ABSTRACT to compare the efficacy of local anesthetic

ABSTRACT                                                                                   

Introduction:
The experience of pain during
dental procedures is a concern to many individuals. In periodontal practice,
the first meet between the patient and the periodontist is usually a
periodontal examination. Probing of periodontal pockets to determine the extent
of the disease is an essential part of this examination and may cause pain in
some individuals. Periodontal probing has been reported to be a significantly
painful experience for as many as 15-77% of patients with untreated periodontal
disease. So far, anesthetic gel, injection, and topical anesthetic agents using
different modes such as before and after scaling and root planning have been
used to reduce this type of pain. The present study aims to compare the
efficacy of  local anesthetic gel &
spray in the reduction of pain on periodontal probing in a group of individuals
with untreated chronic periodontitis.

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Materials and Methods: Thirty participants meeting the
inclusion criteria were included in the study and had full-mouth periodontal
probing done at six sites per tooth. The participants were divided into 2
groups: Group I; 15
patients with LOX 2% gel  and Group II; 15
patients were assessed with LIGNOCAINE spray . Intragroup comparison was done
using paired t-test and Analysis of Variance was done for inter group
comparison.

Results: The pre and post VAS score of two
groups over the periods.  In Group I, the
mean VAS decrease comparatively after the treatment and remain lower as
compared to baseline. In contrast, in Group II, it decrease comparatively at
after 2 min but increase at after 5 min and reach almost baseline .

Conclusion : For early pain relief, study found
LOX 2% gel more effective than LIGNOCAINE SPRAY in the management of untreated
chronic periodontitis .

Keywords : Lignocaine , LOX 2% gel

INTRODUCTION

Examination and evaluation of any response to periodontal
therapy are measured most of all through the surrogate variable of periodontal
probing depth (PD) and its derivatives (attachment loss/clinical attachment
level).1 The experience of pain during dental procedures is a
concern to many individuals. In periodontal practice, the first encounter
between the patient and the periodontist is usually a periodontal examination. Probing
of periodontal pockets to determine the extent of the disease is an essential
part of this examination and may cause pain in some individuals. Periodontal
probing has been reported to be a significantly painful experience for as many
as 15-77% of patients with untreated periodontal disease, mainly attributable
to the fact that periodontal tissues are in their most inflamed state.2-4

It is important that the periodontist at this encounter is
sensitive to the discomfort level that the probing may entail.

Quantification of pain as a measurement is inherently
difficult because it has both physical and psychological aspects. A common
method used in pain studies is the visual analog scale (VAS). It has been
revealed previously to be simple to use, consistent, and valid.5-6

Injection anesthesia is an established method,7
but the unwanted side effects of prolonged anesthesia, anesthesia of adjacent
structures (lips and/or tongue) and the psychological trauma of receiving
multiple invasive ”injections” makes it impractical.8

Topical anesthetics (jellies, ointments, or sprays) preferred
because they produce less post procedure numbness, but problems relating to
lack of efficacy attributable to inadequate depth of penetration, uncontrolled
spreading, insufficient duration of action, and difficulties of administration
have limited their use.7,9-13

 

 

 

MATERIAL AND METHODOLOGY

The clinical
trial was conducted in the Department of Periodontics, Sardar Patel Post
Graduate Institute of Dental & Medical Sciences, Lucknow, Uttar Pradesh,
India. The EthicaL Committee and Review Board of the Institute approved the
study protocol. Total 30 subjects were selected from patients who reported to
the Department of Periodontics. The protocol was clearly explained to all the
patients and informed consent was obtained from all recruits.

Study Population

A total of
30 participants (17 males and 13 females, aged 27-71 years; mean age: 43.90 ±
11.04) meeting the inclusion criteria were included in this study and had full-mouth
periodontal probing done at six sites per tooth.

Inclusion
criteria were : (1).  22-71 years of age
(2). Patients with at
least 20 natural teeth (3). Patients should not have undergone SRP in previous
12 months (4). Patients
with chronic periodontitis .

 Exclusion criteria were : (1). Allergic to
local anesthetics (2).  Patients with
coagulation disorders/or an anticoagulation therapy (3). Patients suffering
from any psychiatric disorder with chronic pain 
(4). Patients
taking non-steroidal anti-inflammatory drugs in 3 days before participation in
the study (5). Patients having acute periodontal pain, pulpitis, abscesses, or
other acute infections (6). Ulcerative lesions in the oral cavity .

 The 30 selected patients were divided into two
groups of 15 subjects each. They are as follows:

Group I: 15 patients with LOX 2% gel

Group II: 15 patients were assessed with
LIGNOCAINE spray for reduction               of pain during periodontal probing.

 

 STATISTICAL ANALYSIS

Data
were summarised as Mean ± SE (standard error of the mean). Groups were compared
by repeated measures two way analysis of variance (ANOVA) and the significance
of mean difference within (intra) and between (inter) groups was done by
Tukey’s HSD (honestly significant difference) post hoc test. A two-tailed (?=2)
p0.05) between
after 2 min and after 5 min i.e. found to be statistically the same.  In contrast, in Group II, it decrease
significantly (p0.05) at after 5
min as compared to baseline.  Conversely,
in Group II, it increase significantly (p0.05)
VAS score between the groups at both baseline and after 5 min. However, at
after 5 min, it was significantly (p