Effectiveness of a transmucosal lidocaine delivery system for local anaesthesia during scaling and root planing

Objective: This study compared the efficacy of transmucosal anaesthetic patches containing lidocaine (46.1 mg/2 cm²) to placebo for local anaesthesia during quadrant scaling and root planing using periodontal clinical indices and patient perception of pain. Material and Methods: Forty healthy adults with moderate periodontal disease and moderate subgingival calculus were scaled at weekly intervals, two quadrants randomized to treatment patches and two quadrants randomized to placebo patches. Bleeding, probing depths and attachment levels were evaluated prior to treatment and 1 month after quadrant scaling was completed. Subjects completed 100mm visual analogue pain scales 15 min. after patch placement and at the end of treatment, and were asked for verbal assessment of perceived pain. Results: Subjects' verbal ratings demonstrated consistently greater pain relief with active patches than placebo (p < 0.0001). Visual analogue scales demonstrated significantly greater pain relief with the treatment patches after 15 min. (p = 0.0003) and at the end of treatment (p = 0.0149). Efficacy of periodontal therapy was equivalent for treatment and control groups. No adverse events were observed; localized minimal gingival irritation was noted in three subjects. Conclusion: Transmucosal lidocaine patches provided sufficient anaesthesia for therapeutic quadrant scaling and root planing procedures.