Efficacy of EMLA cream on tooth pulp and soft tissue

Objectives: Topical anesthetic agent, EMLA® (AstraZeneca, Greece) cream was investigated to determine if different volume and application times could produce a degree of pulpal and soft tissue anesthesia. Methods: 40 healthy young volunteers (20-24 y.), were included in this study. The subjects were divided in 2 groups (A,B) of 20 each. Every subject came in 2 appointments one week apart using the same tooth, the periapical region of a healthy maxillary central incisor. In the first appointment of each group (A1, B1) 0.5 g of cream were applied and in the second appointment (A2, B2) 1g. Time of application in group A was 5 min and in group B 10 min. The pulp reaction measurement was made with the aid of a digital pulp tester (Pulppen®, Denmark) while the soft tissue pain reaction was test by means of a pinch with a forcep. The onset and the duration of the anesthesia were recorded in each minute post cream placement at the buccal apex of the tooth. Results: Onset of anesthesia soft tissue (n=20) Α1s 2,550 ±1,050 Α2s 2,150 ±0,745 Β1s 1,600 ±0,598 Β2s 1,450 ±0,605 Duration of anesthesia (n=20) 11,600 ±3,283 15,800 ±2,821 18,650 ±2,739 21,000 ±2,828 Onset of anesthesia pulp Α1p 7,500 ±0,577 Α2p 8,000 ±2,563 Β1p 10,07 ±2,868 Β2p 9,170 ±1,823 Duration of anesthesia 2,250 ±2,500 2,500 ±1,604 2,790 ±2,517 4,940 ±4,383

Conclusion:The results of this study suggest EMLA cream is effective topical anesthetic agent in the soft tissue even in small amounts and short time of application (0.5 g for 5 min) with increased efficacy with more volume and time of application. Pulp anesthesia of a duration of 5 min can also be achieved with 1g of cream for 10 min.