The efficacy of eutectic mixture of local anesthetics as a topical anesthetic agent used for dental procedures: A brief review

Daneshkazemi, Alireza; Abrisham, Seyed Mohammad Jalil; Daneshkazemi, Pedram; Davoudi, Amin

doi:10.4103/0259-1162.172342

Cited by 19 publications

(10 citation statements)

References 23 publications

(35 reference statements)

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“…The ultimate goal is to produce potent mixtures of local anesthetics to be used in procedures or surgeries that cause minimal or considerable pain. Such mixtures have lower melting points, which in turn promotes easier absorption of the EMLA into the oral mucous membrane [ 15 ].…”

Section: Eutectic Mixtures Of Local Anesthesia (Emla) Creammentioning

confidence: 99%

Recent advances in topical anesthesia

Lee

2016

J Dent Anesth Pain Med

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Topical anesthetics act on the peripheral nerves and reduce the sensation of pain at the site of application. In dentistry, they are used to control local pain caused by needling, placement of orthodontic bands, the vomiting reflex, oral mucositis, and rubber-dam clamp placement. Traditional topical anesthetics contain lidocaine or benzocaine as active ingredients and are used in the form of solutions, creams, gels, and sprays. Eutectic mixtures of local anesthesia cream, a mixture of various topical anesthetics, has been reported to be more potent than other anesthetics. Recently, new products with modified ingredients and application methods have been introduced into the market. These products may be used for mild pain during periodontal treatment, such as scaling. Dentists should be aware that topical anesthetics, although rare, might induce allergic reactions or side effects as a result of an overdose. Topical anesthetics are useful aids during dental treatment, as they reduce dental phobia, especially in children, by mitigating discomfort and pain.

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Section: Eutectic Mixtures Of Local Anesthesia (Emla) Creammentioning

confidence: 99%

Recent advances in topical anesthesia

Lee

2016

J Dent Anesth Pain Med

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“…Lidocaine (LDC) and prilocaine (PLC) are amine-amide local anesthetics (LAs) widely used in biomedical procedures worldwide 1 . When these LAs are combined, they form an eutectic mixture that is commercially available as EMLA, a topical formulation originally designed for dermal use, with proven effectiveness inside the oral cavity 3 . However, the formulation also presents organoleptic characteristics such as a bitter taste (pH = 9.0) and a burning sensation during application, which can hinder its acceptance by patients 2 .…”

Section: Introductionmentioning

confidence: 99%

Hybrid Hydrogel Composed of Polymeric Nanocapsules Co-Loading Lidocaine and Prilocaine for Topical Intraoral Anesthesia

Muniz

Baratelli

Carla

et al. 2018

Sci Rep

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This study reports the development of nanostructured hydrogels for the sustained release of the eutectic mixture of lidocaine and prilocaine (both at 2.5%) for intraoral topical use. The local anesthetics, free or encapsulated in poly(ε-caprolactone) nanocapsules, were incorporated into CARBOPOL hydrogel. The nanoparticle suspensions were characterized in vitro in terms of particle size, polydispersity, and surface charge, using dynamic light scattering measurements. The nanoparticle concentrations were determined by nanoparticle tracking analysis. Evaluation was made of physicochemical stability, structural features, encapsulation efficiency, and in vitro release kinetics. The CARBOPOL hydrogels were submitted to rheological, accelerated stability, and in vitro release tests, as well as determination of mechanical and mucoadhesive properties, in vitro cytotoxicity towards FGH and HaCaT cells, and in vitro permeation across buccal and palatal mucosa. Anesthetic efficacy was evaluated using Wistar rats. Nanocapsules were successfully developed that presented desirable physicochemical properties and a sustained release profile. The hydrogel formulations were stable for up to 6 months under critical conditions and exhibited non-Newtonian pseudoplastic flows, satisfactory mucoadhesive strength, non-cytotoxicity, and slow permeation across oral mucosa. In vivo assays revealed higher anesthetic efficacy in tail-flick tests, compared to a commercially available product. In conclusion, the proposed hydrogel has potential for provision of effective and longer-lasting superficial anesthesia at oral mucosa during medical and dental procedures. These results open perspectives for future clinical trials.

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“…Also, as a side observation, although the gels had a pleasant taste, as far as the strawberry aroma was concerned, good aspiration control was still needed to prevent saliva from spreading the gels into unwanted areas, which could annoy the subjects. In fact, a topical anesthetic that stays in place and prevents unpleasant taste is preferable for both the patient and the dentist, characteristics that the experimental patch evidenced thanks to the excellent muco-adhesiveness and the small size, which allowed its excellent adaptability in every area of the buccal mucosa, compared to other patches studied, in which the major defects were precisely the size and the poor adhesiveness [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Benzocaine requires high concentrations, ranging from 10 to 20%, to have an anesthetic effect and has low solubility. Alternatively, eutectic mixtures of local anesthesia (EMLA) can be used, in which multiple anesthetic molecules are combined to improve their characteristics [ 16 ]. Eutectic mixtures are compounds (5% oil in water emulsion cream with 25 mg/mL of lidocaine, 25 mg/mL of prilocaine) that melt at lower temperatures than any of their components, permitting higher concentrations of anesthetics for use.…”

Section: Introductionmentioning

confidence: 99%

Clinical Efficacy and Tolerability of a New Experimental Mucoadhesive Patch for Topical Anesthesia of Oral Mucosa in Pediatric Dentistry

Ferrazzano,

Di Fabio,

Caruso

et al. 2024

JCM

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Background: The injection of local anesthetics is the procedure that still causes the most fear and anxiety in a dental session; to minimize this problem, we can use topical anesthesia. The aim of this study is to analyze the tolerability and the clinical efficacy in the control of pain, during the subsequent injection of the local anesthetic, of an experimental anesthetic patch with a new formulation, which was previously tested in gel formula. Methods: A total of 150 children, aged 4 to 9 years, were included in the study. Each patient was treated using three different pre-anesthesia methods (placebo gel, experimental gel, and experimental patch), according to a split-mouth procedure, within a week of each other. The injection pain was analyzed using the WBFPRS and FLACC scales. Patients’ caregivers’ satisfaction was recorded at the end of the procedures. The data were analyzed using one-way ANOVA-RM, Wilcoxon–Mann–Whitney, Mann–Whitney U, and χ2 tests. Results: In this study, significantly higher pain ratings were observed with the topical placebo gel and lower pain ratings were observed with the experimental patch. Conclusion: The use of the patch proved to be very effective in reducing pain both subjectively and objectively, in the absence of both local and systemic side effects, validating its use in the oral mucosa.

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The efficacy of eutectic mixture of local anesthetics as a topical anesthetic agent used for dental procedures: A brief review

Cited by 19 publications

References 23 publications

Recent advances in topical anesthesia

Recent advances in topical anesthesia

Hybrid Hydrogel Composed of Polymeric Nanocapsules Co-Loading Lidocaine and Prilocaine for Topical Intraoral Anesthesia

Clinical Efficacy and Tolerability of a New Experimental Mucoadhesive Patch for Topical Anesthesia of Oral Mucosa in Pediatric Dentistry

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