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.
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. Even though success rates between 83 and 90 % have been reported for adults and children \>40kg, \[10\] FDA label (Section 14.2) provides data for children (\>10 kg) indicating that the drug is safe for use in children as long as the dose is adjusted to bodyweight of the child. \[9\] * One 0.1 mL spray for patients weighing 10 kg to less than 20 kg; * Two 0.1 mL sprays for 20 kg to less than 40 kg; or * Two 0.2 mL sprays for patients weighing 40 kg or more. 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 children (at least 6 years of age and weighing \> 20 kg) 2. Evaluate patient anxiety, tolerance and acceptability of Kovanaze in patients undergoing dental procedures
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
3
Intra-nasal local anesthetic
Local anesthetic
Virginia Commonwealth University
Richmond, Virginia, United States
Success Rate of Pupal Anesthesia
% dental procedures completed without the need for rescue anesthesia
Time frame: immediately after dental procedure, an average of 3 hours
Spread of Anesthesia
Number of teeth anesthetized in maxillary arch
Time frame: immediately after dental procedure, an average of 3 hours
Change in Anxiety Level
STAI-Y6 - 6 item youth questionnaire assessing anxiety on a 4 point scale ranging from 1 (Not at all) to 4 (very much). Scores range from 6 to 24.
Time frame: from baseline to immediately after dental procedure
Anxiety
Venham Behavior rating scale - single item 6 point scale used by provider to rate child's behavior during treatment. Item ranges from 0 (no protest) to 5 (high protest, no cooperation from child)
Time frame: immediately after dental procedure, an average of 3 hours
Change in Blood Pressure
Time frame: from baseline to immediately after dental procedure
Change in Heart Rate
Time frame: from baseline to immediately after dental procedure
Change in Pain
Emoji scale ranging from 1 (very negative face) to 7 (very positive face)
Time frame: from baseline to immediately after dental procedure
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