CE
Purchase
Liposomal anesthetic gel for pain control during periodontal therapy in adults: A placebo-controlled randomized trial
You will receive 2 credit(s) of continuing education credit upon successful completion of this course.
Description:

Periodontal therapy usually requires local anesthesia. If effective, a noninvasive, liposomal anesthetic gel could increase the levels of acceptance of patients in relation to 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 or greater. 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 noninvasive digital monitor.

 

Author:
Gustavo Moraes
Outline:

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

References:

1- Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Global epidemiology of dental caries and severe periodontitis - a comprehensive review. J Clin Periodontol. 2017;44(sp. Issue18):S94-s105. doi: 10.1111/jcpe.12677 [ Links ]

2- Canakci CF, Canakci V. Pain experienced by patients undergoing different periodontal therapies. J Am Dent Assoc. 2007;138(12):1563-73. doi: 10.14219/jada.archive.2007.0105 [ Links ]

3- Chung DT, Bogle G, Bernardini M, Stephens D, Riggs ML, Egelberg JH. Pain experienced by patients during periodontal maintenance. J Periodontol. 2003;74(9):1293-301. doi: 10.1902/jop.2003.74.9.1293 [ Links ]

4- Karadottir H, Lenoir L, Barbierato B, Bogle M, Riggs M, Sigurdsson T, et al. Pain experienced by patients during periodontal maintenance treatment. J Periodontol. 2002;73(5):536-42. doi: 10.1902/jop.2002.73.5.536 [ Links ]

5- Yu JF, Lee KC, Hong HH, Kuo SB, Wu CD, Wai YY, et al. Human amygdala activation by the sound produced during dental treatment: a fMRI study. Noise Health. 2015;17(78):337-42. doi: 10.4103/1463-1741.165063 [ Links ]

6- Kochel A, Plichta MM, Schafer A, Schongassner F, Fallgatter AJ, Schienle A. Auditory symptom provocation in dental phobia: a near-infrared spectroscopy study. Neurosci Lett. 2011;503(1):48-51. doi: 10.1016/j.neulet.2011.07.058 [ Links ]

7- Derman SH, Lowden CE, Kaus P, Noack MJ. Pocket-depths-related effectiveness of an intrapocket anaesthesia gel in periodontal maintenance patients. Int J Dent Hyg. 2014;12(2):141-4. doi: 10.1111/idh.12036 [ Links ]

8- Donaldson D, Gelskey SC, Landry RG, Matthews DC, Sandhu HS. A placebo-controlled multi-centred evaluation of an anaesthetic gel (Oraqix) for periodontal therapy. J Clin Periodontol. 2003;30(3):171-5. doi: 10.1034/j.1600-051X.2003.00017.x [ Links ]

9- Friskopp J, Nilsson M, Isacsson G. The anesthetic onset and duration of a new lidocaine/prilocaine gel intra-pocket anesthetic (Oraqix) for periodontal scaling/root planing. J Clin Periodontol. 2001;28(5):453-8. doi: 10.1034/j.1600-051x.2001.028005453.x [ Links ]

10- Antoniazzi RP, Cargnelutti B, Freitas DN, Guimaraes MB, Zanatta FB, Feldens CA. Topical intrapocket anesthesia during scaling and root planing: a randomized clinical trial. Braz Dent J. 2015;26(1):26-32. doi: 10.1590/0103-6440201300131 [ Links ]

11- Jeffcoat MK, Geurs NC, Magnusson I, MacNeill SR, Mickels N, Roberts F, et al. Intrapocket anesthesia for scaling and root planing: results of a double-blind multicenter trial using lidocaine prilocaine dental gel. J Periodontol. 2001;72(7):895-900. doi: 10.1902/jop.2001.72.7.895 [ Links ]

12- van Steenberghe D, Bercy P, De Boever J, Adriaens P, Geers L, Hendrickx E, et al. Patient evaluation of a novel non-injectable anesthetic gel: a multicenter crossover study comparing the gel to infiltration anesthesia during scaling and root planing. J Periodontol. 2004;75(11):1471-8. doi: 10.1902/jop.2004.75.11.1471 [ Links ]

