Comparative evaluation of topical and electronic anesthesia during scaling and root planing.

Author(s): Pandit N, Gupta R, Chandoke U, Gugnani S

Affiliation(s): Department of Periodontics and Oral Implantology, D.A.V. Centenary Dental College and Hospital, Rohtak University, Haryana, India. drnymphea@yahoo.com

Publication date & source: 2010-07, J Periodontol., 81(7):1035-40.

Publication type: Comparative Study; Randomized Controlled Trial

BACKGROUND: Scaling and root planing (SRP) in periodontitis is considered to be painful and thus requires anesthesia. The present study evaluates the effectiveness of a eutectic mixture of 25 mg/g lignocaine plus 25 mg/g prilocaine and thermosetting agents (EMLA), 20% lignocaine patch, and electronic dental anesthesia (EDA) during SRP. METHODS: In a single-center, randomized, controlled study, 25 subjects with probing depth of 5 mm or more and visual analog scale (VAS) score of >or=30 mm on probing were selected and asked to assess the pain by VAS and verbal rating scale (VRS) during SRP after application of the three agents. RESULTS: The difference between VAS values of patch and EDA (P = 0.012) and EMLA and EDA (P = 0.018) is significant, whereas that between patch and EMLA is non-significant (P = 1.000). The difference between VRS values of patch and EDA (P = 0.046) is significant, whereas that between patch and EMLA (P = 0.655) and EMLA and EDA (P = 0.180) is non-significant. According to the VRS scores, 12% of the subjects in the patch group reported no pain, 84% mild pain, and 4% moderate pain. In the EMLA group, 16% reported no pain, 76% mild pain, and 8% moderate pain. In the EDA group, 88% reported mild pain and 12% moderate pain. None reported severe pain. One subject in the patch group had an adverse event of slight redness. CONCLUSIONS: The data suggest the topical agents used, 5% EMLA and 20% lignocaine patch, are more effective and comparable. Both are superior in performance to EDA.