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Hu Q, Liu X, Zhao Z, Guo Z, Liu Q, Liu N. Clinical efficacy and pain control of diode laser-assisted flap surgery in the treatment of chronic periodontitis:A systematic review and meta-analysis. Heliyon 2024; 10:e33510. [PMID: 39040384 PMCID: PMC11260959 DOI: 10.1016/j.heliyon.2024.e33510] [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: 01/08/2024] [Revised: 06/12/2024] [Accepted: 06/21/2024] [Indexed: 07/24/2024] Open
Abstract
Objective To assess the diode laser-assisted periodontal flap surgery's clinical effectiveness and postoperative pain management in treating chronic periodontitis, and to offer evidence-based medical justification for the procedure's clinical use. Data sources and study selection In this study, a computer combined with manual search was used to search for articles on diode laser-assisted periodontal flap surgery for the treatment of chronic periodontitis published from the establishment of the database to September 2023. The databases searched included China Academic Journal Full Text Database (CNKI), China Biomedical Literature Database (CBM), Chinese Science and Technology Journal Database (VIP), Wanfang Database, PubMed, Web of science, Cochrane Library, Embase, and Scopus. Two researchers independently performed the screening and study selection, following the inclusion and exclusion standards to extract basic information and required data. Meta-analysis of the included literature was performed using Revman V5.4 software. Result Thirteen articles were analyzed. Meta-analysis showed that the use of the diode laser was effective in reducing patients' probing pocket depth (PPD) at 3 and 6 months postoperatively (3 months: MD = -0.46, 95 % CI = [-0.89, -0.03], P = 0.04; 6 months: MD = -0.35, 95 % CI = [-0.63, -0.06], P = 0.02), was able to effectively improve 3 month clinical attachment level (CAL) (MD = -0.36, 95 % CI = [-0.66, -0.06], P = 0.02), and was able to promote wound healing and reduce patients' early postoperative pain (MD = 0.67, 95 % CI = [0.01, 1.32], P = 0.05; MD = -1.67, 95 % CI = [-2.23, -1.00], and P < 0. 001), while for gingival index (GI), the use of diode laser did not have a significant effect. Conclusions The available evidence suggests that the use of a diode laser adjunct is effective in reducing PPD, improving CAL, promoting wound healing, and reducing early postoperative pain in patients compared with flap application alone; however, for GI, diode lasers did not show any improvements. Clinical significance Periodontal flap surgery fails to eliminate microorganisms from the soft tissue wall, potentially leading to recolonization, reinfection, and accompanying side effects such as pain and swelling. The use of a diode laser reduces PPD, improves CAL, and relieves early postoperative pain.
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Affiliation(s)
- Qiaoyu Hu
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Xuanning Liu
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Zirui Zhao
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Zhijiao Guo
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Qing Liu
- Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Na Liu
- Department of Preventive Dentistry, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
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Mattos-Pereira GH, Esteves-Lima RP, Cota LOM, Alvarenga-Brant R, Costa FO. Preemptive effects of etoricoxib, acetaminophen, nimesulide, and ibuprofen on postoperative pain management after single-implant surgery: A randomized clinical trial. Clin Oral Implants Res 2023; 34:1299-1308. [PMID: 37638406 DOI: 10.1111/clr.14170] [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: 10/28/2022] [Revised: 08/03/2023] [Accepted: 08/13/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND There is insufficient evidence for pain control in preemptive analgesia (PA) after dental implant surgery, signaling the need for further studies. The objective of this study was to evaluate the efficacy of PA in single dental implant surgeries (SDIS), seeking to identify among the etoricoxib (ETOR), ibuprofen (IBU), nimesulide (NIME), and acetaminophen (ACETA)], which one has the higher efficacy effectiveness in relieving postoperative pain and reducing the use of rescue medication compared to placebo. METHODS In this triple-blind, parallel, randomized controlled clinical trial, 135 individuals with a mean age of 57.6 years (±11.7), both genders, were randomly divided into five groups according to the test drug: I-PLACEBO; II-IBU (600 mg); III-NIME (100 mg); IV-ACETA (750 mg); and V-ETOR (90 mg). The occurrence, duration, and intensity of pain were analyzed using the Chi-square, Fisher's exact and ANOVA tests, and the generalized estimating equation models, when appropriate. RESULTS Test drugs provided a reduction in postoperative pain scores and lower use of rescue medication when compared to placebo. The ETOR group presented significantly lower pain scores, when compared to other active treatments. The IBU group showed the highest mean number of rescue medication used. CONCLUSIONS All test drugs provided a beneficial preemptive effect demonstrated by the reduced postoperative pain and reduced use of rescue medication. The ETOR group presented lower pain scores, and the IBU group showed the highest mean number of rescue medication used among the test groups.
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Affiliation(s)
- Gustavo Henrique Mattos-Pereira
- Department of Clinical Dentistry, Pathology and Oral Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Rafael Paschoal Esteves-Lima
- Department of Clinical Dentistry, Pathology and Oral Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Luís Otávio Miranda Cota
- Department of Clinical Dentistry, Pathology and Oral Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Rachel Alvarenga-Brant
- Department of Clinical Dentistry, Pathology and Oral Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Fernando Oliveira Costa
- Department of Clinical Dentistry, Pathology and Oral Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Santos EC, Huller D, Brigola S, Ferreira MD, Pochapski MT, dos Santos FA. Pain management in periodontal therapy using local anesthetics and other drugs: an integrative review. J Dent Anesth Pain Med 2023; 23:245-256. [PMID: 37841520 PMCID: PMC10567545 DOI: 10.17245/jdapm.2023.23.5.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/17/2023] Open
Abstract
Background Surgical and non-surgical periodontal procedures often lead to postoperative pain. Clinicians use pharmacological methods such as anesthetics, anti-inflammatory drugs, and analgesics for relief. However, the multitude of options makes it challenging to select the best approach for routine dental care. Objective This review aimed to describe previous studies regarding the pharmacological management used for pain control during periodontal procedures as well as factors that may interfere with patients' perception of pain. Methods We included studies (period of 2000-2023, whose approach corresponded to the pharmacological protocols used for preoperative, trans-operative, and postoperative pain control in adult patients undergoing surgical and non-surgical periodontal therapy. Results A total of 32 studies were included in the analysis, of which 17 (53%) were related to anesthetic methods and 15 (47%) were related to therapeutic protocols (anti-inflammatory/analgesic agents). These studies predominantly involved nonsurgical periodontal procedures. Studies have reported that factors related to age, type of procedure, and anxiety can influence pain perception; however, only seven of these studies evaluated anxiety. Conclusions Numerous methods for pain control can be applied in periodontal therapy, which are accomplished through anesthetic methods and/or therapeutic protocols. Factors such as anxiety, age, and type of procedure are related to pain perception in patients. Thus, it is the responsibility of dentists to evaluate each clinical situation and define the best protocol to follow based on the literature.
