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Ferrazzano GF, Di Fabio G, Gatto R, Caruso S, Botticelli G, Caruso S. Effectiveness and Tolerability of a New Formulation of a Topical Anesthetic in Reduction of Pain and Parents’ Satisfaction in Pediatric Dentistry. CHILDREN 2023; 10:children10030444. [PMID: 36980002 PMCID: PMC10047767 DOI: 10.3390/children10030444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023]
Abstract
The aim of the present study was to test a new topical anesthetic gel with a different formulation (10% lidocaine, 10% prilocaine) to analyze its effectiveness in pain control, during the subsequent injection of local anesthetic, and the presence of any side effects. Methods: The study’s research design was a randomized controlled clinical trial on 300 children, aged 5–8 years, divided into two groups, each of 150 patients, according to pre-injection procedures (presence or absence of topical anesthesia). The injection pain was analyzed using the Wong-Baker Faces Pain Rating Scale (PRS) and the Face, Legs, Activity, Cry, Consolability Scale (FLACC). At the end of the procedures, patients’ parents’ satisfaction was recorded. The data were analyzed using the Student’s T test, Mann–Whitney U test and Chi-square test. Results: There were statistically significant differences between the two groups both in the PRS and FLACC ratings. Both in subjective and objective pain evaluations, significantly higher pain ratings were observed in the group without topical anesthesia. There was also a statistically significant difference in terms of patients’ parents’ judgment, as in the group with the use of topical anesthetic the level of parental satisfaction is statistically higher. Conclusion: The experimental anesthetic has proved very effective in its use as a topical gel in both pain measurement scales, thus validating its use on the oral mucosa, for its pharmacological and psychological effect, in the total absence of local and systemic side effects.
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Affiliation(s)
- Gianmaria Fabrizio Ferrazzano
- UNESCO Chair in Health Education and Sustainable Development, Paediatric Dentistry Section, University of Naples “Federico II”, 80138 Naples, Italy
| | - Giuseppe Di Fabio
- Department of Life, Health and Environmental Sciences, Paediatric Dentistry, University of L’Aquila, 67100 L’Aquila, Italy
- Correspondence: (G.D.F.); (S.C.)
| | - Roberto Gatto
- Department of Life, Health and Environmental Sciences, Paediatric Dentistry, University of L’Aquila, 67100 L’Aquila, Italy
| | - Sara Caruso
- Department of Life, Health and Environmental Sciences, Paediatric Dentistry, University of L’Aquila, 67100 L’Aquila, Italy
| | - Gianluca Botticelli
- Department of Life, Health and Environmental Sciences, Paediatric Dentistry, University of L’Aquila, 67100 L’Aquila, Italy
| | - Silvia Caruso
- Department of Life, Health and Environmental Sciences, Paediatric Dentistry, University of L’Aquila, 67100 L’Aquila, Italy
- Correspondence: (G.D.F.); (S.C.)
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Dehgan D, Şermet Elbay Ü, Elbay M. Evaluation of the effects of photobiomodulation with different laser application doses on injection pain in children: a randomized clinical trial. Lasers Med Sci 2022; 38:6. [PMID: 36538177 DOI: 10.1007/s10103-022-03674-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/12/2022] [Indexed: 12/24/2022]
Abstract
The utilization of photobiomodulation (PBM) to decrease the experience of pain during the application of local anesthesia (LA) has been reported in a limited number of studies with children. However, currently, there is no complete consensus regarding its efficacy and application doses. The objective of the clinical trial was to assess the effects of PBM with three different laser application doses (with different power values) plus 10% lidocaine topical anesthetic and to compare them with placebo + 10% lidocaine topical anesthetic on LA injection pain in children. A prospective, parallel-arm, randomized, triple-blind clinical trial was conducted with 160 children aged 6 to 12 years (79 girls and 81 boys; 80 maxillary and 80 mandibular primary first molars). The children were divided into 4 groups with an equal number of subjects in each group. Before topical anesthetic usage, a laser with a power of 0.3 W, 0.4 W, and 0.5 W was applied in Groups 1, 2, and 3, respectively (a diode laser: 940 nm; continuous mode; 20 s for each group). The energy density was calculated as 69 J/cm2, 92 J/cm2, and 115 J/cm2. A placebo laser was used in the fourth group. Injection pain was assessed subjectively and objectively with the Wong-Baker Faces Pain Rating Scale (PRS) and the Face, Legs, Activity, Cry, Consolability (FLACC) Scale. The data were analyzed using the Chi-square test (P < 0.05). The mean (± std) PRS scores were 1.35 ± 1.075, 1.37 ± 1.05, 1.07 ± 1.04, and 2.07 ± 1.09 for Groups 1, 2, and 3 and the placebo group, respectively. Additionally, the mean (± std) FLACC scores were 1.67 ± 1.50, 1.62 ± 1.90, 1.35 ± 1.74, and 2.75 ± 1.64 for Groups 1, 2, and 3 and the placebo group, respectively. Groups 1, 2, and 3 showed significantly lower pain scores than the placebo group (P = 0.02). However, no significant difference was observed between Groups 1, 2, and 3 according to either pain scale score (P = 0.948). In addition, no relationship was found in pain scores related to sex and jaw differences in any group (P = 0.321, P = 0.248). PBM delivered by a 940-nm diode laser plus 10% lidocaine topical anesthetic before the application of LA decreased injection pain regardless of the applied laser dose in this study.
