Topical intrapocket anesthesia during scaling and root planing: a randomized clinical trial.

Although the use of injectable anesthesia prior to subgingival scaling and root planing (SRP) reduces pain, many patients report fear and prolonged numbness of adjacent tissues. The aim of the present study was to compare the effects of a eutectic mixture containing 25 mg/g of lidocaine and 25 mg/g of prilocaine, injectable 2% lidocaine, topical 2% benzocaine and a placebo substance on reducing pain during SRP. In this randomized, split-mouth, masked clinical trial, thirty-two patients presenting more than two teeth with probing depth and clinical attachment level ≥ 5 mm in at least 4 sextants were randomly allocated to four groups: EMLA(r); injectable 2% lidocaine; topical 2% benzocaine and placebo. Pain and discomfort were measured using a visual analogue scale (VAS) and verbal scale (VS). Repeated-measures analysis of variance and Poisson regression were used for analysis. Patient satisfaction with the anesthesia was determined at the end of each treatment session. VAS and VS scores did not differ between injectable 2% lidocaine and EMLA (p > 0.05) and both substances showed significantly better pain control compared to 2% benzocaine and placebo (p < 0.05). 93.7% and 81.2% of the individuals were satisfied with the injectable anesthetic and EMLA, respectively (p = 0.158). Dissatisfaction with benzocaine and placebo was approximately 10 times greater than injectable anesthesia (p = 0.001). In conclusion, EMLA showed an equivalent effect on pain control when compared to the injectable anesthesia and performed better than 2% benzocaine in SRP. Thus, EMLA is a viable anesthetic option during scaling and root planning, despite the frequent need for second application.

Topical Intrapocket Anesthesia During Scaling and Root Planing: a Randomized Clinical Trial

Although the use of injectable anesthesia prior to subgingival scaling and root planing (SRP) reduces pain, many patients report fear and prolonged numbness of adjacent tissues. The aim of the present study was to compare the effects of a eutectic mixture containing 25 mg/g of lidocaine and 25 mg/g of prilocaine, injectable 2% lidocaine, topical 2% benzocaine and a placebo substance on reducing pain during SRP. In this randomized, split-mouth, masked clinical trial, thirty-two patients presenting more than two teeth with probing depth and clinical attachment level ≥5 mm in at least 4 sextants were randomly allocated to four groups: EMLA(r); injectable 2% lidocaine; topical 2% benzocaine and placebo. Pain and discomfort were measured using a visual analogue scale (VAS) and verbal scale (VS). Repeated-measures analysis of variance and Poisson regression were used for analysis. Patient satisfaction with the anesthesia was determined at the end of each treatment session. VAS and VS scores did not differ between injectable 2% lidocaine and EMLA (p>0.05) and both substances showed significantly better pain control compared to 2% benzocaine and placebo (p<0.05). 93.7% and 81.2% of the individuals were satisfied with the injectable anesthetic and EMLA, respectively (p=0.158). Dissatisfaction with benzocaine and placebo was approximately 10 times greater than injectable anesthesia (p=0.001). In conclusion, EMLA showed an equivalent effect on pain control when compared to the injectable anesthesia and performed better than 2% benzocaine in SRP. Thus, EMLA is a viable anesthetic option during scaling and root planning, despite the frequent need for second application.

Embora a anestesia injetável previamente a raspagem e alisamento subgengival (RASUB) reduza a dor, muitos pacientes relatam medo e amortecimento prolongado dos tecidos adjacentes. O objetivo deste estudo foi comparar o efeito de uma mistura eutética contendo 25mg/g de lidocaína e 25 mg/g de prilocaína, lidocaína 2% injetável, benzocaína 2% tópica e um placebo na redução da dor durante a RASUB. Neste ensaio clínico randomizado, cego de boca dividida, trinta e dois pacientes que apresentavam mais que dois dentes com profundidade de sondagem e nível de inserção clínica ≥ 5 mm, em no mínimo 4 sextantes, foram randomicamente alocados em 4 grupos: EMLA(r), lidocaína 2% injetável, benzocaína 2% tópica ou placebo. Dor e desconforto foram mensurados usando uma Escala Visual Analógica (EVA) e Escala Verbal (EV). A satisfação dos pacientes com a anestesia foi determinada ao final de cada consulta. Análise de variância de medidas repetidas e regressão de Poisson foram usadas para análise. Os escores da EVA e EV não demonstraram diferenças estatisticamente significantes entre lidocaína injetável e EMLA(r) (p > 0,05) e ambas as substâncias demonstraram significativamente melhor controle da dor comparadas a benzocaína 2% e placebo (p<0,05). 93,7% e 81,2% dos indivíduos ficaram satisfeitos com o anestésico injetável e EMLA(r), respectivamente (p=0,158). A insatisfação com a benzocaína e placebo foi aproximadamente 10 vezes maior do que com a anestesia injetável (p=0,001). Em conclusão, o EMLA(r) demonstrou um efeito equivalente no controle da dor quando comparado com a anestesia injetável e melhor do que a benzocaína 2% em RASUB. Assim, o EMLA(r) é uma opção anestésica viável durante a raspagem e alisamento radicular, apesar da necessidade frequente de segunda aplicação.