Sains Malaysiana 42(5)(2013): 685–692

 

Efficacy of a Topical Anaesthetic on Pain during Scaling and Root Planing: A Double Blind Split Mouth Pilot Study in Patients with Periodontitis

(Keberkesanan Pembiusan Setempat ke atas Penskaleran dan Pengetaman Akar: Kajian Rintis

Rabun Dua Belah bagi Sebahagian Mulut dalam Kalangan Pesakit Periodontitis)

 

P. Shaju Jacob& SoniaNath

School of Dentistry, International Medical University, No. 126, Jalan Jalil Perkasa 19

Bukit Jalil, 57000 Kuala Lumpur

 

Diserahkan: 11 Mei 2012/Diterima: 20 Oktober 2012

 

ABSTRACT

Scaling and root planing is one of the most commonly performed procedures in a dental clinic. Most patients will consider the procedure to be causing discomfort or even pain. Intrasulcular topical application of anaesthesia will be preferred over injectable anaesthetic by patients for reduction of pain during scaling and root planing. A double blind split mouth pilot study was designed to find if pain was associated with scaling and root planing and to assess if application of topical anaesthesia reduced the pain. Twenty one patients were enrolled to compare the effect of intrasulcularly applied 20% benzocaine with a placebo in reducing pain during scaling and root planing. Heft Parker Visual analog scale was used to record the level of pain experienced by participants during instrumentation. Independent samples and paired samples t test were used for statistical analysis. There was significant pain associated with scaling and root planing with placebo over baseline (p<0.01). There was significant reduction in pain in benzocaine applied side when compared with placebo (p<0.001). Pain level approached baseline in benzocaine applied side. In this study, pain was effectively and significantly reduced with intrasulcular application of 20% benzocaine in periodontitis patients.

 

Keywords: Anaesthesia; benzocaine; pain; scaling root planning

 

ABSTRAK

Penskaleran dan pengetaman akar adalah salah satu prosedur yang paling biasa dilakukan di klinik pergigian. Kebanyakan pesakit akan merasakan bahawa prosedur tersebut adalah kurang menyenangkan atau menyakitkan. Aplikasi bius setempat intrasulkular dijangka lebih digemari oleh pesakit berbanding suntikan anestetik untuk mengurangkan kesakitan semasa pengikisan dan pengetaman akar. Kajian rintis rabun dua belah bagi sebahagian daripada mulut telah direka untuk menentukan sama ada kesakitan adalah dikaitkan dengan penskaleran dan pengetaman akar dan menentukan keberkesanan aplikasi bius setempat dalam mengurangkan kesakitan. Dua puluh satu orang pesakit telah mengambil bahagian bagi membandingkan kesan intrasulkular 20% benzosaine berbanding plasebo dalam mengurangkan kesakitan semasa penskaleran dan pengetaman akar. Skala analog Heft Parker Visual telah digunakan untuk merakam tahap kesakitan yang dialami oleh peserta semasa instrumentasi. Ujian sampel tidak bersandar dan t berpasangan, telah digunakan bagi analisis statistik. Terdapat hubungan yang signifikan bagi kesakitan berkaitan dengan penskaleran dan pengetaman akar di kalangan plasebo pada peringkat dasar (p<0.01). Terdapat pengurangan kesakitan yang ketara di bahagian yang diaplikasi benzosaine berbanding dengan plasebo (p<0.001). Tahap kesakitan menghampiri nilai dasar di sebelah mulut yang diaplikasi dengan benzosaine. Dalam kajian ini, kesakitan telah dapat dikurangkan secara berkesan dan signifikan dengan aplikasi intrasulkular 20% benzosaine dalam kalangan pesakit periodontitis.

 

Kata kunci: Anestesia; benzosaine; kesakitan; pengetaman akar; penskaleran

RUJUKAN

Al-Melh, M.A. & Andersson, L. 2007. Comparison of topical anaesthetics (EMLA/Oraqix vs. benzocaine) on pain experienced during palatal needle injection. Oral Surgery Oral Medecine Oral Pathology Oral Radiology Endodontics 103: e16-e20.

Braun, A., Jepsen, S. & Krause, F. 2007. Subjective intensity of pain during ultrasonic supragingival calculus removal. Journal of Clinical Periodontology 34: 668-672.

Braun, A., Krause, F., Nolden, R. & Frentzen, M. 2003. Subjective intensity of pain during the treatment of periodontal lesions with the Vector TM-system. Journal of Periodontal Research 38: 135-140.

Canakçi, C.E. & Canakçi, V. 2007. Pain experienced by patients undergoing different periodontal therapies. Journal of American Dental Association 138: 1563-1573.

Carr, M.P. & Horton, J.E. 2001. Evaluation of a transoral delivery system for topical anaesthesia. Journal of American Dental Association 132: 1714-1719.

DiRenzo, A., Gresla, T., Johnson, B.R., Rogers, M., Tucker, D. & BeGole, E.A. 2002. Postoperative pain after 1- and 2-visit root canal therapy. Oral Surgery Oral Medecine Oral Pathology Oral Radiology Endodontics 93: 605-610.

