The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 22 , ISSUE 6 ( June, 2021 ) > List of Articles

ORIGINAL RESEARCH

Comparison between Topical and Injection Anesthetics on Pain Related to Orthodontic Miniscrew Placement: A Split-mouth Study

Manal A Al-Melh, Hanan Badr, Lars Andersson

Citation Information : Al-Melh MA, Badr H, Andersson L. Comparison between Topical and Injection Anesthetics on Pain Related to Orthodontic Miniscrew Placement: A Split-mouth Study. J Contemp Dent Pract 2021; 22 (6):637-643.

DOI: 10.5005/jp-journals-10024-3107

License: CC BY-NC 4.0

Published Online: 09-08-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aims and objectives: The aims of this study were to compare the anesthetic effect of a lidocaine/prilocaine (L/P) topical anesthetic with placebo on pain from needle sticks and to compare the anesthetic effect of the L/P topical anesthetic with an infiltrative anesthetic on pain from orthodontic miniscrew placement. Materials and methods: Pain elimination was analyzed from two interventions: (a) needle stick and (b) miniscrew insertion. When assessing pain from needle stick, one side of the mandible received 2.5% lidocaine/2.5% prilocaine topical anesthetic, and the other side received placebo. When evaluating pain from miniscrew placement, one side of the mandible received L/P topical anesthetic and the other side received infiltrative anesthetic. The findings were recorded on a Visual Analogue Scale after needle stick and after miniscrew placement. Subjective assessment was analyzed by a questionnaire. Results: The L/P topical anesthetic significantly eliminated the pain from needle stick (Mann–Whitney test of medians, 29.0 vs 0.0, respectively, p<0.001). However, the injection anesthetic eliminated the pain from the miniscrew placement better than the L/P topical anesthetic (Mann–Whitney test of medians, 0.0 vs 5.5, respectively, p<0.001). Eighty percent of the subjects felt more comfortable with L/P topical anesthetic than injection anesthetic. Pain from needle stick pain was reported to be the most uncomfortable part of the study. Conclusion: The L/P topical anesthetic efficiently eliminated pain from needle stick. The L/P topical anesthetic did not completely eliminate pain from miniscrew placement as the injection anesthesia, but it did reduce pain to tolerable levels. Clinical significance: L/P topical anesthetics can significantly eliminate pain from needle stick injections, and L/P topical anesthetics can reduce pain from orthodontic miniscrew placement to tolerable levels.


