Comparison of efficacy and pain perception using 0.5% Bupivacaine and 2% Lidocaine in periodontal Surgery - A split mouth randomized clinical trial.

Purpose: To evaluate the effectiveness of bupivacaine and lidocaine local anesthesia on the intra-surgical and post-surgical pain control in patients undergoing periodontal flap surgery.

Materials and methods: A randomized, single-blind, split-mouth design was employed in patients who are scheduled for periodontal flap surgery for at least two similar sextants with similar anesthetic techniques. Fifty patients (age range 16-65 years, 32 males and 28 females) enrolled in the present study. On one-site, the flap surgery was performed using 2% lidocaine with 1:200000 epinephrine and on the other with 0.5% bupivacaine with 1:200000 epinephrine. Base line clinical parameters, probing pocket depth, clinical attachment level were recorded. Pain during intra operative period, at the time of loss of numbness and for three consecutive days was measured using visual analog scale (VAS).

Results: Significant differences were observed between the two groups in the intra operative pain scores (p=0.0045) and pain scores at the time of loss of numbness (p=0.0005) but not at the 1st, 2nd and 3rd day after the surgery.

Conclusion: Bupivacaine was markedy more effective than the lidocaine. Thus the usage of bupivacaine can be substantiated for periodontal surgeries for the control of pain in the intra operative and immediate post-operative period to increase patients' comfort.