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Affiliation(s)
| | - Daniela Huller
- Department of Dentistry, Universidade Estadual de Ponta Grossa, Paraná, Brazil
| | - Sabrina Brigola
- Department of Dentistry, Universidade Estadual de Ponta Grossa, Paraná, Brazil
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Dheeraj M, Johar S, Mahajan P, Jandial T, Chauhan S, Gupta K. Comparative Evaluation of the Efficacy of Two Modes of Delivery of Diclofenac for the Management of Post-Endodontic Pain: A Randomized Controlled Clinical Trial. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2023; 15:S1283-S1286. [PMID: 37694025 PMCID: PMC10485447 DOI: 10.4103/jpbs.jpbs_119_23] [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: 02/06/2023] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 09/12/2023] Open
Abstract
Background This study aimed to compare the efficacy of two modes of delivery of diclofenac for the management of post-endodontic pain. Materials and Methods This study comprised 30 patients reporting to the department with pain in their teeth. Pain was assessed using the visual analog scale (VAS): group A (control group), group B (oral diclofenac), and group C (transdermal patch). A VAS was given to the patients in each group, and the severity of any pain was self-assessed by patients after 4 hrs, 8 hrs, 12 hrs, 24 hrs, and 48 hrs following the completion of treatment. Results A comparison between group oral and diclofenac transdermal patch was carried out. The pain frequency was measured at 4 hrs, 8 hrs, 12 hrs, 24 hrs, and 48 hrs postoperatively with P values of 0.744, 0.035, 0.570, 0.060, and 0.508 and was statistically insignificant. Conclusion Preoperative analgesics play an important role in reducing post-endodontic pain. Transdermal patches containing diclofenac show a promising analgesic modality in managing endodontic pain.
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Affiliation(s)
- Munish Dheeraj
- Senior Resident, Department of Dentistry, Andaman and Nicobar Islands Institute of Meical Sciences, Port Blair, Andaman and Nicobar Islands, India
| | - Suksham Johar
- Conservative Dentistry and Endodontics, Desh Bhagat Dental College and General Hospital, Mandi Govindgarh, Punjab, India
| | - Priya Mahajan
- Paedodontics and Preventive Dentistry, National Dental College, Dera Bassi, Punjab, India
| | - Tania Jandial
- Conservative Dentistry and Endodontics, Pacific Dental College and Research Centre, Udaipur, Rajasthan, India
| | - Shikha Chauhan
- Conservative Dentistry and Endodontics, Private Practitioner, Haryana, India
| | - Kamakshi Gupta
- Department of Periodontics, National Dental College, Dera Bassi, Punjab, India
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Motififard M, Hatami S, Feizi A, Toghyani A, Parhamfar M. Comparison of the effects of preoperative celecoxib and gabapentin on pain, functional recovery, and quality of life after total knee arthroplasty: A randomized controlled clinical trial. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2023; 28:50. [PMID: 37496639 PMCID: PMC10366981 DOI: 10.4103/jrms.jrms_416_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/18/2022] [Accepted: 03/22/2023] [Indexed: 07/28/2023]
Abstract
Background Acute pain is one of the main complaints of patients after total knee arthroplasty (TKA), which causes delayed mobility, increased morphine consumption, and subsequently increased costs. Therefore, the present study was performed to evaluate the preventive effect of preoperative celecoxib and gabapentin on reducing patient pain as a primary outcome after TKA surgery. Materials and Methods This randomized, double-blind controlled clinical trial was performed on 270 patients with osteoarthritis that were candidates for TKA surgery allocated into three groups. In the first group, 900 mg of gabapentin was administered orally on a daily basis for 3 days before surgery. In the second group, 200 mg of oral celecoxib was administered twice daily for 3 days before surgery. In the third group, oral placebo was administered twice daily for 3 days before the surgery. The patients' pain score and knee and its functional score were recoded. Results The mean of reduction pain in gabapentin and celecoxib groups was significantly lower than that of the control group at 12, 24, and 48 h after surgery (P < 0.001); however, two groups were not significantly different from each other (P > 0.05). Furthermore, the two medication groups were not significantly different in this regard (P > 0.05). In addition, the knee score in the gabapentin group with the means of 85.40 ± 5.47 and the celecoxib group with the means of 87.03 ± 3.97 were significantly higher than those of the control group with the means of 78.90 ± 4.39 in the 1st month after the surgery (P < 0.001). Conclusion According to the results of the present study, the preventive administration of gabapentin and celecoxib showed a significant and similar effectiveness on reducing patient pain after TKA surgery and on improving the KSS and quality of life scores.
