Effect of eutectic mixture of local anesthetics on pain perception during scaling by ultrasonic or hand instruments: a masked randomized controlled trial.

Abstract

BACKGROUND:

The aims of this study are to evaluate the efficacy of a eutectic mixture of local anesthetic (EMLA) cream on pain perception during scaling and to compare the intensities of pain provoked by hand and ultrasonic instruments.

METHODS:

Forty subjects with chronic gingivitis or periodontitis were enrolled in the study. In this randomized, split-mouth, controlled, masked clinical trial, each of the four quadrants in subjects was randomly assigned to receive one of the following protocols: scaling with an ultrasonic scaler with or without the application of the EMLA cream or scaling with a Gracey curet with or without the application of the EMLA cream. Pain levels after each quadrant of scaling were assessed with a visual analog scale (VAS; 0 to 100 mm) and verbal rating score (VRS; 0 to 4). All subjects were recalled to detect any complications after 24 hours.

RESULTS:

The mean VAS and VRS when EMLA cream was applied (18.39 ± 14.47 mm and 0.95 ± 0.69) were significantly lower (P <0.001 for VAS and VRS) compared to when EMLA cream was not used (26.54 ± 16.46 mm and 1.30 ± 0.75). The mean VAS and VRS of the ultrasonic scaler group (20.43 ± 16.40 mm and 0.98 ± 0.76) were significantly lower (P = 0.024 for VAS; P = 0.003 for VRS) than those of the Gracey curet group (24.50 ± 15.17 mm and 1.28 ± 0.69). None of the subjects showed adverse effects after EMLA-cream application.

CONCLUSION:

Although most patients experienced limited pain during scaling, a significant reduction of pain is achieved by using EMLA cream and ultrasonic scaler.

• Authors: Jae-Eun Chung, Sang-A Koh, Tae-Il Kim, Yang-Jo Seol, Yong-Moo Lee, Young Ku, In-Chul Rhyu, Chong-Pyoung Chung, Ki-Tae Koo
• Journal: Journal of periodontology (J Periodontol) Vol. 82 Issue 2 Pg. 259-66 (Feb 2011) ISSN: 1943-3670 [Electronic] United States
• PMID: 20731585 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Anesthetics, Combined
• Anesthetics, Local
• Drug Combinations
• Lidocaine, Prilocaine Drug Combination
• Prilocaine
• Lidocaine

Topics

• Adult
• Analysis of Variance
• Anesthetics, Combined (therapeutic use)
• Anesthetics, Local (therapeutic use)
• Dental Instruments
• Drug Combinations
• Female
• Follow-Up Studies
• Gingivitis (complications, therapy)
• Humans
• Lidocaine (therapeutic use)
• Lidocaine, Prilocaine Drug Combination
• Male
• Matched-Pair Analysis
• Middle Aged
• Pain (drug therapy, etiology)
• Pain Perception (drug effects)
• Periodontitis (complications, therapy)
• Prilocaine (therapeutic use)
• Root Planing (adverse effects, instrumentation, methods)
• Single-Blind Method
• Treatment Outcome
• Ultrasonic Therapy
• Young Adult