Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
권호 표지
DOI QR코드

DOI QR Code

Topical anesthesia for stainless steel crown tooth preparation in primary molars: a pilot study

  • Received : 2020.05.12
  • Accepted : 2020.07.09
  • Published : 2020.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Placement of full-coverage restorations such as stainless steel crowns (SSCs) for pulpectomy treated primary molars is essential for successful outcomes. The tooth preparation process for SSCs can cause discomfort to gingival tissues since the crown should be seated 1 mm subgingivally. The purpose of this prospective trial was to compare the effectiveness of subgingival and transmucosal application of topical anesthetics on dental pain during SSC tooth preparation among 6- to 8-year-old children. Methods: A consecutive sample of 27 children, aged 6-8 years, who required an SSC after pulp therapy in primary molars were randomly divided into three groups. Group A received infiltration anesthesia before tooth preparation for SSC placement, whereas in Group B and C, only topical anesthesia was applied subgingivally and transmucosally. Wong-Bakers Faces pain rating scale (WBFPS) scores were recorded after tooth preparation. Faces, Legs, Activity, Cry and Consolability (FLACC) scores were evaluated by two blinded and calibrated investigators through video recordings of the patient during tooth preparation. Data were tabulated, and inter-group comparisons were performed using the Kruskal-Wallis and analysis of variance tests. Results: Out of the 27 participants, 48% were boys and 52% were girls, with an overall mean age of 6.83 years. Group A showed the least pain scores according to both the scales, followed by Group B and Group C. The pain intensity was statistically significant on both the pain scales with P = 0.003 for FLACC and P < 0.001 for WBFPS. Conclusion: Subgingival application of topical anesthesia reduced pain to a certain extent but not as effectively as infiltration anesthesia during SSC tooth preparation in primary molars. Transmucosal application of topical anesthesia did not reduce discomfort when compared to the other two interventions.

