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    Clinical Trial Results:
    Multicenter, randomized, split-mouth study to evaluate the acceptance and preference of lidocaine gel compared to injection anesthesia after non surgical periodontal treatment

    Summary
    EudraCT number
    2016-005202-19
    Trial protocol
    DE  
    Global end of trial date
    02 Nov 2018

    Results information
    Results version number
    v1(current)
    This version publication date
    20 Dec 2019
    First version publication date
    20 Dec 2019
    Other versions
    Summary report(s)
    Summary

    Trial information

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    Trial identification
    Sponsor protocol code
    DyMZIS-01
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03354312
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Chemische Fabrik Kreussler & Co. GmbH
    Sponsor organisation address
    Rheingaustrasse 87-93, Wiesabden, Germany, 65203
    Public contact
    Med.-Wiss Abteilung, Chemische Fabrik Kreussler & Co. GmbH, +49 6119271126, Joachim.Otto@kreussler.com
    Scientific contact
    Med.-Wiss Abteilung, Chemische Fabrik Kreussler & Co. GmbH, +49 6119271260, Eva-Katharina.Pauli@kreussler.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    20 Aug 2019
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    02 Nov 2018
    Global end of trial reached?
    Yes
    Global end of trial date
    02 Nov 2018
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective is to compare acceptance and preference of topical lidocaine mouth gel anesthesia vs. injection anesthesia with articaine in patients undergoing subgingival debridement by comparing the proportion of patients after the second periodontal treatment who prefer topical anesthesia with lidocaine gel against the injection anesthesia with articaine to a proportion of 0.5; the patient rates the preferred anesthesia method on a questionnaire by stating if the patient’s preference is treatment with anesthetic gel, treatment with anesthetic injection, or no preference
    Protection of trial subjects
    The present clinical trial was conducted in accordance with the published principles of the guidelines for Good Clinical Practice (ICH-GCP) and applicable legislation (especially the Federal Drug Law [AMG] and the GCP-V). These principles cover, amongst other aspects, ethics committee procedures, the obtaining of informed consent from trial subjects, adherence to the trial protocol, administrative documentation, documentation regarding the IMP, data collection, trial subjects’ medical records (source documents), documentation and reporting of adverse events (AEs), preparation for inspections and audits, and the archiving of trial documentation. All investigators and other staff directly concerned with the study were informed that domestic and foreign supervisory bodies, the competent federal authorities and authorized representatives of the sponsor have the right to review trial documentation and the trial subjects’ medical records at any time.
    Background therapy
    -
    Evidence for comparator
    Articaine hydrochloride/epinephrine (adrenaline) hydrochchloride (Ultracain® DS 1:200,000, Sanofi) was selected as comparator drug, being the most commonly used anesthetic drug for infiltration and nerve-block anesthesia in Germany at the time the study protocol was developed.
    Actual start date of recruitment
    05 Dec 2017
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Germany: 94
    Worldwide total number of subjects
    94
    EEA total number of subjects
    94
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    85
    From 65 to 84 years
    9
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The first patient enrolled on 05.12.2017; the last patient completed the trial on 02.11.2018.

    Pre-assignment
    Screening details
    In summary 94 subjects were enrolled in the study.

    Period 1
    Period 1 title
    Overall Trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    treatment Dynexan/Ultracain both sequences
    Arm description
    Two treatment sessions per subject at intervals of 48 h-14 days. At the first treatment session subjects were randomly assigned to either sequence of anaesthesia (Dynexan Mundgel/Untracain or Ultracain/Dynexan Mundgel). At the first session scaling and root planing (SRP) was performed in the right upper and lower jaw. The second SRP was performed in the left upper and lower jaw.
    Arm type
    split-mouth, cross-over

    Investigational medicinal product name
    Ultracain DS®
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Infiltration
    Dosage and administration details
    Cylinder vials with 1.7 ml solution for injection containing 68 mg articaine and 0.0102 mg epinephrine (1 ml contains 40 mg articaine and 0.006 mg epinephrine) were used.

    Investigational medicinal product name
    Dynexan Mundgel®
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Gel
    Routes of administration
    Periodontal use
    Dosage and administration details
    Cylinder vials with 1.7 g gel containing 34 mg lidocaine (1 g gel contained 20 mg lidocaine) were used. For the application of the study drug all study sites were supplied with identical dental cartridge syringes and blunt cannulas. Application of the gel into the periodontal pockets or the sulcus was performed with a blunt cannula according to the summary of product characteristics (SmPC). A total dose of 40 mg lidocaine should not be exceeded.

