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Comparison of Intranasal Kovacaine Mist, Tetracaine Alone, and Placebo for Anesthetizing Maxillary Teeth in Adults

Phase 3
Completed
Conditions
Anesthesia
Interventions
Registration Number
NCT01710787
Lead Sponsor
St. Renatus, LLC
Brief Summary

The purpose of this study is to compare the efficacy of Kovacaine Mist, Tetracaine only, and Placebo for inducing pulpal anesthesia of the maxillary teeth in adults.

Detailed Description

The study will employ a multi-center, randomized, double-blind, placebo-controlled, parallel-groups design to assess the safety and efficacy of Kovacaine Mist delivered intranasally for inducing pulpal anesthesia of maxillary teeth numbers 4 to 13 (maxillary right second premolar to maxillary left second premolar) sufficient to allow completion of the Study Dental Procedure.

The intent is to treat 110 subjects, with enrollment balanced evenly between the 2 study sites, 2:2:1 randomization within each study site and an overall goal of 44 subjects treated with Kovacaine Mist, 44 treated with Tetracaine alone, and 22 treated with Placebo. Recruitment will be from diverse dental patient populations.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
110
Inclusion Criteria
  • Male or female 18 years of age or older.
  • Need for an operative restorative dental procedure requiring local anesthesia for a single vital maxillary tooth (other than a maxillary first, second, or third molar) with no evidence of pulpal pathology.
  • Normal lip, nose, eyelid, and cheek sensation.
  • Able to understand and sign the study informed consent document, communicate with the investigators, and understand and comply with the requirements of the protocol.
  • Patency of the naris ipsilateral to the tooth undergoing the Study Dental Procedure.
  • Resting heart rate (HR) between 55 and 100 beats per minute (bpm), inclusive.
  • Seated systolic blood pressure (SBP) between 95 and 140 mm Hg, inclusive and seated diastolic blood pressure (DBP) between 60 and 90 mm Hg, inclusive.
Exclusion Criteria
  • Inadequately controlled hypertension (blood pressure greater than 140/90 mm Hg).
  • Inadequately controlled active thyroid disease of any type.
  • Frequent nose bleeds (≥ 5 per month).
  • Having received dental care requiring a local anesthetic within the last 24 hours.
  • History of allergy to or intolerance of tetracaine, benzyl alcohol, other ester local anesthetics, or para-aminobenzoic acid (as found in PABA-containing sunscreen).
  • History of allergy or hypersensitivity to articaine, oxymetazoline, epinephrine, or sulfite preservatives.
  • Use of a monoamine oxidase inhibitor within the 3 weeks preceding study entry.
  • Nursing, pregnant, suspected of being pregnant, or trying to become pregnant. (Females of child-bearing potential will be required to take a urine pregnancy test on the day of, but prior to, study drug administration to rule out pregnancy.)
  • Having received any investigational drug and/or participation in any clinical trial within 30 days prior to study participation.
  • Having used oxymetazoline or phenylephrine nasal spray, nasal irrigation, or other nasal or oral decongestant on the day of the study procedure.
  • History of congenital or idiopathic methemoglobinemia

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Kovacaine Mist, 3 sprays unilateralTetracaine HCl 3% and Oxymetazoline HCl 0.05%Tetracaine HCl 3% and Oxymetazoline HCl 0.05%
Placebo, 3 sprays unilateralPlaceboPlacebo
Tetracaine Only, 3 sprays unilateralTetracaine HCl 3%Tetracaine HCl 3%
Primary Outcome Measures
NameTimeMethod
Number of Participants Who Completed the Study Dental Procedure After Without Need for Rescue by Injection of Local Anesthetic.at 15 minutes with a 3 minute window

If the participant does not have sufficient anesthesia to complete the Study Dental Procedure, the participant is given a rescue injection of local anesthetic and is considered a failure for this outcome.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With a Heart Rate Higher Than 125 Bpmat any time within 120 minutes following drug administration
Number of Participants With a Heart Rate Lower Than 50 Bpmat any time within 120 minutes following drug administration
Absolute Maximum Change From Baseline in Heart Ratefrom baseline to 120 minutes following drug administration
Number of Participants With an Increase From Baseline in Systolic Blood Pressure Greater Than or Equal to 25 mm Hg and to a Value Higher Than 160 mm Hgat any time within 120 minutes following drug administration
Intraoral Soft-tissue Anesthesia (Yes/no)at Baseline, 15, 30, 45, 60, 90, and 120 minutes with a 3 minute window

Number of patients who reported no pain when incisive papilla soft-tissue was tested with a probe at designated timepoints

Number of Participants With a Decrease From Baseline in Systolic Blood Pressure Greater Than or Equal to 15 mm Hg and to a Value Lower Than 90 mm Hgat any time within 120 minutes following drug administration
Number of Participants With an Increase From Baseline in Diastolic Blood Pressure Greater Than or Equal to 15 mm Hg and to a Value Higher Than 105 mm Hgat any time within 120 minutes following drug administration
Number of Participants With a Decrease From Baseline in Diastolic Blood Pressure Greater Than or Equal to 10 mm Hg and to a Value Lower Than 50 mm Hgat any time within 120 minutes following drug administration
Absolute Maximum Change From Baseline in Systolic Blood Pressurefrom baseline to 120 minutes following drug administration
Absolute Maximum Change From Baseline in Diastolic Blood Pressurefrom baseline to 120 minutes following drug administration
The Profile Over Time of Heart Ratefrom baseline to 120 minutes following drug administration
The Profile Over Time of Systolic Blood Pressurefrom baseline to 120 minutes following drug administration
The Profile Over Time of Diastolic Blood Pressurefrom baseline to 120 minutes following drug administration
Alcohol Sniff Testadministered at baseline, 120 minutes and approximately 24 hours after drug administration

The distance from the nose (in centimeters) that a patient is able to detect the smell of alcohol on an alcohol swab.

Intraoral Soft-tissue Anesthesia (Onset and Duration)up to 120 mins post-dose

Mean onset and duration of incisive papilla anesthesia based on number of patients who reported no pain when soft-tissue was tested with a probe at designated timepoints

Trial Locations

Locations (3)

University of Buffalo

🇺🇸

Buffalo, New York, United States

Jean Brown Research

🇺🇸

Salt Lake City, Utah, United States

Family and Cosmetic Dentistry

🇺🇸

Salt Lake City, Utah, United States

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