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Falci SGM, Fernandes IA, Guimarães MTBÁ, Galvão EL, de Souza GM, Al-Moraissi EA. Complementary and alternative therapies for managing postoperative pain after lower third molar surgery: a systematic review and network meta-analysis. Clin Oral Investig 2024; 28:231. [PMID: 38538810 DOI: 10.1007/s00784-024-05625-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/19/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVE The objective of this study was to evaluate the impact of complementary and alternative treatments on postoperative pain following lower third molar surgeries. METHODS A comprehensive search of Electronic databases (Embase, MEDLINE via PubMed, and Cochrane Library) and grey literature was conducted up until May 2022. Randomized clinical trials investigating the effect of acupuncture, ozone therapy, laser (LLLT), drainage tube, kinesio-taping, ice therapy, and compressions on pain after LTM surgeries were included. The estimated mean differences (MD) for alternative therapies were pooled using the frequentist approach to random-model network meta-analysis NMA. RESULTS Eighty-two papers were included in the qualitative analysis; 33 of them were included in the quantitative analyzes. NMA revealed that drainage tube and kinesio-taping were superior in controlling pain 24-hours postoperatively than no-treatment. At 48-hours follow-up, kinesio-taping and LLLT more effective than placebo and drainage tube; and kinesio-taping and LLLT were superior to no treatment. At 72 h postoperatively, ozone therapy was superior to placebo; and drainage tube, kinesio-taping, and LLLT were better than no treatment. At 7-days follow-up, ozone and LLLT were superior to placebo; and LLLT and kinesio-taping were superior to no treatment. The SUCRA-ranking placed drainage tube as top-ranking intervention at 48-hours (98.2%) and 72-hours (96%) follow-ups, and ozone (83.5%) at 7-days follow-up. CONCLUSION The study findings suggest that these alternative and complementary therapies may be useful in reducing postoperative pain after LTM surgeries, and may offer advantages when combined to traditional pain management methods. CLINICAL RELEVANCE Non-pharmacological therapies are gaining popularity among healthcare professionals and patients. This study found that some of these therapies, specifically kinesio-taping and drainage tube were effective in controlling postoperative pain after third molar surgeries. These findings have important implications for clinical practice, as they highlight the potential benefits of incorporating these therapies into postoperative pain management plans.
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Affiliation(s)
- Saulo Gabriel Moreira Falci
- Department of Dentistry, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
| | - Ighor Andrade Fernandes
- Department of Dentistry, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | | | - Endi Lanza Galvão
- Department of Physiotherapy, Federal University of Vales do Jequitinhonha e Murcuri, Diamantina, Minas Gerais, Brazil
| | - Glaciele Maria de Souza
- Department of Dentistry, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Essam Ahmed Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Dhamar, Yemen
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Pereira RVS, de Moraes SLD, Monteiro JLGC, Gomes ACA, Pellizzer EP, Vasconcelos BCDE. Effectiveness of Elastic Therapeutic Tape in Reducing Edema, Pain and Trismus following Surgery for Facial Fractures: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:997. [PMID: 38398310 PMCID: PMC10888644 DOI: 10.3390/jcm13040997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Facial fractures cause postoperative morbidity, including edema, pain, and trismus. Elastic therapeutic tapes are used for optimizing recovery. Background: The aim of the present systematic review and meta-analysis was to evaluate the effectiveness of elastic tape Kinesio taping (KT) in reducing postoperative morbidity in facial fractures surgeries. Methods: A systematic review was conducted in accordance with the PRISMA guidelines. Searches were conducted in the Cochrane, Medline, Scopus, Embase and Web of Science databases using a pre-established search strategy. Results: A total of 811 studies were retrieved after the duplicates were removed, and only randomized clinical trials were included. Eight trials, involving 319 participants, were deemed eligible. One study solely investigated the effect on edema, while the others analyzed at least two of the variables of interest. Results from two RCTs, where qualitative analysis was applicable, suggest a potential reduction in edema in the KT group compared to the control group on the second (RR -0.55, 95% CI -0.89 to -0.22; p = 0.01; I2 = 0%) and third postoperative days (RR -0.71, 95% CI -1.01 to -0.40; p < 0.00001; I2 = 0%). Conclusions: KT is effective in controlling postoperative edema following surgery for facial fractures. However, the effects on pain and trismus should be explored further in studies with standardized methods.
