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Kovanaze Vs. Articaine in Achieving Pulpal Anesthesia of Maxillary Teeth - Endodontics

Phase 2
Withdrawn
Conditions
Apical Periodontitis
Caries,Dental
Interventions
Registration Number
NCT04105985
Lead Sponsor
Virginia Commonwealth University
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

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
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.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Articaine Injections (endodontics)Articaine InjectionAdults (\>18 years) who require non-surgical root canal treatment in maxillary anterior teeth
Kovanaze Nasal Spray (endodontics)Kovanaze Nasal SprayAdults (\>18 years) who require non-surgical root canal treatment in maxillary anterior teeth
Primary Outcome Measures
NameTimeMethod
Success rate of pupal anesthesiaimmediately after dental procedure, an average of 3 hours

% dental procedures completed without the need for rescue anesthesia

Secondary Outcome Measures
NameTimeMethod
Spread of anesthesiaimmediately after dental procedure, an average of 3 hours

Number of teeth anesthetized in maxillary arch

Change in Anxiety levelfrom 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 pressurefrom baseline to immediately after dental procedure
Change in heart ratefrom baseline to immediately after dental procedure
Change in painfrom baseline to immediately after dental procedure

Heft-Parker visual analog scale rated from none (0mm) to maximum possible (170mm)

Satisfaction with Kovanazeimmediately 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 effects24 hours

Phone survey asking about any side effects experienced from the anesthesia

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