Intrapocket anesthesia for scaling and root planing: Results of a double-blind multicenter trial using lidocaine prilocaine dental gel

Background: The efficacy of a novel anesthetic gel (lidocaine 25 mg/g plus prilocaine 25 mg/g in thermosetting agents) for non-invasive periodontal po cket anesthesia was evaluated. Methods: One hundred twenty-two (122) patients in 8 centers with moderate t o severe periodontitis requiring scaling and root planing (SRP) were enroll ed in this multicenter, randomized, double-blind, controlled clinical trial . The active dental gel or a matching placebo gel was applied into the peri odontal pocket using a blunt applicator. Following a waiting period of 30 s econds to 2 minutes, scaling and root planing were performed. If the patien t had any discomfort, a second application of the gel was applied. If the p atient continued to experience discomfort, conventional anesthesia was offe red. After all teeth in the test quadrant had received SRP, the overall pai n was assessed by the patient using a 100 mm horizontal, ungraded visual an alog scale in which the left side was marked "no pain" and the right side m arked "worst pain imaginable." Patients also assessed pain by using a 5-poi nt verbal rating scale, from "no pain" to "very severe pain." Results: The visual analog scale showed significant reductions in reported pain, favoring the active gel over the placebo (mean reduction, 8 mm; P <0. 0005). The verbal rating scale revealed that 90% of patients treated with a ctive gel reported no pain or mild pain compared to 64% of placebo-treated patients (P<0.001). Conclusions: Intrapocket administration of lidocaine 25 mg/g plus prilocain e 25 mg/g and thermosetting agents may be effective for pain control for sc aling and root planing and may offer an alternative to infiltration anesthe sia.