Apical Periodontitis, Caries,Dental
Conditions
Keywords
Necrotic teeth, root canals
Brief summary
The primary goal of the study is to compare the success rates of pulpal anesthesia (defined as ability to complete the intended dental procedure without the need for rescue anesthesia) between Kovanaze nasal mist and Articaine needle anesthesia.
Detailed description
In June 2016, an intranasal delivery system of local anesthesia called Kovanaze, gained FDA approval. \[9\] Kovanaze is available as a 0.2 ml metered spray and is intended to achieve pulpal anesthesia of 5 maxillary teeth on either side of the face. With the ability to avoid the traditional painful injection Kovanaze offers promise in the field of maxillary anesthesia and this study intends to: 1. Compare Kovanaze to conventional needle anesthetic for procedures other than fillings and/or involving multiple teeth in adults 2. Evaluate patient anxiety, tolerance and acceptability of Kovanaze in patients undergoing dental procedures
Interventions
Intra-nasal local anesthetic
Local anesthetic
Sponsors
Virginia Commonwealth University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* American Society of Anesthesiologists Class I or II * Preoperative heart rate of 55 to 100 beats per minute * Maximum blood pressure reading of 166/100 mmHg * Treatment for a pathology in the maxillary anterior tooth or premolar that requires administering local anesthesia * Adults (\>18 years) who require non-surgical root canal treatment in maxillary anterior teeth
Exclusion criteria
* Inadequately controlled thyroid disease * Five or more nosebleeds in the past month * Known allergy to any study drug or para-aminobenzoic acid * History of methemoglobinemia * Taking monoamine oxidase inhibitors, tricyclic antidepressants (i.e. amitriptyline), or non-selective beta adrenergic antagonists (i.e. propranolol); * Taking oxymetazoline-containing products (i.e., Afrin) in the last 24 hours.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Success rate of pupal anesthesia | immediately after dental procedure, an average of 3 hours | % dental procedures completed without the need for rescue anesthesia |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in heart rate | from baseline to immediately after dental procedure | — |
| Spread of anesthesia | immediately after dental procedure, an average of 3 hours | Number of teeth anesthetized in maxillary arch |
| Change in Anxiety level | from baseline to immediately after dental procedure | Modified Dental Anxiety Scale - 5 item questionnaire assessing dental visit related anxiety on a 5 point scale ranging from 1 (not anxious) to 5 (extremely anxious). Scores range from 5 to 25. |
| Change in Blood pressure | from baseline to immediately after dental procedure | — |
| Satisfaction with Kovanaze | immediately after dental procedure, an average of 3 hours | 8-item questionnaire with a variety of scales designed to measure satisfaction with Kovanaze |
| Number of post treatment anesthesia side effects | 24 hours | Phone survey asking about any side effects experienced from the anesthesia |
| Change in pain | from baseline to immediately after dental procedure | Heft-Parker visual analog scale rated from none (0mm) to maximum possible (170mm) |
Outcome results
None listed