy of a topical anesthetic in a clinical situation, which may be recommended as a simple pharmacologic strategy to reduce pain and unpleasantness during scaling procedures.
Asunto(s)
Anestesia Dental/métodos , Anestésicos Locales , Raspado Dental/efectos adversos , Dolor Facial/prevención & control , Bolsa Gingival/terapia , Lidocaína , Prilocaína , Administración Tópica , Adulto , Anestesia Local/métodos , Anestésicos Locales/administración & dosificación , Raspado Dental/métodos , Método Doble Ciego , Combinación de Medicamentos , Dolor Facial/etiología , Femenino , Humanos , Lidocaína/administración & dosificación , Combinación Lidocaína y Prilocaína , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Apósitos Periodontales , Periodontitis/terapia , Prilocaína/administración & dosificación , Estadísticas no ParamétricasRESUMEN
Several self-aspirating syringes have been introduced into dentistry during the last decade. The efficacy of such a self-aspirating system, the EVERS-syringe, has been tested in relation to varying liquid pressure and diameter of the needle. It was found that the EVERS system was able to secure aspiration, irrespective of pressure and needle diameter. The passive back-flow of liquid through the needle, however, did depend on pressure and needle diameter. 3 different brands of local analgetics were evaluated, and it was found that the degree of self-aspiration was identical, regardless of brand and thereby cartridge type.