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Affiliation(s)
- Dalya Dehgan
- Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Ülkü Şermet Elbay
- Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey.
| | - Mesut Elbay
- Department of Pediatric Dentistry, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
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Singh R, Gupta N, Gambhir N. Comparative Evaluation of Reduction in Pain Perception Using 5% Topical LA vs Freezed Cone as a Preparatory Agent for Intraoral Injection in Children and Effect of VRD as Distraction Technique. Int J Clin Pediatr Dent 2022; 15:558-563. [PMID: 36865722 PMCID: PMC9973116 DOI: 10.5005/jp-journals-10005-2453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Aim To compare freezed cone and 5% lignocaine as a numbing agent before intraoral injection and evaluate the effect of virtual reality distraction (VRD) as a distraction technique in reducing pain perception in children. Study design Around 60 children of 6-11 years old undergoing treatment for the extraction or any pulp therapy of primary tooth were selected. Freezed cone and 5% lidocaine were used to decrease the pain during local anesthesia (LA). VRD was used as a distraction method and to analyze the pain perception, Wong-Baker Faces Pain Rating Scale was used. Materials and methods Each child was randomly assigned to receive ice as a topical anesthetic or lignocaine 5% as a topical anesthetic agent. The pain perception was evaluated after the injection of 2% lignocaine hydrochloride (HCL). The primary researcher evaluated the pain during injection using the sound, eye, motor (SEM) scale. The pain experienced during injection was evaluated using Wong-Baker Faces Pain Rating Scale. Results In the freezed cone group with the VRD technique, maximum responded to the less pain score. On the contrary, many responded to higher pain scores in the freezed cone group without the VRD technique. Conclusion It was concluded that the VRD technique can be used for distraction and the frozen ice cone can be an alternative method to reduce the pain perception during LA. How to cite this article Singh R, Gupta N, Gambhir N. Comparative Evaluation of Reduction in Pain Perception Using 5% Topical LA vs Freezed Cone as a Preparatory Agent for Intraoral Injection in Children and Effect of VRD as Distraction Technique. Int J Clin Pediatr Dent 2022;15(5):558-563.
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Affiliation(s)
- Rashi Singh
- Department of Pediatric and Preventive Dentistry, Santosh Medical/Dental Colleges and Hospital (Deemed to be University), Ghaziabad, Uttar Pradesh, India
| | - Nidhi Gupta
- Department of Pediatric and Preventive Dentistry, Santosh Medical/Dental Colleges and Hospital (Deemed to be University), Ghaziabad, Uttar Pradesh, India
| | - Natasha Gambhir
- Department of Pediatric and Preventive Dentistry, Santosh Medical/Dental Colleges and Hospital (Deemed to be University), Ghaziabad, Uttar Pradesh, India
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Aksoy F, Tosun S. Effects of different topical anesthetics on pain from needle insertion and injection, and the influence of anxiety in patients awaiting endodontic treatment. Restor Dent Endod 2022; 47:e25. [PMID: 36090513 PMCID: PMC9436649 DOI: 10.5395/rde.2022.47.e25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/09/2021] [Accepted: 01/10/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives This study aimed to evaluate the effects of 5% lidocaine and 2.5% lidocaine/2.5% prilocaine topical anesthetic on pain during needle insertion and infiltration injection in the labial mucosa of anterior maxillary teeth, and to assess the relationship between patients’ anxiety and pain scores. Materials and Methods The Modified Dental Anxiety Scale questionnaire was applied and recorded. Patients were randomly divided into 4 groups (n = 30), as follows: G1 group: 5% lidocaine and placebo for 1 minute, G2 group: 2.5% lidocaine/2.5% prilocaine and placebo for 1 minute, G3 group: 5% lidocaine and placebo for 3 minutes, and G4 group: 2.5% lidocaine/2.5% prilocaine and placebo for 3 minutes. Before the application of topical anesthesia, one side was randomly selected as the topical anesthesia and the contralateral side as the placebo. The pain levels were measured with Visual Analog Scale (VAS) immediately after needle insertion and injection and were compared. The correlation between anxiety and pain scores was analyzed. Results Administration of 5% lidocaine for 1 minute had significantly higher pain scores for both insertion and infiltration injection than the other groups (p < 0.05). There was a significant moderate positive correlation between dental anxiety and the injection-induced VAS pain score in the placebo side in all groups (p < 0.05). Conclusions Topical anesthetics significantly reduced the pain caused by both needle insertion and injection pain in comparison to the placebo side. The pain scores of patients with dental anxiety were lower on the topical anesthesia compared to the placebo side. Trial Registration Thai Clinical Trials Registry Identifier: TCTR20201217002