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Affiliation(s)
- Rebeca Valeska Soares Pereira
- Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery and Traumatology, University of Pernambuco, Recife 50100-130, Brazil; (R.V.S.P.); (A.C.A.G.)
| | | | | | - Ana Cláudia Amorim Gomes
- Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery and Traumatology, University of Pernambuco, Recife 50100-130, Brazil; (R.V.S.P.); (A.C.A.G.)
| | - Eduardo Piza Pellizzer
- Araçatuba Dental School, Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), Araçatuba 16015-050, Brazil;
| | - Belmiro Cavalcanti do Egito Vasconcelos
- Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery and Traumatology, University of Pernambuco, Recife 50100-130, Brazil; (R.V.S.P.); (A.C.A.G.)
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Gonçalves MWA, Souza MRF, Becheleni MT, Galvão EL, Al-Moraissi EA, Falci SGM. Does cyanoacrylate have the best postoperative outcomes after third molar extractions when compared to conventional sutures? A systematic review and meta-analysis. Heliyon 2024; 10:e23058. [PMID: 38163159 PMCID: PMC10755274 DOI: 10.1016/j.heliyon.2023.e23058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 10/30/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024] Open
Abstract
Purpose Tissue synthesis is extremely important for the attenuation of postoperative discomforts, as it keeps the tissues coapted, accelerates the healing process, and reduces the bleeding period of the surgical wound. Thus, this study aimed to systematically review the results of clinical trials that compared the use of cyanoacrylate with conventional sutures after third molars extraction. Materials and methods Searches were conducted on MEDLINE (via PubMed), Cochrane Central Registry of Controlled Trials (CENTRAL), Virtual Health Library (VHL), and Web of Science. Articles published up to February 20, 2022, were included. No restrictions were imposed on data or language of publication. Results A total of 8 studies (5 randomized controlled trials and 3 non-randomized comparative clinical studies) were included in this review and five studies were included in the meta-analysis, comprising 440 patients. The use of cyanoacrylate promoted better results in pain reduction in the first postoperative day when compared to the use of conventional suture (SMD: -1.01; 95%CI -1.90 to -0.12). Cyanoacrylate group promoted significant but borderline edema reduction compared to conventional sutures in the 7th postoperative day (SMD: -0.24, 95%CI -0.46 to -0.01, I2 = 0 %). For the trismus outcome, in all periods evaluated no differences were found between the groups. Conclusion Although promising results, there is no high-quality evidence to suggest the use of cyanoacrylate was better than conventional sutures.
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Affiliation(s)
| | - Marina Rocha Fonseca Souza
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Marco Túllio Becheleni
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Endi Lanza Galvão
- Department of Physical Therapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
| | - Essam Ahmed Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen
| | - Saulo Gabriel Moreira Falci
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil
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Pławecki P, Pierwocha K, Terlecki W, Kawulok A, Bogacz M, Balicz A, Jędrusik-Pawłowska M, Dąbrowska-Galas M, Morawiec T. Kinesio Taping as an Adjunct Therapy in Postoperative Care after Extraction of Impacted Third Lower Molars—A Randomized Pilot Study. J Clin Med 2023; 12:jcm12072694. [PMID: 37048776 PMCID: PMC10095148 DOI: 10.3390/jcm12072694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/30/2023] [Accepted: 03/31/2023] [Indexed: 04/08/2023] Open
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly administered according to protocol for the management of complications such as pain, swelling, and trismus following the removal of the third impacted lower molar; however, treatment with NSAIDs may result in multiple adverse effects. The aim of this study was to compare the effectiveness of kinesio taping (KT) and the use of NSAIDs in the treatment of postoperative complications after extraction of an impacted third lower molar. Material and methods: The study comprised a group of 30 patients, randomly divided into the test group (with KT, n = 15) or the control group (without KT, n = 15). The surgery was performed according to standard procedures. In the test group, KT was applied immediately after surgery. Pain, swelling, and trismus were assessed. The VAS scale was used to assess pain. Swelling was measured based on six reference points on the face using a tailor’s meter, and a caliper was used to measure the distance between the upper and lower medial incisors of the upper and lower teeth to determine the extent of trismus. Measurements were performed three times: on the day of the surgery, on the second day following the surgery, and on the 7th day after the surgery. Results: Pain intensity (day of procedures), maximum mouth opening (on the seventh day after the surgery), and the use of NSAIDs (day of surgery) were significantly lower (p < 0.05) in the test group than in the control group. Conclusions: Kinesio taping in addition to NSAIDs was found to be more effective than NSAIDs alone in increasing the degree of jaw opening, decreasing pain intensity, and reducing the non-steroid anti-inflammatory dosage in patients after impacted mandibular wisdom teeth surgery.
