Volume 36, Issue 256 (4-2026)
J Mazandaran Univ Med Sci 2026, 36(256): 134-143 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Yadolahi B, Sadri L, Taghian M. The Role of Liposomal Delivery in Topical Palatal Anesthesia: Systematic Review and Meta-Analysis. J Mazandaran Univ Med Sci 2026; 36 (256) :134-143
URL: http://jmums.mazums.ac.ir/article-1-22382-en.html
URL: http://jmums.mazums.ac.ir/article-1-22382-en.html
Abstract: (45 Views)
This study evaluated the efficacy of liposomal topical anaesthesia for pain control and prolonged anaesthetic duration in the palatal region of the oral cavity. Liposomal delivery systems enable controlled drug release, potentially enhancing local effects while reducing systemic toxicity. However, current evidence comparing these formulations with conventional agents remains inconsistent. A comprehensive search of PubMed, Scopus, Web of Science, and the Cochrane Library (2000-2025) was conducted in accordance with PRISMA guidelines. Four randomised controlled trials (RCTs), including 142 participants aged 18-60 years, met the inclusion criteria. These studies compared liposomal formulations (lidocaine, ropivacaine, or lidocaine–prilocaine) with control agents (e.g., EMLA or benzocaine gels) for palatal anaesthesia. Outcomes assessed included pain during needle insertion (Visual Analogue Scale [VAS], cm) and duration of anaesthesia (minutes). Findings were inconsistent across studies. Some reported improved pain relief and prolonged anaesthetic effect with liposomal agents, while others found no significant differences. A meta-analysis of VAS scores from three studies showed a pooled mean difference of 0.62 cm (95% CI: -0.01 to 1.25; I² = 64%), indicating no statistically significant advantage over controls. The observed heterogeneity was attributed to differences in agents, concentrations, application times (2–5 minutes), and comparator formulations. One study reported a significant increase in anaesthetic duration in favour of liposomal lidocaine–prilocaine (MD 9.97 minutes; 95% CI: 7.23–12.71; P < 0.0001), with a 100% success rate for injection-free palatal anaesthesia during upper molar extractions, compared with 60% in the non-liposomal group (risk ratio 1.67). No adverse events were reported. The overall risk of bias was mostly unclear due to insufficient reporting. Limitations of this review include small sample sizes, exclusion of non-English studies, absence of Embase search, and no additional RCTs identified after 2023. Despite these limitations, liposomal formulations show potential for prolonging anaesthetic duration and supporting injection-free procedures in selected clinical settings, thereby improving patient comfort. However, evidence for pain reduction remains limited and heterogeneous. Further well-designed, larger-scale RCTs with standardised protocols and longer application times are required to confirm these findings and optimise clinical application.
Keywords: liposome, oral tissue, dental tissue, drug delivery system, liposomal delivery system, topical anesthesia
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Articles Copyright © The Author(s). Owned by Mazandaran University of Medical Sciences.
Contact Us
Address: Journal Office, Building No. 2, Mazandaran University of Medical Sciences, Moallem Square, Sari.Tel: +98 (011)34484874 Postal code: 48175-866 E-Mail: jmums@mazums.ac.ir Telefax: +98 (011)33262679