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Affiliation(s)
- Fatih Aksoy
- Department of Endodontics, Faculty of Dentistry, Adıyaman University, Adıyaman, Turkey
| | - Samet Tosun
- Department of Endodontics, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
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Patel D, Lahiri B, El-Patal MAE, Alazmah A, Patel P, Abokhlifa YH. To Compare and Analyze the Potency of two Topical Anesthetic Gels in Reducing Inferior Alveolar Injection Pain in Children of 8-12 Years: A Double-Blinded Clinical Trial. J Pharm Bioallied Sci 2021; 13:S646-S650. [PMID: 34447172 PMCID: PMC8375789 DOI: 10.4103/jpbs.jpbs_772_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 11/28/2020] [Accepted: 11/30/2020] [Indexed: 11/25/2022] Open
Abstract
Aim: To compare and analyze the clinical adequacy of two topical anesthetic gels, Precaine (8% lidocaine + 0.8% dibucaine) and Precaine B (20% benzocaine) in children before intraoral local anesthetic injections. Materials and Methods: This clinical study included thirty children who needed an inferior alveolar nerve block. They were divided into three groups: Group A: Precaine topical gel group, Group B: Precaine B topical gel Group, Group C: no anesthetic topical gel group (control group). These two effective topical gels were applied before giving intraoral local anesthesia, and afterward, the child's pain response was surveyed utilizing the Wong-Baker Faces Pain Rating Scale. The scores obtained were subjected to statistical analysis. Results: Intergroup comparison showed a significant mean difference between the control group and Precaine group (P > 0.05) as well as Precaine B group (P > 0.05). However, there is no significant difference obtained between Group A and Group B (P < 0.05). Conclusion: It is psychologically and clinically beneficial to apply a topical anesthetic agent before injecting any intraoral anesthesia. In this study, both anesthetic gels showed a nonsignificant difference in reducing inferior alveolar injection pain, but Precaine B shows more promising results than Precaine.
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Affiliation(s)
- Dharati Patel
- Department of Pedodontics and Preventive Dentistry, Narsinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat, India
| | - Banibrata Lahiri
- Department of Oral and Maxillofacial Surgery, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Mohamed Abd-Ellatif El-Patal
- Department of Pedodontics and Oral Health, College of Dentistry, Al Azhar University, Cairo, Egypt.,Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Alkharj, Kingdom of Saudi Arabia
| | - Abdulfatah Alazmah
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdul Aziz University, Alkharj, Kingdom of Saudi Arabia
| | - Parth Patel
- Dental Practitioner, Gujarat University, Ahmedabad, Gujarat, India
| | - Yousef H Abokhlifa
- Department of Pedodontics and Oral Health, College of Dentistry, Al Azhar University, Cairo, Egypt
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Kotian N, Mani G, Ramakrishnan M. Comparative Evaluation of Two Different Topical Anesthetic Agents in Controlling Pain during Intraoral Local Anesthetic Administration in Children: A Split-mouth Triple-blinded Randomized Clinical Trial. Int J Clin Pediatr Dent 2021; 14:180-182. [PMID: 34413587 PMCID: PMC8343671 DOI: 10.5005/jp-journals-10005-1905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Aim To compare the efficacy of lignocaine and benzocaine when applied as a topical anesthetic before intraoral local anesthetic administration in children. Materials and methods Forty-four patients aged between 4 years and 10 years indicated for pulp therapy of primary teeth under inferior alveolar nerve block were selected for this study. The participants were randomly allocated into two groups of 22 each. Group I (lignocaine gel) and group II (benzocaine gel) were applied before inferior alveolar nerve block. The pain scale was assessed by a trained examiner using the visual analog scale (VAS) and sound eye motor scale. Results Lignocaine when used as a topical anesthetic agent showed lower mean scores under both the pain scales when compared with benzocaine but the results were statistically insignificant. Conclusion Lignocaine and benzocaine are equally effective when applied as a topical anesthetic agent. But lignocaine was more preferred in taste when compared with benzocaine. How to cite this article Kotian N, Mani G, Ramakrishnan M. Comparative Evaluation of Two Different Topical Anesthetic Agents in Controlling Pain during Intraoral Local Anesthetic Administration in Children: A Split-mouth Triple-blinded Randomized Clinical Trial. Int J Clin Pediatr Dent 2021;14(2):180–182.