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Affiliation(s)
- Piotr Pławecki
- Department of Dental Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Plac Akademicki 17, 41-902 Bytom, Poland
| | - Karolina Pierwocha
- Students Scientific Association, Department of Oral Surgery in Bytom, 41-902 Bytom, Poland
| | - Wojciech Terlecki
- Students Scientific Association, Department of Oral Surgery in Bytom, 41-902 Bytom, Poland
| | - Anna Kawulok
- Students Scientific Association, Department of Oral Surgery in Bytom, 41-902 Bytom, Poland
| | - Mateusz Bogacz
- Department of Dental Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Plac Akademicki 17, 41-902 Bytom, Poland
| | - Agnieszka Balicz
- Department of Dental Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Plac Akademicki 17, 41-902 Bytom, Poland
| | - Magdalena Jędrusik-Pawłowska
- Department of Dental Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Plac Akademicki 17, 41-902 Bytom, Poland
| | - Magdalena Dąbrowska-Galas
- Department of Kinesitherapy and Special Methods, School of Health Sciences in Katowice, Medical University of Silesia, 40-752 Katowice, Poland
| | - Tadeusz Morawiec
- Department of Dental Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Plac Akademicki 17, 41-902 Bytom, Poland
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Efficacy of Probiotics Compared to Chlorhexidine Mouthwash in Improving Periodontal Status: A Systematic Review and Meta-Analysis. Int J Dent 2023; 2023:4013004. [PMID: 36726858 PMCID: PMC9886484 DOI: 10.1155/2023/4013004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/26/2022] [Accepted: 01/04/2023] [Indexed: 01/25/2023] Open
Abstract
Purpose To critically evaluate the available literature and conduct a systematic review of recent randomized controlled trials to assess the effectiveness of probiotics compared to chlorhexidine mouthwash in enhancing periodontal health. Methods Five databases were searched electronically, as well as the gray literature. Using the Cochrane risk-of-bias tool for randomized clinical trials, the risk of bias was examined. The weighted mean difference (WMD) method was used to calculate the effect sizes. Heterogeneity was assessed using I 2 and τ 2 statistics. The GRADE approach was adopted to assess the certainty of the evidence. To assess the robustness of the findings, sensitivity analysis and publication bias assessment were undertaken. Results A total of 1850 studies were initially identified. Sixteen clinical trials were eligible for qualitative synthesis, and ten were included in the meta-analysis. In terms of the gingival index, in total, no statistically significant difference was observed between chlorhexidine and probiotics within 4 weeks (WMD -0.03, 95% CI: -0.09∼0.04, P = 0.3885). Similar to GI, no statistically significant difference was observed between chlorhexidine and probiotics regarding the plaque index within 4 weeks (WMD 0.11, 95% CI: -0.05∼0.28, P = 0.1726). No statistically significant difference was observed between chlorhexidine and probiotics in all time intervals regarding oral hygiene index-simplified (WMD -0.01, 95% CI: -0.05∼0.04, P = 0.7508). The robustness of these findings was confirmed by sensitivity analysis and publication bias assessments. Conclusions Based on the findings, probiotics were an acceptable alternative to conventional chlorhexidine in improving periodontal health. High-quality studies with rigorous methodology should be conducted to assess the optimum doses of probiotics for clinical implications.
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