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Anxious patients frequently delay dental visits until their pain becomes severe, which further heightens their anxiety. Buccal patches offer a noninvasive way to deliver anesthetics, potentially easing these concerns. Previous studies highlighted the effectiveness of topical Lidocaine and Articaine, prompting this randomized controlled trial to develop an optimized buccal drug delivery system.
For dental procedures, Lidocaine-loaded patches provide superior pain relief and a quicker onset compared to Articaine-loaded patches. However, Articaine sustains its effect for a longer period.
Anxious patients frequently delay dental visits until their pain becomes severe, which further heightens their anxiety. Buccal patches offer a noninvasive way to deliver anesthetics, potentially easing these concerns. Previous studies highlighted the effectiveness of topical Lidocaine and Articaine, prompting this randomized controlled trial to develop an optimized buccal drug delivery system.
Researchers created and optimized three-layered patches loaded with Lidocaine or Articaine using Design-Expert software. They investigated the effects of Ethylcellulose, Eudragit polymer, and Carbopol concentrations on key patch properties, such as mucoadhesion and elasticity. The efficacy of the optimized patches was then tested in a randomized, double-blind clinical trial where pain levels were evaluated on a visual analogue scale (VAS) after receiving either Lidocaine or Articaine compared to a placebo.
Increasing the concentrations of Ethylcellulose and Eudragit enhanced mucoadhesion, while increasing Ethylcellulose and reducing Eudragit increased the Young’s modulus. Increasing the amount of Carbopol and reducing the amount of Eudragit markedly improved the elongation at break of the patch (better stretchability). The optimized formulation included 4.72% Ethylcellulose, 2% Carbopol, and 5% Eudragit. Participants using Lidocaine-loaded patches reported lower VAS scores and faster onset of action when compared to those using Articaine. However, Articaine provided a longer duration of effect.
When compared to Articaine-loaded formulation, the Lidocaine-loaded three-layered buccal patch formulation proved more effective in alleviating injection pain, suggesting a promising new approach to improving patient comfort in dental care.
Heliyon
Optimization and comparison of unidirectional lidocaine-loaded buccal patch with the articaine-loaded buccal patch to reduce injection pain and increment of patients' compliance in dental procedures: A double-blind randomized controlled trial
Elham Panahandeh et al.
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