Comparative efficacy of different anesthetic techniques on pain perception during nonsurgical periodontal treatment: A parallel, blinded, randomized controlled trial

Background: Nonsurgical periodontal treatment improves clinical parameters; however, the procedure is often associated with patient discomfort. Pain control should be considered during periodontal instrumentation. This study evaluated pain perception during periodontal instrumentation using computerized anesthesia versus a noninvasive lidocaine/prilocaine gel. Materials and Methods: A parallel, blinded, randomized, clinical trial included 76 volunteers receiving either invasive anesthesia with a computerized device, or noninvasive anesthesia with lidocaine/prilocaine gel during nonsurgical periodontal instrumentation. Pain perception was assessed using an 11-point Numerical Rating Scale and anxiety with the Modified Dental Anxiety Scale. Anesthetic supplementation needs were recorded, and hemodynamic parameters were measured before and after anesthesia. Statistical analyses used the t -test or Mann–Whitney test for quantitative variables. Qualitative variables were analyzed using the Chi-square test (α = 0.05). Results: Participants included 45 women and 31 men (mean age of 44.2 ± 12.9 years), with no significant differences in age or sex between groups. Pain intensity was similar between groups. Anxiety was similar among participants, most having low anxiety ( P > 0.05). The need for supplementary anesthesia differed significantly between groups. All patients (38; 100%) in the noninvasive group required additional anesthesia. In the invasive group, only nine patients (24%) required additional anesthesia ( P < 0.001). Systolic and diastolic blood pressure, along with oxygen saturation, remained stable, with no relevant variations among the study groups. Conclusion: Both techniques provided similar pain control during periodontal instrumentation; however, the noninvasive gel required significantly more supplementary anesthesia in comparison with the computerized-controlled system. Pretreatment anxiety levels were low and comparable between groups.