    Number of subjects in period 1
    treatment Dynexan/Ultracain both sequences
    Started
    94
    Visit 0
    94
    Visit 1
    92
    Visit 2
    91
    Completed
    91
    Not completed
    3
         Consent withdrawn by subject
    1
         Patient stayed away
    1
         Alleged violation of exclusion criterion
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall Trial
    Reporting group description
    -

    Reporting group values
    Overall Trial Total
    Number of subjects
    94 94
    Age categorical
    Overall age range 18-70 years
    Units: Subjects
        Adults (18-64 years)
    84 84
        From 65-84 years
    10 10
    Gender categorical
    Units: Subjects
        Female
    55 55
        Male
    39 39

    End points

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    End points reporting groups
    Reporting group title
    treatment Dynexan/Ultracain both sequences
    Reporting group description
    Two treatment sessions per subject at intervals of 48 h-14 days. At the first treatment session subjects were randomly assigned to either sequence of anaesthesia (Dynexan Mundgel/Untracain or Ultracain/Dynexan Mundgel). At the first session scaling and root planing (SRP) was performed in the right upper and lower jaw. The second SRP was performed in the left upper and lower jaw.

    Primary: Preference

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    End point title
    Preference [1]
    End point description
    End point type
    Primary
    End point timeframe
    Comparison of the proportion of patients who preferred gel anesthesia versus injection anesthesia. Evaluation of this end point was performed after the second treatment session (Visit 2) had been completed and the patient had filled out the questionnaire.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: The null hypothesis of the study states that the patients prefer the anesthetic gel and the anesthetic injection equally often (pGel = pInjektion = 0.5). Based on the data collected in the study, H0 is rejected. The patients preferred the anesthesia with Dynexan Mundgel.
    End point values
    treatment Dynexan/Ultracain both sequences
    Number of subjects analysed
    91
    Units: subjects
        No preference
    18
        Gel
    53
        Injection
    20
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Two treatment sessions at intervals of 48 h - 14 days. Duration of each treatment session was one hour. Recording of anesthesia induced adverse effects after Treatment as well as with a Patient diary 4h and 24h after treatment.
    Adverse event reporting additional description
    No serious and severe AEs occurred with any treatment. Furthermore, no patients discontinued the study due to AEs.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    21.1
    Reporting groups
    Reporting group title
    Ultracain
    Reporting group description
    -

    Reporting group title
    Dynexan Mundgel
    Reporting group description
    -

    Serious adverse events
    Ultracain Dynexan Mundgel
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 47 (0.00%)
    0 / 45 (0.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Ultracain Dynexan Mundgel
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    37 / 47 (78.72%)
    21 / 45 (46.67%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1
    General disorders and administration site conditions
    Application site pain
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Application site swelling
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Facial pain
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Fatigue
         subjects affected / exposed
    1 / 47 (2.13%)
    2 / 45 (4.44%)
         occurrences all number
    1
    2
    Feeling jittery
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Influenza like illness
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Injection site pain
         subjects affected / exposed
    2 / 47 (4.26%)
    0 / 45 (0.00%)
         occurrences all number
    2
    0
    Pain
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 45 (2.22%)
         occurrences all number
    1
    1
    Swelling
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1
    Product issues
    Product taste abnormal
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1
    Investigations
    Body temperature increased
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Injury, poisoning and procedural complications
    Injury
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Procedural pain
         subjects affected / exposed
    3 / 47 (6.38%)
    3 / 45 (6.67%)
         occurrences all number
    3
    3
    Wound complication
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 45 (2.22%)
         occurrences all number
    1
    1
    Cardiac disorders
    Palpitations
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 45 (2.22%)
         occurrences all number
    1
    1
    Nervous system disorders
    Ageusia
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1
    Burning sensation
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1
    Dizziness
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1
    Dysgeusia
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1
    Headache
         subjects affected / exposed
    7 / 47 (14.89%)
    2 / 45 (4.44%)
         occurrences all number
    7
    2
    Hypoaesthesia
         subjects affected / exposed
    23 / 47 (48.94%)
    3 / 45 (6.67%)
         occurrences all number
    23
    3
    Migraine
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Movement disorder
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Slow response to stimuli
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Speech disorder
         subjects affected / exposed
    2 / 47 (4.26%)
    0 / 45 (0.00%)
         occurrences all number
    2
    0
    Blood and lymphatic system disorders
    Lymphadenopathy
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Ear and labyrinth disorders
    Ear discomfort
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Eye disorders
    Ocular discomfort
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Gastrointestinal disorders
    Dental discomfort
         subjects affected / exposed
    1 / 47 (2.13%)
    1 / 45 (2.22%)
         occurrences all number
    1
    1
    Gingival ulceration
         subjects affected / exposed
    0 / 47 (0.00%)
    2 / 45 (4.44%)
         occurrences all number
    0
    2
    Hypoaesthesia oral
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Nausea
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1
    Oral discomfort
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1
    Sensitivity of teeth
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1
    Tongue discomfort
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1
    Toothache
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Skin and subcutaneous tissue disorders
    Erythema
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Hyperhidrosis
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Subcutaneous emphysema
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1
    Musculoskeletal and connective tissue disorders
    Jaw disorder
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Mastication disorder
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Myalgia
         subjects affected / exposed
    1 / 47 (2.13%)
    0 / 45 (0.00%)
         occurrences all number
    1
    0
    Infections and infestations
    Gastroenteritis
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1
    Oral herpes
         subjects affected / exposed
    0 / 47 (0.00%)
    1 / 45 (2.22%)
         occurrences all number
    0
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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