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Affiliation(s)
- Niharika Kotian
- Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Geo Mani
- Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Mahesh Ramakrishnan
- Department of Pedodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
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Favatela F, Horst M, Bracone M, Gonzalez J, Alvarez V, Lassalle V. Gelatin/Cellulose nanowhiskers hydrogels intended for the administration of drugs in dental treatments: Study of lidocaine as model case. J Drug Deliv Sci Technol 2021. [DOI: 10.1016/j.jddst.2020.101886] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Chilakamuri S, Svsg N, Nuvvula S. The effect of pre-cooling versus topical anesthesia on pain perception during palatal injections in children aged 7-9 years: a randomized split-mouth crossover clinical trial. J Dent Anesth Pain Med 2020; 20:377-386. [PMID: 33409366 PMCID: PMC7783376 DOI: 10.17245/jdapm.2020.20.6.377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/03/2020] [Accepted: 11/05/2020] [Indexed: 11/15/2022] Open
Abstract
Background To compare pain perception during palatal injection administration in children aged 7-9 years while using pre-cooling of the injection site versus application of topical anesthesia as a pre-injection anesthetic during the six months. Methods A prospective randomized split-mouth crossover trial was conducted among 30 children aged 7-9 years, who received topical application of either a pencil of ice (test group) or 5% lignocaine gel (control group) for 2 min before injection. The primary and secondary outcome measures were pain perception and child satisfaction, measured by the composite pain score and the faces rating scale, respectively. Unpaired t-test was performed to determine significant differences between groups. Results The test group had significantly lower pain scores for self-report and behavioral measures (P < 0.0001). The changes in physiological parameters at the baseline (P = 0.74) during (P = 0.37) and after (P = 0.88) the injection prick were not statistically significant. Children felt better by the pre-cooling method (P < 0.0001). Conclusion Ice application using a pencil of ice for 2 min reduced pain perception significantly compared to the use of a topical anesthetic. Moreover, ice application was preferred by children.
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Affiliation(s)
- Sandeep Chilakamuri
- Department of Pedodontics and Preventive Dentistry, Narayana Dental College & Hospital, Nellore, India
| | - Nirmala Svsg
- Department of Pedodontics and Preventive Dentistry, Narayana Dental College & Hospital, Nellore, India
| | - Sivakumar Nuvvula
- Department of Pedodontics and Preventive Dentistry, Narayana Dental College & Hospital, Nellore, India
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Aghababaie ST, Monteiro J, Stratigaki E, Ashley PF. Techniques for effective local anaesthetic administration for the paediatric patient. Br Dent J 2020; 229:779-785. [DOI: 10.1038/s41415-020-2453-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 07/15/2020] [Indexed: 12/20/2022]
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Hindocha N, Manhem F, Bäckryd E, Bågesund M. Ice versus lidocaine 5% gel for topical anaesthesia of oral mucosa - a randomized cross-over study. BMC Anesthesiol 2019; 19:227. [PMID: 31842771 PMCID: PMC6913024 DOI: 10.1186/s12871-019-0902-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 12/03/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Topical anaesthesia is important to optimize pain control during dental injection. Our aim was to describe a new simple method for topical anaesthesia of oral mucosa and to compare the effectiveness of ice and lidocaine 5% gel for topical anaesthesia of oral mucosa. METHODS A total of 40 patients aged 10.7-19.5 years were included. The side and method of application were both randomized. Heart rate was recorded, and discomfort and pain were evaluated with a visual analogue scale (VAS). A paired t-test was used to compare mean values, a chi2 test was used to compare proportions, and a Pearson correlation test was used to examine correlations between variables. RESULTS When ice was used, buccal injection VAS pain was rated lower (p = 0.044), and VAS discomfort was rated higher (p = 0.001), in comparison to when lidocaine 5% gel was used. There was no significant difference in relative heart rate change between ice and lidocaine 5% gel at either needle stick or injection. Lidocaine 5% gel produced a relative heart rate reduction after palatal injection (0.99 ± 0.06) while buccal injection produced an increased relative heart rate (1.02 ± 0.08) (p = 0.010). Unpleasant taste was more frequently reported when lidocaine 5% gel was used (p = 0.025). An application time of 1 min was sufficient for both ice and lidocaine 5% gel to achieve pain reduction from needle stick in buccal mucosa. CONCLUSION The cheap and readily available described method using ice for topical anaesthesia of oral mucosa before dental injection is an effective alternative to lidocaine 5% gel. TRIAL REGISTRATION The European Union Drug Regulating Authorities Clinical Trials Database EudraCT201300530531. Date of registration: February 10th, 2014.