13- Derman SH, Lowden CE, Hellmich M, Noack MJ. Influence of intra-pocket anesthesia gel on treatment outcome in periodontal patients: a randomized controlled trial. J Clin Periodontol. 2014;41(5):481-8. doi: 10.1111/jcpe.12239 [ Links ]

14- Winning L, Polyzois I, Nylund K, Kelly A, Claffey N. A placebo-controlled trial to evaluate an anesthetic gel when probing in patients with advanced periodontitis. J Periodontol. 2012;83(12):1492-8. doi: 10.1902/jop.2012.110106 [ Links ]

15- Herdevall BM, Klinge B, Persson L, Huledal G, Abdel-Rehim M. Plasma levels of lidocaine, o-toluidine, and prilocaine after application of 8.5 g Oraqix in patients with generalized periodontitis: effect on blood methemoglobin and tolerability. Acta Odontol Scand. 2003;61(4):230-4. doi: 10.1080/00016350310004106 [ Links ]

16- Magnusson I, Geurs NC, Harris PA, Hefti AF, Mariotti AJ, Mauriello SM, et al. Intrapocket anesthesia for scaling and root planing in pain-sensitive patients. J Periodontol. 2003;74(5):597-602. doi: 10.1902/jop.2003.74.5.597 [ Links ]

17- Franz-Montan M, Baroni D, Brunetto G, Sobral VR, Silva CM, Venâncio P, et al. Liposomal lidocaine gel for topical use at the oral mucosa: characterization, in vitro assays and in vivo anesthetic efficacy in humans. J Liposome Res. 2015;25(1):11-9. doi: 10.3109/08982104.2014.911315 [ Links ]

18- Araujo DR, Cereda CM, Brunetto GB, Vomero VU, Pierucci A, Santo H Neto, et al. Pharmacological and local toxicity studies of a liposomal formulation for the novel local anaesthetic ropivacaine. J Pharm Pharmacol. 2008;60(11):1449-57. doi: 10.1211/jpp.60.11.0005 [ Links ]

19- Boogaerts JG, Lafont ND, Declercq AG, Luo HC, Gravet ET, Bianchi JA, et al. Epidural administration of liposome-associated bupivacaine for the management of postsurgical pain: a first study. J Clin Anesth. 1994;6(4):315-20. doi: 10.1016/0952-8180(94)90079-5 [ Links ]

20- Eichenfield LF, Funk A, Fallon-Friedlander S, Cunningham BB. A clinical study to evaluate the efficacy of ELA-Max (4% liposomal lidocaine) as compared with eutectic mixture of local anesthetics cream for pain reduction of venipuncture in children. Pediatrics. 2002;109(6):1093-9. doi: 10.1542/peds.109.6.1093 [ Links ]

21- Franz-Montan M, Silva AL, Cogo K, Bergamaschi Cde C, Volpato MC, Ranali J, et al. Liposome-encapsulated ropivacaine for topical anesthesia of human oral mucosa. Anesth Anal. 2007;104(6):1528-31. doi: 10.1213/01.ane.0000262040.19721.26 [ Links ]

22- Franz-Montan M, Silva AL, Fraceto LF, Volpato MC, Paula E, Ranali J, et al. Liposomal encapsulation improves the duration of soft tissue anesthesia but does not induce pulpal anesthesia. J Clin Anesth. 2010;22(5):313-7. doi: 10.1016/j.jclinane.2010.03.001 [ Links ]

23- Antczak-Bouckoms AA, Tulloch JF, Berkey CS. Split-mouth and cross-over designs in dental research. J Clin Periodontol. 1990;17(7 Pt 1):446-53. doi: 10.1111/j.1600-051X.1990.tb02343.x [ Links ]

24- Tu YK, Gilthorpe MS, Griffiths GS, Maddick IH, Eaton KA, Johnson NW. The application of multilevel modeling in the analysis of longitudinal periodontal data--part I: absolute levels of disease. J Periodontol. 2004;75(1):127-36. doi: 10.1902/jop.2004.75.1.127 [ Links ]

25- Wambier LM, Geus JL, Chibinski AC, Wambier DS, Rego RO, Loguercio AD, et al. Intra-pocket anaesthesia and pain during probing, scaling and root planing: a systematic review and meta-analysis. J Clin Periodontol. 2016;43(9):754-66. doi: 10.1111/jcpe.12565 [ Links ]