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Affiliation(s)
- Mehdi Motififard
- Department of Orthopedic Surgery, Kashani University Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeed Hatami
- Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Epidemiology and Biostatistics, School of Health, Cardiac Rehabilitation Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arash Toghyani
- Department Faculty of Health, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Parhamfar
- Department of Orthopedic Surgery, Kashani University Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Leira Y, Cho H, Marletta D, Orlandi M, Diz P, Kumar N, D'Aiuto F. Complications and treatment errors in periodontal therapy in medically compromised patients. Periodontol 2000 2023; 92:197-219. [PMID: 36166645 DOI: 10.1111/prd.12444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/26/2022] [Indexed: 11/28/2022]
Abstract
Patients who are medically compromised may be at an increased risk of complications and treatment errors following periodontal therapy. A review of the evidence on the topic is presented, in relation to the type of complication reported, of periodontal treatment, and of patients' medical status. Further, a framework for risk assessment and appropriate treatment modifications is introduced, with the aim of facilitating the management of patients with existing comorbidities and reducing the incidence of treatment complications.
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Affiliation(s)
- Yago Leira
- Periodontology Unit, UCL Eastman Dental Institute & NIHR UCLH Biomedical Research Centre, University College London, London, UK
- Periodontology Unit, Faculty of Odontology, University of Santiago de Compostela & Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
- Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Hana Cho
- Special Care Dentistry Unit, ENT & Eastman Dental Hospital, UCLH NHS Foundation Trust, London, UK
| | | | - Marco Orlandi
- Periodontology Unit, UCL Eastman Dental Institute & NIHR UCLH Biomedical Research Centre, University College London, London, UK
| | - Pedro Diz
- Special Care Dentistry Unit, Faculty of Odontology, University of Santiago de Compostela & Medical-Surgical Dentistry Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Navdeep Kumar
- Special Care Dentistry Unit, ENT & Eastman Dental Hospital, UCLH NHS Foundation Trust, London, UK
| | - Francesco D'Aiuto
- Periodontology Unit, UCL Eastman Dental Institute & NIHR UCLH Biomedical Research Centre, University College London, London, UK
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Jafari H, Latifi SA, Bayani M. Evaluation of the effectiveness of Lactuca Sativa syrup in controlling pain after periodontal flap surgery: a split-mouth, randomized, double-blind placebo-controlled trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:457-463. [PMID: 35796290 DOI: 10.1515/jcim-2021-0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Effective pain control after oral surgeries including periodontal flap surgery is one of the biggest problems in the periodontology field. The use of Nonsteroidal Anti-inflammatory Drugs (NSAIDs) to reduce pain after periodontal flap surgery is common, but these have some adverse side effects such as impaired platelet function and causing digestive problems. Today, the tendency to use omedicinal plants is more than synthetic drugs due to their safety. Therefore, we designed a split-mouth randomized controlled clinical trial to evaluate the effects of Lactuca Sativa (L. Sativa) syrup as an adjunct therapy in reducing pain after periodontal flap surgery. METHODS This split-mouth, randomized, double-blind, placebo-controlled trial was performed on 26 subjects. Patients were assigned for two surgery. Primary surgery was performed on the right maxilla and after 30 days, secondary surgery was performed on the left maxilla. In primary surgery, patients consumed L. Sativa syrup (3 times a day for 72 h) and in secondary surgery, patients consumed placebo syrup (3 times a day for 72 h). Pain intensity was measured at 6, 12, 24, 48, and 72 h after a periodontal flap surgery in both surgeries using the Visual Analogue Scale (VAS). All patients received their routine drugs, including analgesics. The number of analgesics used after surgery was recorded. Statistical analysis of t-test was used to compare the results of the two surgery. RESULTS The results showed that the mean pain based on VAS score at 6, 12, 24, 48 and 72 h after primary periodontal flap surgery was significantly reduced compared to the secondary periodontal flap surgery (p<0.001). The results also showed that the use of analgesics after 72 h of surgery was significantly reduced in the primary periodontal flap surgery compared to the secondary periodontal flap surgery (p<0.001). CONCLUSIONS According to the results of this study, L.Sativa syrup can be effective as adjuvant therapy in reducing pain after periodontal flap surgery.
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Affiliation(s)
- Hadi Jafari
- Periodontics Department, Faculty of Dentistry, Arak University of Medical Sciences, Arak, Iran
| | - Seyed Amirhossein Latifi
- Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Mojtaba Bayani
- Periodontics Department, Faculty of Dentistry, Arak University of Medical Sciences, Arak, Iran
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Faramarzi M, Sadighi M, Shirmohamadi A, Kazemi R, Zohdi M. Effectiveness of Bromelain in the control of postoperative pain after periodontal surgery: A crossover randomized clinical trial. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2023; 15:22-27. [PMID: 37645550 PMCID: PMC10460776 DOI: 10.34172/japid.2023.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/13/2023] [Indexed: 08/31/2023]
Abstract
Background This study aimed to compare the analgesic effects of Ibuprofen and bromelain after periodontal surgery. Methods A double-blinded crossover clinical trial was conducted on 22 patients needing two crown lengthening surgeries without bone surgery or with limited bone surgery on two quadrants of the maxilla, with control and test sides. Each quadrant was randomly assigned to bromelain (500 GUD) or ibuprofen (400 mg). Immediately after the surgery and 6 hours after it, the first dose of the drugs was packaged in the same capsules in A and B. Postoperative pain was evaluated during the first 8 hours and on the following day using a visual analog scale (VAS). Results Using the VAS, the Ibuprofen group showed significantly lower mean pain scores than the bromelain group at 4 hours (P=0.047). In contrast, there were no significant differences between the two groups at 2, 6, 8, 10, 12, 24, and 48 hours (P>0.05). Conclusion The effectiveness of bromelain for pain control following periodontal surgery was comparable to that of Ibuprofen. Therefore, bromelain can be an efficient replacement for ibuprofen in managing pain after periodontal surgery, especially in patients with gastric ulceration and increased bleeding tendency.