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Affiliation(s)
- Nishma Hindocha
- Department of Ear, Nose, Throat and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
| | - Filip Manhem
- Public Dental Service Östergötland, Linköping, Region Östergötland, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Emmanuel Bäckryd
- Pain and Rehabilitation Center, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Mats Bågesund
- Centre for Orthodontics and Paediatric Dentistry, Norrköping, Public Dental Service Östergötland, Region Östergötland, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
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Gupte T, Modi UA, Gupte S, Sawant A. Determination of Onset of Action and Efficacy of Topical Lignocaine Anesthesia in Children: An In Vivo Study. Int J Clin Pediatr Dent 2019; 12:178-181. [PMID: 31708611 PMCID: PMC6811940 DOI: 10.5005/jp-journals-10005-1615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Anxiety is one of the major issues in the dental treatment in children and needle is the most anxiety provoking armamentarium. For this reason, pediatric dentists are on a constant search to find more comfortable means for administering anesthesia. Topical anesthesia has proven to be a boon in this attempt. Literature shows that quite often there is little pain relief from topical anesthesia and one reason for failure may be that there is no consensus regarding the most appropriate time duration for topical anesthesia to anesthetize intraoral tissue prior to injection. Therefore, the aim and objectives of the study are as follows: (1) To determine duration for onset of action of lignocaine gel and lignocaine spray used as a topical anesthesia during local anesthetic infiltration in palatal area in pediatric patients. (2) To compare the efficacy of lignocaine spray and lignocaine gel in the same patient with bilateral injection. The study group consists of children in the age group of 6–12 years of both genders. Only those children who require palatal bilateral infiltration for their treatment, included in the study. A total of 120 children divided equally into 3 sub-groups depending on the amount of time gap between topical anesthetic application and local infiltration. (1) Group I–30 seconds (2) group II–1 minute (3) group III–3 minutes. Pain responses compared based on subject self-report using visual analogue scale to record subjective symptoms and sem (sound eye motor) scales to record objective symptoms. Results subjected to statistical analysis.
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Affiliation(s)
- Tejashri Gupte
- Department of Pediatric and Preventive Dentistry, Nair Hospital and Dental College, Mumbai, Maharashtra, India
| | - Urvi A Modi
- Department of Pediatric and Preventive Dentistry, Nair Hospital and Dental College, Mumbai, Maharashtra, India
| | - Shreyas Gupte
- YMT Dental College and Hospital, Oral and Maxillofacial Surgery, Navi Mumbai, Maharashtra, India
| | - Ameya Sawant
- Department of Pediatric and Preventive Dentistry, Nair Hospital and Dental College, Mumbai, Maharashtra, India
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Clitherow KH, Murdoch C, Spain SG, Handler AM, Colley HE, Stie MB, Mørck Nielsen H, Janfelt C, Hatton PV, Jacobsen J. Mucoadhesive Electrospun Patch Delivery of Lidocaine to the Oral Mucosa and Investigation of Spatial Distribution in a Tissue Using MALDI-Mass Spectrometry Imaging. Mol Pharm 2019; 16:3948-3956. [PMID: 31361498 PMCID: PMC7007276 DOI: 10.1021/acs.molpharmaceut.9b00535] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
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Many
oral mucosal conditions cause considerable and prolonged pain
that to date has been difficult to alleviate via topical delivery,
and the use of injection causes many patients dental anxiety and needle-prick
pain. Therefore, developing a noninjectable drug delivery system as
an alternative administration procedure may vastly improve the health
and wellbeing of these patients. Recent advances in the development
of mucoadhesive electrospun patches for the direct delivery of therapeutics
to the oral mucosa offer a potential solution, but as yet, the release
of local anesthetics from this system and their uptake by oral tissue
have not been demonstrated. Here, we demonstrate the fabrication of
lidocaine-loaded electrospun fiber patches, drug release, and subsequent
uptake and permeation through the porcine buccal mucosa. Lidocaine
HCl and lidocaine base were incorporated into the electrospun patches
to evaluate the difference in drug permeation for the two drug compositions.