HTML PDF Share
  1. Carano A, Velo S, Leone P, et al. Clinical applications of the Miniscrew Anchorage System. J ClinOrthod 2005;39(1):9–24. PMID: 15735349.
  2. Baumgaertel S, Razavi MR, Hans MG. Mini-implant anchorage for the orthodontic practitioner. Am J Orthod Dentofacial Orthop 2008;133(4):621–627. DOI: 10.1016/j.ajodo.2007.03.022.
  3. Lee JS, Park HS, Kyung HM. Micro-implant anchorage for lingual treatment of a skeletal Class II malocclusion. J Clin Orthod 2001;35(10):643–647. PMID: 11764608.
  4. Buschang PH, Carrillo R, Ozenbaugh B, et al. 2008 survey of AAO members on miniscrew usage. J ClinOrthod 2008;42(9):513–518. PMID: 18974458.
  5. Kanomi R. Mini-implant for orthodontic anchorage. J Clin Orthod 1997;31(11):763–767. PMID: 9511584.
  6. Kravitz ND, Kusnoto B. Placement of mini-implants with topical anesthetic. J Clin Orthod 2006;40(10):602–604. PMID:17062912.
  7. Graham JW. Profound, needle-free anesthesia in orthodontics. J ClinOrthod 2006;40(12):723–724. PMID: 17261909.
  8. Baumgaertel S. Compound topical anesthetics in orthodontics:putting the facts into perspective. Am J Orthod Dentofacial Orthop2009;135(5):556–557. DOI: 10.1016/j.ajodo.2009.01.001.
  9. Reznik DS, Jeske AH, Chen JW, et al. Comparative efficacy of 2 topical anesthetics for the placement of orthodontic temporary anchorage devices. AnesthProg 2009;56(3):81–85. DOI: 10.2344/0003-3006-56.3.81.
  10. Friedman PM, Mafong EA, Friedman ES, et al. Topical anesthetics update: EMLA and beyond. DermatolSurg 2001;27(12):1019–1026. PMID: 11849263. DOI: 10.1046/j.1524-4725.2001.01855.x.
  11. Meechan JG. The use of EMLA for an intraoral soft-tissue biopsy in a needle phobic: a case report. Anesth Prog 2001;48(1):32–34. PMID: 11495404.
  12. Donaldson D, Gelskey SC, Landry RG, et al. A placebo-controlled multi-centred evaluation of an anaesthetic gel (Oraqix) for periodontal therapy. J Clin Periodontol 2003;30(3):171–175. DOI: 10.1034/j.1600-051x.2003.00017.x.
  13. Friskopp J, Nilsson M, Isacsson G. The anesthetic onset and duration of a new lidocaine/prilocaine gel intra-pocket anesthetic (Oraqix) for periodontal scaling/root planning. J Clin Periodontol 2001;28(5):453–458. DOI: 10.1034/j.1600-051x.2001.028005453.x.
  14. Al-Melh MA, Andersson L, Behbehani E. Reduction of pain from needle stick in the oral mucosa by topical anaesthetics: a comparative study between lidocaine/prilocaine and benzocaine. J Clin Dent 2005;16(2):1–4. PMID: 16170977.
  15. 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(5):e16–e20. DOI: 10.1016/j.tripleo.2006.11.033.
  16. Al-Melh MA, Andersson L. Reducing pain from palatal needle stick by topical anesthetics: a comparative study between two lidocaine/prilocaine substances. J Clin Dent 2008;19(2):43–47. PMID: 18763685.
  17. Al-Asfour A, Al-Melh M, Andersson L, et al. Healing pattern of experimental soft tissue lacerations after application of novel topical anesthetic agents - an experimental study in rabbits. Dent Traumatol 2008;24(1):27–31. DOI: 10.1111/j.1600-9657.2006.00482.x.
  18. Musawi AA, Andersson L. Use of topical as only anesthetic for suturing a traumatic facial laceration. Dent Traumatol 2010;26(3):292–293. DOI: 10.1111/j.1600-9657.2010.00881.x.
  19. Al-Melh M, Andersson L. The effect of a lidocaine/prilocainetopical anesthetic on pain and discomfort associated with orthodontic elastomeric separator placement. ProgOrthod 2017;18(1):1. DOI: 10.1186/s40510-016-0156-7.
  20. Lacerda-Santos R, Bravin TC, Carvalho FG, et al. Efficacy of topical anesthetics in pain perception during mini-implant insertion: systematic review of controlled clinical trials. AnesthProg 2019;66(3):119–132. DOI: 10.2344/anpr-66-01-11.
  21. Kwong TS, Kusnoto B, Viana G, et al. The effectiveness of Oraqix versus TAC (a) for placement of orthodontic temporary anchorage devices. Angle Orthod2011;81(5):754–759. DOI: 10.2319/020811-91.1.
  22. Lamberton JA, Oesterle LJ, Shellhart WC, 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: acrossover, prospective, randomized clinical trial. Am J Orthod Dentofacial Orthop 2016;149(1):15–23. DOI: 10.1016/j.ajodo.2015.08.013.
  23. Valieri MM, Freitas, Valarelli FP, et al. Comparison of topical and infiltration anesthesia for orthodontic mini-implant placement. Dental Press J Orthod 2014;19(2):76–83. DOI: 10.1590/2176-9451. 19.2.076-083.oar.
  24. Park J, Cho HJ. Three-dimensional evaluation of interradicular spaces and cortical bone thickness for the placement and initial stability of microimplants in adults. Am J Orthod Dentofacial Orthop 2009;136(3):314. DOI: 10.1016/j.ajodo.2009.01.023.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.