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Affiliation(s)
- Masoumeh Faramarzi
- Department of Periodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrnoosh Sadighi
- Department of Periodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Adileh Shirmohamadi
- Department of Periodontics, Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Kazemi
- School of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsa Zohdi
- Students Research Committee, Tabriz University of Medical Science, Tabriz, Iran
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Ghasemi S, Bakhtiari F, Rahimi Asl P, Babaloo A, Ghasemi A. Evaluation of the effect of Echium amoenum on pain control after clinical crown lengthening surgery. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2023; 15:56-59. [PMID: 37645557 PMCID: PMC10460778 DOI: 10.34172/japid.2023.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 04/13/2023] [Indexed: 08/31/2023]
Abstract
Background Pain after periodontal surgeries is one of the most common complications. Echium amoenum is among the important therapeutic herbs in Iranian traditional medicine. Various studies have shown its pain control properties. This study aimed to evaluate this herb's efficacy in controlling pain after periodontal surgeries. Methods In this randomized clinical trial, 50 patients referred to Tabriz Dental School for clinical crown lengthening surgery were divided into two equal groups: control and test. In the test group (using E. amoenum), 24 hours before surgery, E. amoenum was administered to the patient at home every 12 hours, and a dose of E. amoenum was administered one hour before the procedure. The postoperative pain was assessed using VAS 30 minutes, 1 hour, and 3 hours after the surgery and verbal rating scale (VRS) 24, 48, and 72 hours postoperatively. A chi-square test was used to compare the pain severity between the two groups. Results The VAS index was significantly lower in the E. amoenum group compared to the control group (30 minutes, 1 hour, and 3 hours after the procedure) (P<0.05). In both groups, pain severity increased significantly up to 3 hours postoperatively (P<0.05). In the first 24 hours, the VRS index of the E. amoenum group was significantly lower than that of the control group (P<0.05), with no significant differences between the two groups at 48 and 72 hours (P>0.05). Conclusion The E. amoenum herb reduced the pain severity after clinical crown lengthening surgeries.
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Affiliation(s)
- Shima Ghasemi
- Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Fatemeh Bakhtiari
- Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Pariya Rahimi Asl
- Student Research Committee, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Amirreza Babaloo
- Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Atieh Ghasemi
- Department of Pediatrics, Faculty of Medicine, Tabriz University of Medical Science, Tabriz, Iran
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Isiordia-Espinoza MA, Gómez-Sánchez E, Mora-Falcón IJ, Amador-Beas IA, Hernández-Gómez A, Serafín-Higuera NA, Franco-de la Torre L. Analgesic Efficacy of COX-2 Inhibitors in Periodontal Surgery: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2023; 11:healthcare11071054. [PMID: 37046983 PMCID: PMC10093797 DOI: 10.3390/healthcare11071054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/04/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023] Open
Abstract
The objective of this systematic review and meta-analysis was to evaluate the analgesic efficacy of COX-2 inhibitors versus other drugs in periodontal surgery. Two researchers searched PubMed, Google Scholar, ACM Digital, BASE, EBSCOhost, Scopus, or Web of Science for clinical trials using various combinations of words. All articles that met the selection criteria were assessed using the Cochrane Collaboration’s risk of bias tool. For data analysis, the inverse variance and mean difference statistical method was used with Review Manager 5.3 software for Windows. According to the conclusion of each study (qualitative evaluation), only one clinical trial had results in favor of a COX-2 inhibitor when compared to placebo, one clinical study informed that a COX-2 was better that an active control, four studies showed similar analgesic efficacy to active controls, and one clinical study informed the analgesic effect of one celecoxib-caffeine combination in comparison with celecoxib alone and placebo (n = 337). The COX-2 inhibitors showed a decrease in the rescue analgesic consumption (n = 138; I2 = 15%; mean difference = −0.31; 95%CIs = −0.6 to −0.01), and lower pain intensity at four hours (n = 178; I2 = 0%; mean difference = −2.25; 95%CIs = −2.94 to −1.55; p = 0.00001) when compared to active controls after periodontal surgery. In conclusion, the data indicate that COX-2 agents produce better pain relief in comparison to placebo and other drugs after periodontal surgery.
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Affiliation(s)
- Mario Alberto Isiordia-Espinoza
- Instituto de Investigación en Ciencias Médicas, Departamento de Clínicas, División de Ciencias Biomédicas, Centro Universitario de los Altos, Universidad de Guadalajara, Av. Rafael Casillas Aceves No. 1200, Tepatitlán de Morelos 47620, Jalisco, Mexico
| | - Eduardo Gómez-Sánchez
- División de Disciplinas Clínicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Sierra Mojada 950, Colonia Independencia Oriente, Guadalajara 44340, Mexico
| | - Itzel Joselyn Mora-Falcón
- Instituto de Investigación en Ciencias Médicas, Departamento de Clínicas, División de Ciencias Biomédicas, Centro Universitario de los Altos, Universidad de Guadalajara, Av. Rafael Casillas Aceves No. 1200, Tepatitlán de Morelos 47620, Jalisco, Mexico
| | - Iván Agustín Amador-Beas
- Instituto de Investigación en Ciencias Médicas, Departamento de Clínicas, División de Ciencias Biomédicas, Centro Universitario de los Altos, Universidad de Guadalajara, Av. Rafael Casillas Aceves No. 1200, Tepatitlán de Morelos 47620, Jalisco, Mexico
| | - Adriana Hernández-Gómez