Lidocaine released from the lidocaine HCl-containing electrospun patches
was significantly quicker than from the lidocaine base patches, with
double the amount of drug released from the lidocaine HCl patches
in the first 15 min (0.16 ± 0.04 mg) compared to that from the
lidocaine base patches (0.07 ± 0.01 mg). The permeation of lidocaine
from the lidocaine HCl electrospun patches through ex vivo porcine
buccal mucosa was also detected in 15 min, whereas permeation of lidocaine
from the lidocaine base patch was not detected. Matrix-assisted laser
desorption ionization-mass spectrometry imaging was used to investigate
localization of lidocaine within the oral tissue. Lidocaine in the
solution as well as from the mucoadhesive patch penetrated into the
buccal mucosal tissue in a time-dependent manner and was detectable
in the lamina propria after only 15 min. Moreover, the lidocaine released
from lidocaine HCl electrospun patches retained biological activity,
inhibiting veratridine-mediated opening of voltage-gated sodium channels
in SH-SY5Y neuroblastoma cells. These data suggest that a mucoadhesive
electrospun patch may be used as a vehicle for rapid uptake and sustained
anesthetic drug delivery to treat or prevent oral pain.
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Affiliation(s)
- Katharina H Clitherow
- School of Clinical Dentistry , University of Sheffield , 19 Claremont Crescent , Sheffield S10 2TA , U.K
| | - Craig Murdoch
- School of Clinical Dentistry , University of Sheffield , 19 Claremont Crescent , Sheffield S10 2TA , U.K
| | - Sebastian Guy Spain
- Department of Chemistry , University of Sheffield , Brook Hill , Sheffield S3 7HF , U.K
| | - Anna Mette Handler
- Department of Pharmacy , University of Copenhagen , 2 Universitetsparken , Copenhagen DK-2100 , Denmark
| | - Helen E Colley
- School of Clinical Dentistry , University of Sheffield , 19 Claremont Crescent , Sheffield S10 2TA , U.K
| | - Mai Bay Stie
- Department of Pharmacy , University of Copenhagen , 2 Universitetsparken , Copenhagen DK-2100 , Denmark
| | - Hanne Mørck Nielsen
- Department of Pharmacy , University of Copenhagen , 2 Universitetsparken , Copenhagen DK-2100 , Denmark
| | - Christian Janfelt
- Department of Pharmacy , University of Copenhagen , 2 Universitetsparken , Copenhagen DK-2100 , Denmark
| | - Paul V Hatton
- School of Clinical Dentistry , University of Sheffield , 19 Claremont Crescent , Sheffield S10 2TA , U.K
| | - Jette Jacobsen
- Department of Pharmacy , University of Copenhagen , 2 Universitetsparken , Copenhagen DK-2100 , Denmark
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Kaewjiaranai T, Srisatjaluk RL, Sakdajeyont W, Pairuchvej V, Wongsirichat N. The efficiency of topical anesthetics as antimicrobial agents: A review of use in dentistry. J Dent Anesth Pain Med 2018; 18:223-233. [PMID: 30186969 PMCID: PMC6115368 DOI: 10.17245/jdapm.2018.18.4.223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/18/2018] [Accepted: 08/22/2018] [Indexed: 01/04/2023] Open
Abstract
Topical anesthetics are commonly used in oral & maxillofacial surgery to control pain in the oral cavity mucosa before local anesthetic injection. These anesthetic agents come in many forms, developed for different usages, to minimize adverse reactions, and for optimal anesthetic efficiency. Earlier studies have revealed that these agents may also limit the growth of microorganisms in the area of anesthetic application. Many topical anesthetic agents show different levels of antimicrobial activity against various bacterial strains and Candida. The dosage of local anesthetic agent used in some clinical preparations is too low to show a significant effect on microbial activity. Efficiency of antimicrobial activity depends on the local anesthetic agent's properties of diffusion within the bloodstream and binding efficiency with cytoplasmic membrane, which is followed by disruption of the bacterial cell membrane. The antimicrobial properties of these agents may extend their usage in patients to both control pain and infection. To develop the topical local anesthetic optimal usage and antimicrobial effect, a collaborating antiseptic agent may be used to benefit the local anesthetic. However, more research is required regarding minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of topical local anesthetic agents with drug interaction between anesthetics and antiseptic agents.
