Liposomal anesthetic gel for pain control during periodontal therapy in adults: a placebo-controlled RCT

J Appl Oral Sci. 2019 Nov 25:28:e20190025. doi: 10.1590/1678-7757-2019-0025. eCollection 2020.

Abstract

Introduction: Periodontal therapy usually requires local anesthesia. If effective, a non-invasive, liposomal anesthetic gel could increase the levels of acceptance of patients in relation to periodontal therapy.

Objective: This study investigated the efficacy of liposomal anesthetic gel for pain control during periodontal therapy.

Methodology: Forty volunteers with moderate to severe chronic periodontitis were recruited, of which at least three sextants required periodontal therapy. At least one of the selected teeth had one site with a probing depth of ≥4 mm. The volunteers received the following three gels: a placebo, lidocaine/prilocaine (Oraqix®), or a liposomal lidocaine/prilocaine, which were applied to different sextants. Pain frequency was registered during treatment and the volunteers received a digital counter to register any painful or uncomfortable experiences. At the end of each session, the volunteers indicated their pain intensity using rating scales (NRS-101 and VRS-4). The volunteers had their hemodynamic parameters measured by a non-invasive digital monitor.

Results: Pain frequency/intensity did not show statistical difference between intervention groups. The tested gels did not interfere with the hemodynamic indices. Dental anxiety, suppuration and probing depth could influence pain during periodontal therapy.

Conclusion: Our results suggest limited indications for the use of non-invasive anesthesia when used for scaling and root planing. Intra-pocket anesthetic gel could be a good option for anxious patients, or those who have a fear of needles.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Anesthesia, Dental / methods*
  • Anesthetics, Local / administration & dosage*
  • Chronic Periodontitis / complications
  • Chronic Periodontitis / therapy
  • Dental Scaling / adverse effects*
  • Double-Blind Method
  • Female
  • Gels / administration & dosage*
  • Humans
  • Lidocaine / administration & dosage
  • Lidocaine, Prilocaine Drug Combination
  • Male
  • Middle Aged
  • Pain / prevention & control*
  • Pain Measurement / methods
  • Periodontal Pocket
  • Placebos
  • Prilocaine / administration & dosage
  • Root Planing / adverse effects*
  • Young Adult

Substances

  • Anesthetics, Local
  • Gels
  • Lidocaine, Prilocaine Drug Combination
  • Placebos
  • Prilocaine
  • Lidocaine