Keywords

References

  1. Innes NP, Ricketts D, Chong LY, Keightley AJ, Lamont T, Santamaria RM. Preformed crowns for decayed primary molar teeth. Cochrane Database Syst Rev 2015; 12: 1-43.
  2. American Academy of Paediatric Dentistry. Guideline on Paediatric Restorative Dentistry. Reference Manual 2014; 37: 226-34.
  3. Kindelan SA, Day P, Nichol R, Willmott N, Fayle SA, British Society of Paediatric Dentistry stainless steel preformed crowns for primary molars. Int J Paediatr Dent 2008; 18: 20-8. https://doi.org/10.1111/j.1365-263X.2008.00935.x
  4. Seale NS, Randall R. The use of stainless steel crowns: a systematic literature review. Pediatr Dent 2015; 37: 145-60.
  5. Clark L, Wells MH, Harris EF, Lou J. Comparison of amount of primary tooth reduction required for anterior and posterior zirconia and stainless steel crowns. Pediatr Dent 2016; 38: 42-6.
  6. Seale NS. The use of stainless steel crowns. Pediatr Dent 2002; 24: 501-5.
  7. Mathewson RJ, Primosch RE, Robertson D. Stainless Steel crown procedures for posterior primary teeth. Fundamentals of Pediatric Dentistry. 2nd ed. Chicago: Quintessence Publishing Co. 1987, pp 252-66.
  8. Ramazani N, Ranjbar M. Effect of tooth preparation on microleakage of stainless steel crowns placed on primary mandibular first molars with reduced mesiodistal dimension. J Dent (Tehran) 2015; 12: 18-24.
  9. American Academy of Pediatric Dentistry. guideline on use of local anesthesia for pediatric dental patients. Pediatr Dent 2016; 38: 204-10.
  10. Kudo M. Initial injection pressure for dental local anesthesia: effects on pain and anxiety. Anesth Prog 2005; 52: 95-101. https://doi.org/10.2344/0003-3006(2005)52[95:IIPFDL]2.0.CO;2
  11. Wambier LM, de Geus JL, Boing TF, Chibinski ACR, Wambier DS, Rego RO, et al. Intrapocket topical anesthetic versus injected anesthetic for pain control during scaling and root planing in adult patients: Systematic review and meta-analysis. J Am Dent Assoc 2017; 148: 814-24. https://doi.org/10.1016/j.adaj.2017.06.019
  12. Berteretche MV and Hue O. Topical anesthesia for prosthetic implant procedures. J Prosthet Dent 2009; 102: 128-9. https://doi.org/10.1016/S0022-3913(09)60124-4
  13. Yoon RK and Chussid S. Topical anesthesia for rubber dam clamp placement in sealant placement: comparison of lidocaine/prilocaine gel and benzocaine. Pediatr Dent 2009; 31: 377-81.
  14. Wambier LM, Gonzaga CC, Chibinski AC, Wambier DS, Farago PV, Loguercio AD, et al. Efficacy of a Light-cured Tetracaine-based Anesthetic Gel for Rubber Dam Clamp Placement: A Triple-blind Randomized Clinical Trial. Oper Dent 2020; 45: E57-65. https://doi.org/10.2341/18-130-c
  15. Wambier LM, de Geus JL, Boing TF, Brancher JA, Chibinski AC, Wambier DS, et al. A randomized clinical trial evaluating rubber dam clamp pain reduction from a new topical liposomal anesthetic gel. Pediatr Dent 2018; 40: 190-4.
  16. Lim S, Julliard K. Evaluating the efficacy of EMLA topical anesthetic in sealant placement with rubber dam. Pediatr Dent 2004; 26: 497-500.
  17. Al-Melh MA, Andersson L. The effect of a lidocaine/prilocaine topical anesthetic on pain and discomfort associated with orthodontic elastomeric separator placement. Prog Orthod 2017; 18: 1. https://doi.org/10.1186/s40510-016-0156-7
  18. Lacerda-Santos R, Bravin TC, Carvalho FG, Pithon MM, Lima AB, da Silva KG. Efficacy of topical anesthetics in pain perception during mini-implant insertion: systematic review of controlled clinical trials. Anesth Prog 2019; 66: 119-32. https://doi.org/10.2344/anpr-66-01-11
  19. Dayakar MM and Akbar SM. A randomized placebocontrolled trial to evaluate a novel noninjectable anesthetic gel with thermosetting agent during scaling and root planing in chronic periodontitis patients. Saudi J Anaesth 2016; 10: 192-7. https://doi.org/10.4103/1658-354X.168823
  20. Lee HS. Recent advances in topical anesthesia. J Dent Anesth Pain Med 2016; 16: 237-44. https://doi.org/10.17245/jdapm.2016.16.4.237
  21. Boyce RA, Kirpalani T, Mohan N. Updates of topical and local anesthesia agents. Dent Clin North Am 2016; 60: 445-71. https://doi.org/10.1016/j.cden.2015.12.001
  22. Franz-Montan M, Ribeiro LNM, Volpato MC, Cereda CM, Groppo FC, Tofoli GR, et al. Recent advances and perspectives in topical oral anesthesia. Expert Opin Drug Deliv 2017; 14: 673-84. https://doi.org/10.1080/17425247.2016.1227784