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Affiliation(s)
- Thanawat Kaewjiaranai
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Watus Sakdajeyont
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Verasak Pairuchvej
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Natthamet Wongsirichat
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Lee HS. Recent advances in topical anesthesia. J Dent Anesth Pain Med 2016; 16:237-244. [PMID: 28879311 PMCID: PMC5564188 DOI: 10.17245/jdapm.2016.16.4.237] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 11/20/2022] Open
Abstract
Topical anesthetics act on the peripheral nerves and reduce the sensation of pain at the site of application. In dentistry, they are used to control local pain caused by needling, placement of orthodontic bands, the vomiting reflex, oral mucositis, and rubber-dam clamp placement. Traditional topical anesthetics contain lidocaine or benzocaine as active ingredients and are used in the form of solutions, creams, gels, and sprays. Eutectic mixtures of local anesthesia cream, a mixture of various topical anesthetics, has been reported to be more potent than other anesthetics. Recently, new products with modified ingredients and application methods have been introduced into the market. These products may be used for mild pain during periodontal treatment, such as scaling. Dentists should be aware that topical anesthetics, although rare, might induce allergic reactions or side effects as a result of an overdose. Topical anesthetics are useful aids during dental treatment, as they reduce dental phobia, especially in children, by mitigating discomfort and pain.
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Affiliation(s)
- Hyo-Seol Lee
- Department of Pediatric Dentistry, School of Dentistry, Kyung Hee University, Seoul, Korea
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15
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Franz-Montan M, Ribeiro LNDM, Volpato MC, Cereda CMS, Groppo FC, Tofoli GR, de Araújo DR, Santi P, Padula C, de Paula E. Recent advances and perspectives in topical oral anesthesia. Expert Opin Drug Deliv 2016; 14:673-684. [DOI: 10.1080/17425247.2016.1227784] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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16
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Couto RO, Cubayachi C, Lopez RFV, de Gaitani CM, Pedrazzi V, de Freitas O. A simple and high-resolution HPLC-PDA method for simultaneous quantification of local anesthetics inin vitrobuccal permeation enhancement studies. Biomed Chromatogr 2015; 30:857-66. [DOI: 10.1002/bmc.3619] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/10/2015] [Accepted: 09/14/2015] [Indexed: 11/12/2022]
Affiliation(s)
- Renê O. Couto
- Faculty of Pharmaceutical Sciences of Ribeirão Preto; University of São Paulo; 14040-903 Ribeirão Preto SP Brazil
| | - Camila Cubayachi
- Faculty of Pharmaceutical Sciences of Ribeirão Preto; University of São Paulo; 14040-903 Ribeirão Preto SP Brazil
| | - Renata F. V. Lopez
- Faculty of Pharmaceutical Sciences of Ribeirão Preto; University of São Paulo; 14040-903 Ribeirão Preto SP Brazil
| | - Cristiane M. de Gaitani
- Faculty of Pharmaceutical Sciences of Ribeirão Preto; University of São Paulo; 14040-903 Ribeirão Preto SP Brazil
| | - Vinícius Pedrazzi
- School of Odontology of Ribeirão Preto; University of São Paulo; 14040-904 Ribeirão Preto SP Brazil
| | - Osvaldo de Freitas
- Faculty of Pharmaceutical Sciences of Ribeirão Preto; University of São Paulo; 14040-903 Ribeirão Preto SP Brazil
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Sharma A, Suprabha BS, Shenoy R, Rao A. Efficacy of lignocaine in gel and spray form during buccal infiltration anesthesia in children: a randomized clinical trial. J Contemp Dent Pract 2014; 15:750-4. [PMID: 25825102 DOI: 10.5005/jp-journals-10024-1611] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To compare the efficacy of 15% lignocaine spray and 8% lignocaine gel as a topical anesthetic, in reducing pain, during buccal infiltration in children. MATERIALS AND METHODS Forty-two patients aged between 7 and 12 years requiring restorative procedures/extraction/pulp therapy of primary/ permanent teeth in the maxillary arch, under buccal infiltration anesthesia were selected for the study. The participants were randomly allocated into 2 groups of 21 each. In group A, 8% lignocaine gel and in group B, 15% lignocaine spray was applied prior to buccal infiltration. Pain was assessed using Wong-Baker faces pain rating scale (WBFPRS) and faces legs activity cry and consolability (FLACC) painscale. RESULTS Pearson's chi-square test revealed that there was no significant difference in the FLACC scores of the two groups (p = 0.54). Independent t-test demonstrated that there was no significant difference in Wong-Bakers faces pain score between the two agents (p = 0.07). CONCLUSION There is no significant difference in the efficacy of 15% lignocaine spray and 8% lignocaine gel as a topical anesthetic in controlling pain during buccal infiltration anesthesia, in children.