- Instituto de Investigación en Ciencias Médicas, Departamento de Clínicas, División de Ciencias Biomédicas, Centro Universitario de los Altos, Universidad de Guadalajara, Av. Rafael Casillas Aceves No. 1200, Tepatitlán de Morelos 47620, Jalisco, Mexico
| | - Nicolás Addiel Serafín-Higuera
- Centro de Ciencias de la Salud, Facultad de Odontología, Universidad Autónoma de Baja California, Campus Mexicali, Mexicali 21040, Mexico
| | - Lorenzo Franco-de la Torre
- Instituto de Investigación en Ciencias Médicas, Departamento de Clínicas, División de Ciencias Biomédicas, Centro Universitario de los Altos, Universidad de Guadalajara, Av. Rafael Casillas Aceves No. 1200, Tepatitlán de Morelos 47620, Jalisco, Mexico
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Hegde V, Shanmugasundaram S, Shaikh S, Kulkarni V, Suresh N, Setzer FC, Nagendrababu V. Effect of Preoperative Oral Steroids in Comparison to Anti-inflammatory on Anesthetic Success of Inferior Alveolar Nerve Block in Mandibular Molars with Symptomatic Irreversible Pulpitis-A Double-blinded Randomized Clinical Trial. J Endod 2023; 49:354-361. [PMID: 36736586 DOI: 10.1016/j.joen.2023.01.007] [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: 12/14/2022] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 02/05/2023]
Abstract
INTRODUCTION This randomized double-blinded trial aimed to compare the anesthetic success of inferior alveolar nerve blocks (IANBs) with 2% lidocaine in mandibular molars with symptomatic irreversible pulpitis (SIP) after oral premedication of prednisolone, dexamethasone, and ketorolac with placebo. METHODS One hundred eighty-four patients diagnosed with SIP in mandibular molars randomly received prednisolone, dexamethasone, ketorolac, or placebo (n = 46 each) 60 minutes before the administration of an IANB. The access cavity preparation was initiated after successfully confirming lip numbness and two consecutive negative responses to electric pulp testing. The success of the anesthesia was clinically confirmed when pain was absent during the endodontic access or instrumentation. A one-way analysis of variance test was used to compare quantitative variables among the groups, and chi-square tests were used for comparing categorical variables. Binary logistic regression was performed to analyze the relationship of age, preoperative pain, and preoperative medications. RESULTS When premedicated with oral dexamethasone, ketorolac, prednisolone, and placebo, the success rate of IANB was determined to be 60.86 %, 65.21 %, 56.52 %, and 21.73 %, respectively. Compared to the placebo, the success rate of IANB was significantly increased when patients were premedicated with prednisolone, dexamethasone, or ketorolac. However, there were no statistically significant differences among prednisolone, dexamethasone, and ketorolac. One individual in the ketorolac group reported gastritis, whereas no adverse effects were reported in the dexamethasone or prednisolone groups. CONCLUSIONS Preoperative use of oral ketorolac, dexamethasone, or prednisolone may increase the anesthetic efficacy of IANB in mandibular molars with SIP.
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Affiliation(s)
- Vivek Hegde
- Department of Conservative Dentistry and Endodontics, M.A. Rangoonwala College of Dental Sciences and Research Center, Pune, India
| | - Srilatha Shanmugasundaram
- Department of Conservative Dentistry and Endodontics, M.A. Rangoonwala College of Dental Sciences and Research Center, Pune, India
| | - Samia Shaikh
- Department of Conservative Dentistry and Endodontics, M.A. Rangoonwala College of Dental Sciences and Research Center, Pune, India
| | - Vaidehi Kulkarni
- Department of Conservative Dentistry and Endodontics, M.A. Rangoonwala College of Dental Sciences and Research Center, Pune, India
| | - Nandini Suresh
- Faculty of dentistry, Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research (MAHER), Tamilnadu, India
| | - Frank C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE.
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12
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Santos BFE, Costa FO, Vasconcelos AMA, Cyrino RM, Cota LOM. Preemptive effects of ibuprofen and nimesulide on postoperative pain control after open flap periodontal surgeries: A randomized placebo-controlled split-mouth clinical trial. J Periodontol 2021; 93:298-307. [PMID: 34031888 DOI: 10.1002/jper.20-0887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/13/2021] [Accepted: 05/17/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND Data on preemptive analgesia in periodontal surgeries are scarce and still diverse. The aim of this study was to evaluate and compare the analgesic effects of the preemptive administration of ibuprofen and nimesulide in open flap periodontal surgeries. METHODS The present randomized controlled clinical trial comprised 40 individuals, divided into two groups (n = 20), according to the test drug (ibuprofen and nimesulide) to be administered 1 hour preoperatively. Participants underwent bilateral periodontal surgeries at two different times, and were randomly given the test drug or placebo in a split-mouth design. Postoperative pain and rescue medication were evaluated at different times. Comparisons between ibuprofen and nimesulide were performed through a Generalized Estimation Equation model, using test drug and evaluation times, along with an interaction between these two variables as predictors. RESULTS In intergroup comparisons regarding pain control, ibuprofen showed better effects than placebo only at the first postoperative hour, whereas nimesulide showed better effects than placebo at 1, 6, 24, and 48 postoperative hours. In intergroup comparisons, nimesulide showed better effects than ibuprofen at 24, 48, and 72 postoperative hours, demonstrating a higher overall preemptive effect. No differences were observed in relation to the number of rescue medication. CONCLUSION Preemptive administration of nimesulide showed better overall preemptive effects on postoperative pain control when compared with ibuprofen.