Oral Radiology Endodontics 93: 605-610.

Donaldson, D., Gelskey, S.C., Landry, R.G., Matthews, D.C. & Sandhu, H.S. 2003. A placebo controlled multi-centred evaluation of an anaesthetic gel (Oraqixs) for periodontal therapy. Journal of Clinical Periodontology 30: 171-175.

Drisko, C.H. 2001. Nonsurgical periodontal therapy. Periodontol 2000 25: 77-88.

Ettlin, D.A., Ettlin, A., Bless, K., Puhan, M., Bernasconi, C., Tillmann, H.C., Palla, S. & Gallo, L.M. 2006. Ibuprofen arginine for pain control during scaling and root planing: A randomized, triple-blind trial. Journal of Clinical Periodontology 33(5): 345-350.

Frere, C.L., Crout, R., Yorty, J. & Mcneil, D.W. 2001. Effects of audiovisual distraction during dental prophylaxis. Journal of American Dental Association 132: 1031-1038.

Gould, D., Kelly, D., Goldstone, L. & Gammon, J. 2001. Examining the validity of pressure ulser risk assessment scales: Developing and using illustrated patient simulations to collect the data INFORMATIONPOINT: Visual Analogue Scale. Journal of Clinical Nursing 10(5): 697-706.

Heft, M.W. & Parker, S.R. 1984. An experimental basis for revising the graphic rating scale for pain. Pain 19: 153-161.

Hoffman, A., Marshall, R.I. & Bartold, P.M. 2005. Use of the vectort scaling unit in supportive periodontal therapy: A subjective patient evaluation. Journal of Clinical Periodontology 32: 1089-1093.

Jeffcoat, M.K., Geurs, N.C., Magnusson, I., MacNeill, S.R., Mickels, N., Roberts, F., Robinson, P., Salamati, A. & Yukna, R. 2001. Intrapocket anaesthesia for scaling and root planing: Results of a double-blind multicenter trial using lidocaine prilocaine dental gel. Journal of Periodontology 72(7): 895-900.

Kocher, T., Fanghanel, J., Schwahn, C. & Ruhling, A. 2005. A new ultrasonic device in maintenance therapy: Perception of pain and clinical efficacy. Journal of Clinical Periodontology 32: 425-429.

Kocher, T., Rodemerk, B., Fangha¨nel, J. & Meissner, G. 2005a. Pain during prophylaxis treatment elicited by two power-driven instruments. Journal of Clinical Periodontology 32: 535-538.

Listgarten, M.A., Schifter, C.C. & Laster, L. 1985. 3-year longitudinal study of the periodontal status of an adult population with gingivitis. Journal of Clinical Periodontology 12(3): 225-238.

Loesche, W.J. 1979. Clinical and microbiological aspects of chemotherapeutic agents used according to the specific plaque hypothesis. Journal of Dental Research 58(12): 2404-2412.

Loomer, P.M. & Perry, D.A. 2004. Computer-controlled delivery versus syringe delivery of local anaesthetic injections for therapeutic scaling and root planing. Journal of American Dental Association 135: 358-365.

Magnusson, I., Jeffcoat, M.K., Donaldson, D., Otterbom, I.L. and Henriksson, J. 2004. Quantification and analysis of pain in nonsurgical scaling and/or root planing. Journal of American Dental Association 135(12): 1747-1754.

Meechan, J.G. 2008. Intraoral topical anaesthesia. Periodontol 2000 46: 56-79.

Perry, D.A., Gansky, S.A. & Loomer, P.M. 2005. Effectiveness of a transmucosal lidocaine delivery system for local anaesthesia during scaling and root planing. Journal of Clinical Periodontology 32: 590-594.

Pihlstrom, B.L., Hargreaves, K.M., Bouwsma, O.J., Myers, W.R., Goodale, M.B. & Doyle, M.J. 1999. Pain after periodontal scaling and root planing. Journal of American Dental Association 30: 801-807.

Saloum, F.S., Baumgartner, C. J., Marshall, G. & Tinkle, J, 2000. A clinical comparison of pain perception to the Wand and a traditional syringe. Oral Surgery Oral Medicine Oral Pathology Oral Radiology Endodontics 89: 691-695.

Stoltenberg, J.L., Osborn, J.B., Carlson, J.F., Hodges, J.S. & Michalowicz, B.S. 2007. A preliminary study of intra-pocket topical versus injected anaesthetic for scaling and root planing. Journal of Clinical Periodontology 34: 892-896.

Svensson, P., Petersen, J.K. & Svensson, H. 1994. Efficacy of a topical anaesthetic on pain and unpleasantness during scaling of gingival pockets. Anesthesia Progress 41: 35-39.

Van Wijk, A.J., Duyx, M.P.M.A. & Hoogstraten. 2004. The effect of written information on pain experience during periodontal probing. Journal of Clinical Periodontology 31(4): 273-281.

 

 

*Pengarang untuk surat-menyurat; email: shaju_jacob@imu.edu.my