title: Topical intrapocket anesthesia during scaling and root planing: a randomized clinical trial.
abstract: 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.
authors: Dental School, Franciscan University Center, Santa Maria, RS, Brazil.
authors: Raquel Pippi
authors: RP
authors: Antoniazzi
authors: Dental School, Franciscan University Center, Santa Maria, RS, Brazil.
authors: Bruna
authors: B
authors: Cargnelutti
authors: Postgraduate Program in Dentistry, UFSM - Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors: Daniela Napoleão
authors: DN
authors: Freitas
authors: Dental School, Franciscan University Center, Santa Maria, RS, Brazil.
authors: Magáli Beck
authors: MB
authors: Guimarães
authors: Postgraduate Program in Dentistry, UFSM - Federal University of Santa Maria, Santa Maria, RS, Brazil.
authors: Fabricio Batistin
authors: FB
authors: Zanatta
authors: Postgraduate Program in Dentistry, ULBRA - Lutheran University of Brazil, Canoas, RS, Brazil.
authors: Carlos Alberto
authors: CA
authors: Feldens
mesh_terms: D000766:Anesthesia, Dental / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D001566:Benzocaine / Q000627:therapeutic use; D012534:Dental Scaling; D004338:Drug Combinations; D005260:Female; D005891:Gingivitis / Q000628:therapy*; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010147:Pain Measurement; D017060:Patient Satisfaction; D011318:Prilocaine / Q000627:therapeutic use; D015203:Reproducibility of Results; D016745:Root Planing; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D004338:Drug Combinations; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine; D001566:Benzocaine