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

Abstract 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.

Root Dentine Sensitivity.

Background: Dentine hypersensitivity is one of the most painful, ubiquitous and least satisfactorily treated of all the chronic oral problems involving the teeth. Active Periodontal treatment appears to be one of the significant causes of hypersensitivity. Also, the role of plaque control in treatment of hypersensitivity is controversial. Thus the present study is aimed to study the degree to which a sample of patient developed Root Dentine Sensitivity (RDS) following nonsurgical periodontal treatment. Material & Methods: A total of 60 dental patients were evaluated for plaque scores and pain scoring using Scratch test and Air blast test. Visual Analogue Scale (VAS) was used for pain scoring. Oral hygiene instructions were given and non- surgical periodontal treatment was done quadrant wise over a period of 4 weeks. Results: The intensity of RDS given by VAS score and the percentage of teeth sensitive to both the test increased after scaling and root planing but gradually decreased when meticulous plaque control was maintained. Conclusion: Non- surgical periodontal treatment i.e. SRP and Oral hygiene maintenance may temporarily increase RDS, which reduces subsequently over a period of time with meticulous plaque control.