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Affiliation(s)
- Bianca F E Santos
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Fernando O Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Andrea M A Vasconcelos
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Renata M Cyrino
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Minas Gerais, Brazil
| | - Luís O M Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Minas Gerais, Brazil
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13
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Vieth MP, Deas DE, Archontia Palaiologou A, Diogenes A, Mader MJ, Mealey BL. Effect of intravenous dexamethasone on postoperative pain and swelling following periodontal flap surgery: A randomized controlled trial of patient-centered outcomes. J Periodontol 2021; 93:237-245. [PMID: 34021915 DOI: 10.1002/jper.21-0153] [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: 03/11/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND This randomized, crossover trial sought to determine if a preoperative intravenous (IV) dose of dexamethasone reduces pain, swelling, and analgesic usage following periodontal surgery. METHODS Thirty-seven patients planned for two similar periodontal flap surgeries under IV sedation were enrolled. Patients were randomized to receive either 2 mL (8 mg) dexamethasone sodium phosphate or 2 mL of IV solution (placebo) before the first surgery, and 2 mL of the other solution before the second surgery. Postoperative discomfort was managed with a standardized regimen of 600 mg ibuprofen and 325 mg acetaminophen. A smartphone application was used to record self-assessed pain and swelling scores using 21-point numerical (NRS-21) and 4-point verbal (VRS-4) rating scales as well as the number of analgesic medications taken at 12-, 24-, 48-, 72-, 168-, and 336-hours following each surgery. RESULTS IV dexamethasone was associated with a significant reduction in pain at 12, 24, 48, and 72 hours (P <0.05), and swelling at 12, 24, 48, and 168 hours (P < 0.05) postoperatively when compared with placebo based on NRS-21 responses. VRS-4 data showed significant reductions in pain at 12, 72, and 168 hours and swelling at 12, 24, and 168 hours postoperatively with dexamethasone. No significant differences were found in the number of tablets of ibuprofen or acetaminophen between dexamethasone and placebo surgeries. CONCLUSIONS Preoperative, intravenously administered dexamethasone reduces pain and swelling within the first postoperative week following periodontal flap surgery and should be considered a useful adjunct for perioperative management.
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Affiliation(s)
- Michael P Vieth
- Department of Periodontics, UT Health San Antonio School of Dentistry, San Antonio, TX
| | - David E Deas
- Department of Periodontics, UT Health San Antonio School of Dentistry, San Antonio, TX
| | | | - Anibal Diogenes
- Department of Endodontics, UT Health San Antonio School of Dentistry, San Antonio, TX
| | - Michael J Mader
- Research and Development Service, South Texas Veterans Health Care System, San Antonio, TX
| | - Brian L Mealey
- Department of Periodontics, UT Health San Antonio School of Dentistry, San Antonio, TX
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14
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Wagner JC, Johnson TM, Gilbert WA. Should periodontists prescribe postoperative oral corticosteroids to control pain and swelling? A systematic review. Clin Adv Periodontics 2021; 12:134-142. [PMID: 33988318 DOI: 10.1002/cap.10169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/08/2021] [Indexed: 11/05/2022]
Abstract
FOCUSED CLINICAL QUESTION In generally healthy patients receiving third molar, periodontal, or dental implant surgery, do postoperative oral corticosteroids effectively limit pain and swelling compared with placebo or alternative medications?
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Affiliation(s)
- Jennah C Wagner
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, Georgia
| | - Thomas M Johnson
- Department of Periodontics, Army Postgraduate Dental School, Uniformed Services University of the Health Sciences, Fort Gordon, Georgia
| | - William A Gilbert
- Department of Periodontics, US Army Dental Health Activity, Joint Base Lewis McChord, Tacoma, Washington
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Naser AY, Qadus S, Alwafi H, Jarrar Q, Ayoub R, Jaradat AA, Atiyah RM, Alqaisy AI. Dexamethasone and diclofenac intramuscular mixture injection and risk of death: A case series study. Clin Case Rep 2021; 9:2218-2221. [PMID: 33936668 PMCID: PMC8077341 DOI: 10.1002/ccr3.3988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/08/2021] [Accepted: 02/13/2021] [Indexed: 11/06/2022] Open
Abstract
Diclofenac and dexamethasone injection mixture could be associated with fatal cardiovascular events, further studies are warrantied to explore the safety of this injection mixture and explore the genetic role of it.
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Affiliation(s)
- Abdallah Y. Naser
- Department of Applied Pharmaceutical Sciences and Clinical PharmacyFaculty of PharmacyIsra UniversityAmmanJordan
| | - Sami Qadus
- Department of Applied Pharmaceutical Sciences and Clinical PharmacyFaculty of PharmacyIsra UniversityAmmanJordan
| | - Hassan Alwafi
- Faculty of MedicineUmm Alqura UniversityMeccaSaudi Arabia
| | - Qais Jarrar
- Department of Applied Pharmaceutical Sciences and Clinical PharmacyFaculty of PharmacyIsra UniversityAmmanJordan
| | - Rami Ayoub
- Department of Applied Pharmaceutical Sciences and Clinical PharmacyFaculty of PharmacyIsra UniversityAmmanJordan
| | - Abdolelah Ali Jaradat
- Department of Applied Pharmaceutical Sciences and Clinical PharmacyFaculty of PharmacyIsra UniversityAmmanJordan
| | | | - Abdulrahman Ibrahim Alqaisy
- Department of Applied Pharmaceutical Sciences and Clinical PharmacyFaculty of PharmacyIsra UniversityAmmanJordan
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Suresh N, Nagendrababu V, Koteeswaran V, Haritha JS, Swetha SD, Varghese A, Natanasabapathy V. Effect of preoperative oral administration of steroids in comparison to an anti-inflammatory drug on postoperative pain following single-visit root canal treatment - a double-blind, randomized clinical trial. Int Endod J 2020; 54:198-209. [PMID: 32976660 DOI: 10.1111/iej.13416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/04/2020] [Accepted: 09/17/2020] [Indexed: 01/01/2023]
Abstract
AIM This randomized, double-blinded, clinical trial evaluated the effect of oral premedication of piroxicam, prednisolone, dexamethasone or placebo on postoperative pain after single-visit root canal treatment in teeth with symptomatic irreversible pulpitis and symptomatic apical periodontitis. METHODOLOGY The trial is reported according to the Preferred Reporting Items for RAndomized Trials in Endodontics (PRIRATE) 2020 guidelines. The protocol was registered at the clinical trial registry (India) (CTRI/2019/06/019818). In total, 160 patients, assigned to four groups, received orally either 20 mg piroxicam, 20 mg prednisolone, 4 mg dexamethasone or a placebo 60 min before root canal treatment. Patients recorded their postoperative pain intensity at 6, 12, 24, 48 and 72 h using a 10-cm visual analogue scale. Intergroup comparison was performed using Kruskal-Wallis tests with post hoc analysis using Dunns test. Incidence of pain was analysed using chi-square tests. A P value < 0.05 was considered to be statistically significant. Binary logistic regression was used to determine the odds of postoperative pain, with incidence of pain as the dependent variable and intervention groups, gender, age and type of tooth as independent variables. RESULTS In total, 156 patients were analysed in the trial, since four patients dropped out during follow-up. All drugs were associated with a significantly lower incidence of postoperative pain compared to the placebo at 6 h (P = 0.009), 12 h (P = 0.003) and 24 h (P = 0.008). Mean intensity of pain was significantly more intense at 6, 12 and 24 h with the use of placebo in comparison to the other three intervention groups (P < 0.05). Intensity of pain was not significantly different between the premedications used (P > 0.05). One patient in the piroxicam group reported gastritis, whereas no adverse effects were recorded in other groups. CONCLUSION Preoperative oral administration of a single dose of 4 mg dexamethasone, 20 mg piroxicam or 20 mg prednisolone reduced the incidence and severity of postoperative pain following single-visit root canal treatment compared to a placebo in patients with symptomatic irreversible pulpitis and symptomatic apical periodontitis up to 24 h. The odds of postoperative pain at 24 h for patients premedicated with 4 mg dexamethasone or 20 mg piroxicam or 20 mg prednisolone were 5.3 times, 3.4 times and 2.5 times less compared to the placebo, respectively.
