title: Recent advances and perspectives in topical oral anesthesia.
abstract: Topical anesthesia is widely used in dentistry to reduce pain caused by needle insertion and injection of the anesthetic. However, successful anesthesia is not always achieved using the formulations that are currently commercially available. As a result, local anesthesia is still one of the procedures that is most feared by dental patients. Drug delivery systems (DDSs) provide ways of improving the efficacy of topical agents. Areas covered: An overview of the structure and permeability of oral mucosa is given, followed by a review of DDSs designed for dental topical anesthesia and their related clinical trials. Chemical approaches to enhance permeation and anesthesia efficacy, or to promote superficial anesthesia, include nanostructured carriers (liposomes, cyclodextrins, polymeric nanoparticle systems, solid lipid nanoparticles, and nanostructured lipid carriers) and different pharmaceutical dosage forms (patches, bio- and mucoadhesive systems, and hydrogels). Physical methods include pre-cooling, vibration, iontophoresis, and microneedle arrays. Expert opinion: The combination of different chemical and physical methods is an attractive option for effective topical anesthesia in oral mucosa. This comprehensive review should provide the readers with the most relevant options currently available to assist pain-free dental anesthesia. The findings should be considered for future clinical trials.
authors.affiliation: a Department of Physiological Sciences, Piracicaba Dental School , University of Campinas - UNICAMP , Piracicaba , Brazil.
authors.forename: Michelle
authors.initials: M
authors.lastname: Franz-Montan
authors.affiliation: b Department of Biochemistry and Tissue Biology, Institute of Biology , University of Campinas - UNICAMP , Campinas , Brazil.
authors.forename: Lígia Nunes de Morais
authors.initials: LNM
authors.lastname: Ribeiro
authors.affiliation: a Department of Physiological Sciences, Piracicaba Dental School , University of Campinas - UNICAMP , Piracicaba , Brazil.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Volpato
authors.affiliation: b Department of Biochemistry and Tissue Biology, Institute of Biology , University of Campinas - UNICAMP , Campinas , Brazil.|c Laboratory of Immunology and Molecular Biology , São Leopoldo Mandic Institute and Research Center , Campinas , Brazil.
authors.forename: Cintia Maria Saia
authors.initials: CMS
authors.lastname: Cereda
authors.affiliation: a Department of Physiological Sciences, Piracicaba Dental School , University of Campinas - UNICAMP , Piracicaba , Brazil.
authors.forename: Francisco Carlos
authors.initials: FC
authors.lastname: Groppo
authors.affiliation: c Laboratory of Immunology and Molecular Biology , São Leopoldo Mandic Institute and Research Center , Campinas , Brazil.
authors.forename: Giovana Randomille
authors.initials: GR
authors.lastname: Tofoli
authors.affiliation: d Human and Natural Sciences Centre , Federal University of ABC , São Paulo , Brazil.
authors.forename: Daniele Ribeiro
authors.initials: DR
authors.lastname: de Araújo
authors.affiliation: e Department of Pharmacy , University of Parma, Parco Area delle Scienze , Parma , Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Santi
authors.affiliation: e Department of Pharmacy , University of Parma, Parco Area delle Scienze , Parma , Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Padula
authors.affiliation: b Department of Biochemistry and Tissue Biology, Institute of Biology , University of Campinas - UNICAMP , Campinas , Brazil.
authors.forename: Eneida
authors.initials: E
authors.lastname: de Paula
mesh_terms: D000287:Administration, Topical; D000772:Anesthesia, Local / Q000379:methods*; D002626:Chemistry, Pharmaceutical; D003505:Cyclodextrins / Q000737:chemistry; D016503:Drug Delivery Systems; D006801:Humans; D020100:Hydrogels; D007478:Iontophoresis; D008055:Lipids / Q000737:chemistry; D008081:Liposomes; D009061:Mouth Mucosa / Q000378:metabolism*; D053758:Nanoparticles; D049329:Nanostructures; D011108:Polymers / Q000737:chemistry
chemical_list: D003505:Cyclodextrins; D020100:Hydrogels; D008055:Lipids; D008081:Liposomes; D011108:Polymers
keywords: Dentistry; buccal films; cyclodextrins; dental topical anesthesia; dentistry; drug delivery systems; liposomes; nanoparticles; oral mucosa