26- Svensson P, Petersen JK, Svensson H. Efficacy of a topical anesthetic on pain and unpleasantness during scaling of gingival pockets. Anesth Prog. 1994;41(2):35-9. [ Links ]

27- Magnusson I, Jeffcoat MK, Donaldson D, Otterbom IL, Henriksson J. Quantification and analysis of pain in nonsurgical scaling and/or root planing. J Am Dent Assoc. 2004;135(12):1747-54. doi: 10.14219/jada.archive.2004.0129 [ Links ]

28- Lee MC, Absalom AR, Menon DK, Smith HL. Awake insertion of the laryngeal mask airway using topical lidocaine and intravenous remifentanil. Anaesthesia. 2006;61(1):32-5. doi: 10.1111/j.1365-2044.2005.04471.x [ Links ]

29- Friskopp J, Huledal G. Plasma levels of lidocaine and prilocaine after application of Oraqix, a new intrapocket anesthetic, in patients with advanced periodontitis. J Clin Periodontol. 2001;28(5):425-9. doi: 10.1034/j.1600-051x.2001.028005425.x [ Links ]

30- Ueno T, Tsuchiya H, Mizogami M, Takakura K. Local anesthetic failure associated with inflammation: verification of the acidosis mechanism and the hypothetic participation of inflammatory peroxynitrite. J Inflamm Res. 2008;1:41-8. doi: 10.2147/JIR.S3982 [ Links ]

31- Biagini G, Checchi L, Miccoli MC, Vasi V, Castaldini C. Root curettage and gingival repair in periodontitis. J Periodontol. 1988;59(2):124-9. doi: 10.1902/jop.1988.59.2.124 [ Links ]

32- Brand HS, Gortzak RA, Palmer-Bouva CC, Abraham RE, Abraham-Inpijn L. Cardiovascular and neuroendocrine responses during acute stress induced by different types of dental treatment. Int Dent J. 1995;45(1):45-8. [ Links ]

33- Liau FL, Kok SH, Lee JJ, Kuo RC, Hwang CR, Yang PJ, et al. Cardiovascular influence of dental anxiety during local anesthesia for tooth extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(1):16-26. doi: 10.1016/j.tripleo.2007.03.015 [ Links ]

34- Shamriz O, Cohen-Glickman I, Reif S, Shteyer E. Methemoglobinemia induced by lidocaine-prilocaine cream. Isr Med Assoc J. 2014;16(4):250-4. [ Links ]

35- Mayor-Subirana G, Yague-Garcia J, Valmaseda-Castellon E, Arnabat-Dominguez J, Berini-Aytes L, Gay-Escoda C. Anesthetic efficacy of Oraqix(R) versus Hurricaine(R) and placebo for pain control during non-surgical periodontal treatment. Med Oral Patol Oral Cir Bucal. 2014;19(2):e192-201. doi: 10.4317/medoral.19202 [ Links ]

36- Stoltenberg JL, Osborn JB, Carlson JF, Hodges JS, Michalowicz BS. A preliminary study of intra-pocket topical versus injected anaesthetic for scaling and root planing. J Clin Periodontol. 2007;34(10):892-6. doi: 10.1111/j.1600-051X.2007.01128.x [ Links ]

37- Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152(10):2399-404. doi: 10.1016/j.pain.2011.07.005 [ Links ]

38- Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005;14(7):798-804. doi: 10.1111/j.1365-2702.2005.01121.x [ Links ]

39- Santos Calderon P, Peixoto RF, Gomes VM, Mota Correa AS, Alencar EN, Rossetti LM, et al. Concordance among different pain scales in patients with dental pain. J Orofac Pain. 2012;26(2):126-31. [ Links ]

Release date: November 26, 2019
Review date: January 1, 2030
Expiration date: October 31, 2031
Purchase
DrBicuspid.com
CE courses are administered by IMV, Ltd.
IMV, Ltd is an ADA CERP Recognized Provider.

ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

Concerns or complaints about this CE provider may be directed to DrBicuspid.com support or to ADA CERP at www.ada.org/cerp.