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Affiliation(s)
- N Suresh
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - V Nagendrababu
- Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.,Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
| | - V Koteeswaran
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - J S Haritha
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - S D Swetha
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - A Varghese
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
| | - V Natanasabapathy
- Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Meenakshi Ammal Dental College, Chennai, India
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Caporossi LS, Dos Santos CS, Calcia TBB, Cenci MS, Muniz FWMG, da Silveira Lima G. Pharmacological management of pain after periodontal surgery: a systematic review with meta-analysis. Clin Oral Investig 2020; 24:2559-2578. [PMID: 32572640 DOI: 10.1007/s00784-020-03401-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/09/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To assess and compare the pharmacological effect of different drugs on pain relief after periodontal surgery. MATERIALS AND METHODS Five databases were searched up to September 2019. The eligible studies comprised randomized clinical trials, involving only adult individuals that received any periodontal surgery and presenting two distinct groups of therapeutic regimens to control postoperative pain. Placebo groups could be included. The risk of bias was assessed with the RoB 2 Cochrane tool and the GRADE system. Meta-analyses were performed using different follow-up and drug comparisons. RESULTS Overall, 2398 studies were identified, of which 35 were included. Low risk of bias was determined for the majority of the studies. The meta-analyses showed that the comparison of dexamethasone or non-steroidal anti-inflammatory drugs (NSAID) versus placebo favored the use of both interventions in a follow-up of 1 to 8 h for open flap procedures (OFP). However, no statistical difference was found for the comparison between NSAID and dexamethasone for OFP. CONCLUSIONS Patients may benefit from several pharmacological schemes for pain relief after periodontal surgeries. However, due to the high heterogeneity among studies, no fixed pharmacological protocol could be proposed. CLINICAL RELEVANCE There is not enough evidence to recommend one therapeutic scheme. However, untreated pain is harmful to the patients and it is not advisable.
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Affiliation(s)
- Leonardo Stephan Caporossi
- Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, Rio Grande do Sul, Brazil
| | - Cinthia Studzinski Dos Santos
- Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, Rio Grande do Sul, Brazil
| | | | - Maximiliano Sergio Cenci
- Department of Operative Dentistry, Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves, St., Pelotas, Rio Grande do Sul, Brazil
| | - Francisco Wilker Mustafa Gomes Muniz
- Department of Periodontology, Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, Rio Grande do Sul, Brazil
| | - Giana da Silveira Lima
- Department of Operative Dentistry, Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves, St., Pelotas, Rio Grande do Sul, Brazil.
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18
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Kumar S, Sanghavi P, Patel P, Sonvane P, Dave P, Gor V, Mohammed I. Efficacy of preemptive oral doses of acetaminophen and celecoxib for post-operative pain management after open-flap debridement: A randomised controlled study. ADVANCES IN HUMAN BIOLOGY 2020. [DOI: 10.4103/aihb.aihb_83_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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Pereira GM, Cota LOM, Lima RPE, Costa FO. Effect of preemptive analgesia with ibuprofen in the control of postoperative pain in dental implant surgeries: A randomized, triple-blind controlled clinical trial. J Clin Exp Dent 2020; 12:e71-e78. [PMID: 31976047 PMCID: PMC6969969 DOI: 10.4317/medoral.56171] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 12/09/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Preemptive analgesia has as its basic principle the administration of analgesics before the onset of painful stimuli, in order to reduce or prevent postoperative pain, but this question is little explored in implantology. Thus, this study was conducted in order to evaluate the clinical efficacy of ibuprofen in pain prevention after unit implant surgery. MATERIAL AND METHODS For this triple-blind, parallel, placebo-controlled and randomized clinical trial, 54 insertion surgeries of unitary implants were performed. Two groups have received two different protocols 1 hour before surgery: Ibuprofen group (IBU) 600 mg of ibuprofen; and (2) placebo group (maize starch). The intensity of the pain was evaluated through the visual analogue scale (VAS) in 6 times (1, 6, 12, 24, 48 and 72 hours after the surgery). Patients were instructed to take 750 mg of paracetamol as rescue medication, if necessary. The occurrence and the intensity of pain were analyzed by means of an analysis of variance ANOVA with repeated measurements using the general linear model procedure. RESULTS The IBU group had significantly lower VAS scores overall (IBU = 0.30, ± 0.57; placebo = 1.14, ± 1.07; p<0.001) and at all times in the intra, intergroup comparisons and time/group interaction than the placebo group (p<0.001). The use of rescue medication was significantly lower and the postoperative time was longer in the IBU group compared to placebo (p = 0.002). CONCLUSIONS The single use of ibuprofen was found to be significantly superior in reducing pain after unit implant surgery compared to placebo. Key words:Analgesia, dental implants, pain, surgery, oral.