  23. Kravitz ND. The use of compound topical anesthetics: a review. J Am Dent Assoc 2007; 138: 1333-9. https://doi.org/10.14219/jada.archive.2007.0048
  24. Berini Aytes L, Gay Escoda C. Anestesia Odontologica. 2th ed. Madrid: Avances; 2000. pp. 150-230.
  25. Nakamura S, Matsuura N, Ichinohe T. A new method of topical anesthesia by using anesthetic solution in a patch. J Endod 2013; 39: 1369-73. https://doi.org/10.1016/j.joen.2013.07.019
  26. Kreider KA, Stratmann RG, Milano M, Agostini FG, Munsell M. Reducing children's injection pain: lidocaine patches versus topical benzocaine gel. Pediatr Dent 2001; 23: 19-23.
  27. Wu SJ, Julliard K. Children's preference of benzocaine gel versus the lidocaine patch. Pediatr Dent 2003; 25: 401-5.
  28. Shehab LA, Basheer B, Baroudi K. Effectiveness of lidocaine Denti $patch^{(R)}$ system versus lidocaine gel as topical anesthetic agent in children. J Indian Soc of Pedod and Prev Dent 2015; 33: 285-90. https://doi.org/10.4103/0970-4388.165664
  29. Leopold A, Wilson S, Weaver JS, Moursi AM. Pharmacokinetics of lidocaine delivered from a transmucosal patch in children. Anesth Prog 2002; 49: 82-7.
  30. Stecker SS, Swift JQ, Hodges JS, Erickson PR. Should a mucoadhesive patch (DentiPatch) be used for gingival anesthesia in children? Anesth Prog 2002; 49: 3-8.
  31. Kumar S, Madurantakam P. Topical intra-pocket anaesthetic gel reduces the risk and intensity of pain during periodontal scaling and root planing and probing. Evid Based Dent 2017; 18: 111-2. https://doi.org/10.1038/sj.ebd.6401271
  32. Oulis CJ, Vadiakas GP, Vasilopoulou A. The effectiveness of mandibular infiltration compared to mandibular block anesthesia in treating primary molars in children. Pediatr Dent 1996; 18: 301-5.
  33. Wynn RL, Meiller TF, Crossley HL. Drug information handbook for dentistry: oralmedicine for medicallycompromised patients & specific oral conditions. 7th edition. Hudson (OH): Lexi-Comp Inc; 2002. p 352.
  34. Kishimoto T, Matsuura N, Kasahara M, Ichinohe T. Effect of topical anesthesia using an adhesive patch and anesthetic solution. Anesth Prog 2017; 64: 73-9. https://doi.org/10.2344/anpr-64-02-05
  35. Rosivack RG, Koenigsberg SR, Maxwell KC. An analysis of the effectiveness of two topical anesthetics. Anesth Prog 1990; 37: 290-2.
  36. Alqareer A, Alyahya A, Andersson L. The effect of clove and benzocaine versus placebo as topical anesthetics. J Dent 2006; 34: 747-50. https://doi.org/10.1016/j.jdent.2006.01.009
  37. Rosa AL, Sverzut CE, Xavier SP, Lavrador MA. Clinical effectiveness of lidocaine and benzocaine for topical anesthesia. Anesth Prog 1999; 46: 97-9.
  38. Al-Melh MA, Andersson L. Comparison of topical anesthetics (EMLA/Oraqix vs. benzocaine) on pain experienced during palatal needle injection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007; 103: e16-20. https://doi.org/10.1016/j.tripleo.2006.11.033
  39. Lamberton JA, Oesterle LJ, Shellhart WC, Newman SM, Harrell RE, Tilliss T, et al. Comparison of pain perception during miniscrew placement in orthodontic patients with a visual analog scale survey between compound topical and needle-injected anesthetics: a crossover, prospective, randomized clinical trial. Am J Orthod Dentofacial Orthop 2016; 149: 15-23. https://doi.org/10.1016/j.ajodo.2015.08.013
  40. Valieri MM, De Freitas KMS, Valarelli FP, Cancado RH. Comparison of topical and infiltration anesthesia for orthodontic mini-implant placement. Dental Press J Orthod 2014; 19: 76-83. https://doi.org/10.1590/2176-9451.19.2.076-083.oar
  41. Hersh EV, Houpt MI, Cooper SA, Feldman RS, Wolff MS, Levin LM. Analgesic efficacy and safety of an intraoral lidocaine patch. J Am Dent Assoc 1996; 127: 1626-34. https://doi.org/10.14219/jada.archive.1996.0098
  42. Taware CP, Mazumdar S, Pendharkar M, Adani MH, Devarajan PV. A bioadhesive delivery system as an alternative to infiltration anesthesia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 84: 609-15. https://doi.org/10.1016/S1079-2104(97)90360-7
  43. Carr MP, Horton JE. Evaluation of a transoral delivery system for topical anesthesia. J Am Dent Assoc 2001; 132: 1714-9. https://doi.org/10.14219/jada.archive.2001.0127