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Affiliation(s)
- Anshul Sharma
- Former Postgraduate Student, Department of Pedodontics and Preventive Dentistry Manipal College of Dental Sciences, Manipal University Mangalore, Karnataka, India
| | - B S Suprabha
- Additional Professor, Department of Pedodontics and Preventive Dentistry, 'Shreyas' 15/17/940-13, 5th Cross Road, Shivabagh, Kadri, Mangalore 575002, Karnataka, India, Phone: 091-0824-2428716, Fax: 091-0824-2422653, e-mail:
| | - Ramya Shenoy
- Associate Professor, Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka India
| | - Arathi Rao
- Professor and Head, Department of Pedodontics and Preventive Dentistry Manipal College of Dental Sciences, Manipal University Mangalore, Karnataka, India
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Monteiro J, Tanday A, Ashley PF, Parekh S, Petrie A. Interventions for increasing acceptance of local anaesthetic in children having dental treatment. Hippokratia 2014. [DOI: 10.1002/14651858.cd011024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Joana Monteiro
- UCL Eastman Dental Institute; Paediatric Dentistry; 256 Gray's Inn Road London UK WC1X 8LD
| | - Ajit Tanday
- UCL Eastman Dental Institute; Paediatric Dentistry; 256 Gray's Inn Road London UK WC1X 8LD
| | - Paul F Ashley
- UCL Eastman Dental Institute; Paediatric Dentistry; 256 Gray's Inn Road London UK WC1X 8LD
| | - Susan Parekh
- UCL Eastman Dental Institute; Paediatric Dentistry; 256 Gray's Inn Road London UK WC1X 8LD
| | - Aviva Petrie
- UCL Eastman Dental Institute; Biostatistics Unit; 256 Gray's Inn Road London UK WC1X 8LD
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Nakamura S, Matsuura N, Ichinohe T. A new method of topical anesthesia by using anesthetic solution in a patch. J Endod 2013; 39:1369-73. [PMID: 24139256 DOI: 10.1016/j.joen.2013.07.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 07/22/2013] [Accepted: 07/22/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION We investigated the effects of topical anesthesia of the oral mucosa by using an adhesive patch instilled with 2% lidocaine hydrochloride solution. METHODS The subjects were 20 healthy adult volunteers who gave written informed consent. Each patient was treated in a randomized crossover fashion with a hemostatic adhesive patch instilled with one of the following agents: 2% lidocaine hydrochloride with 12.5 μg/mL epinephrine, 2% lidocaine hydrochloride, 20% ethyl aminobenzoate, or physiological saline solution. A cotton ball containing 20% ethyl aminobenzoate was also tested. The adhesive patch or cotton ball was placed on the gingivobuccal fold of the maxillary right canine for 2 or 5 minutes. Then, a 33-gauge or 30-gauge needle was inserted to a depth of 2 mm. Insertion pain was evaluated with a visual analog scale (VAS) and a 4-level verbal rating scale immediately after needle removal. Efficacy of analgesia was calculated from the verbal rating scale. RESULTS The VAS was lower and the efficacy of analgesia was higher on 33-gauge needle insertion than on 30-gauge needle insertion in all treatments. The VAS was also significantly lower and the efficacy of analgesia was higher in the lidocaine groups than in the other groups. Adding epinephrine did not enhance the anesthetic effect of lidocaine hydrochloride. CONCLUSIONS Topical mucosal anesthesia with an adhesive patch containing 2% lidocaine hydrochloride solution is simple and may be more effective than conventional methods.
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Affiliation(s)
- Shun Nakamura
- Department of Dental Anesthesiology, Tokyo Dental College, Chiba, Japan.
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Cavallari C, Fini A, Ospitali F. Mucoadhesive multiparticulate patch for the intrabuccal controlled delivery of lidocaine. Eur J Pharm Biopharm 2013; 83:405-14. [DOI: 10.1016/j.ejpb.2012.10.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 10/17/2012] [Accepted: 10/20/2012] [Indexed: 11/25/2022]
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NAKATSUKA K, ADACHI T, KATO T, OISHI M, MASUDA Y. Regulatory relationship between tactile sensation at the vermilion of the lips and lip-closing force. J Oral Rehabil 2011; 38:579-87. [DOI: 10.1111/j.1365-2842.2010.02198.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abdellatif AM. Pain assessment of two palatal anesthetic techniques and their effects on the child's behavior. PEDIATRIC DENTAL JOURNAL 2011. [DOI: 10.1016/s0917-2394(11)70239-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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