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Affiliation(s)
- Gustavo-Mattos Pereira
- Department of Dental Clinics, Oral Surgery and Oral Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luís-Otávio-Miranda Cota
- Department of Dental Clinics, Oral Surgery and Oral Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rafael-Paschoal-Esteves Lima
- Department of Dental Clinics, Oral Surgery and Oral Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernando-Oliveira Costa
- Department of Dental Clinics, Oral Surgery and Oral Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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20
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Comparison of Low Pre-Emptive Oral Doses of Celecoxib Versus Acetaminophen for Postoperative Pain Management After Third Molar Surgery: A Randomized Controlled Study. J Oral Maxillofac Surg 2020; 78:75.e1-75.e6. [DOI: 10.1016/j.joms.2019.09.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/22/2019] [Accepted: 09/23/2019] [Indexed: 02/07/2023]
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21
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Lafzi A, Kadkhodazadeh M, Mojahedi SM, Amid R, Shidfar S, Baghani MT. The Clinical Evaluation of the Effects of Low-Level Laser Therapy on the Donor and Recipient Sites of the Free Gingival Graft: A Case Series. J Lasers Med Sci 2019; 10:355-360. [PMID: 31875132 PMCID: PMC6885901 DOI: 10.15171/jlms.2019.58] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Introduction: Free gingival grafting is among the most foreseeing procedures for increasing the zone of keratinized attached gingiva and enhancing soft tissue around the teeth and dental implants. Nowadays low-level laser therapy (LLLT) is a promising approach in providing patients with more pleasing results in terms of esthetics and comfort. This study aims to investigate the effects of LLLT on gingival recessions treated with free gingival graft (FGG). Methods: This case series was conducted on 12 individuals requiring a bilateral gingival graft in the mandibular region. There was a 30-day interval between the two operations. The test side was selected randomly and irradiated by a low-level laser (LLL) just before surgery. The patients did not know which side was irradiated. LLLT was applied to the donors' as well as recipients' site immediately after the operation and 48 hours later. The patients were instructed to record their post-operative pain in a visual analogue scale (VAS) 3 and 24 hours and 7 days after the surgical procedure. The clinical photographs were taken immediately and 30 days after surgical treatment were graded by three experienced periodontists for color matching to adjacent tissues. Results: Ten individuals could finish the study. The test group presented significantly better shade matching and wound healing at the palatal donor site on days 7, 14 and 21. There was a significant reduction in post-operative pain after 24 hours (P = 0.007). No statistically significant difference was found between both groups in terms of clinical periodontal indices. Conclusion: LLLT could reduce post-operative pain 24 hours after surgical treatment. Furthermore, the application of LLLT could improve the donors' site healing and the recipients' site color matching.
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Affiliation(s)
- Ardeshir Lafzi
- Department of Periodontics, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Kadkhodazadeh
- Department of Periodontics, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Mojahedi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Amid
- Department of Periodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shireen Shidfar
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Periodontics, School of Dentistry, QOM University of medical sciences, QOM, Iran
| | - Mohammad Taghi Baghani
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Konagala RK, Mandava J, Pabbati RK, Anupreeta A, Borugadda R, Ravi R. Effect of pretreatment medication on postendodontic pain: A double-blind, placebo-controlled study. J Conserv Dent 2019; 22:54-58. [PMID: 30820083 PMCID: PMC6385568 DOI: 10.4103/jcd.jcd_135_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/15/2018] [Accepted: 01/25/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Posttreatment endodontic pain has been reported in 25%-40% of all endodontic patients. Effective management of endodontic pain represents a continuing challenge. AIM To evaluate and compare the efficacy of preoperative single dose of nonsteroidal anti-inflammatory drug, piroxicam (20 mg), with two types of corticosteroid drugs - dexamethasone (4 mg) or deflazacort (30 mg) - for the prevention and control of postendodontic pain. MATERIALS AND METHODS A total of 132 volunteers selected for nonsurgical root canal therapy were randomly divided into the following four groups (n = 30 each) according to preoperative medication given: Group 1, piroxicam (20 mg); Group 2, dexamethasone (4 mg); Group 3, deflazacort (30 mg); and Group 4, placebo. The preoperative medications were administrated 1 h before the start of standard endodontic treatment. Patients were instructed to complete a pain diary using Visual Analog Scale preoperatively and at 6-, 12-, 24-, 48-, and 72-h intervals after root canal instrumentation. STATISTICAL ANALYSIS The correlation between preoperative endodontic pain to postoperative pain and pair-wise comparison of four groups was evaluated by Kruskal-Wallis analysis of variance test followed by Mann-Whitney U-test. RESULTS Compared to the placebo group, piroxicam, dexamethasone, and deflazacort resulted in a statistically significant reduction in postendodontic pain at 6, 12, and 24 h (P < 0.05). CONCLUSION Preoperative single oral dose of piroxicam or dexamethasone or deflazacort is equally effective in controlling postendodontic pain.
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Affiliation(s)
- Ravi Kumar Konagala
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Jyothi Mandava
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Ravi Kumar Pabbati
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - A. Anupreeta
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Roopesh Borugadda
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Ravichandra Ravi
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
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Shen S, Gao Z, Liu J. The efficacy and safety of methylprednisolone for pain control after total knee arthroplasty: A meta-analysis of randomized controlled trials. Int J Surg 2018; 57:91-100. [DOI: 10.1016/j.ijsu.2018.07.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/24/2018] [Accepted: 07/27/2018] [Indexed: 11/25/2022]
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Isler SC, Eraydin N, Akkale H, Ozdemir B. Oral flurbiprofen spray for mucosal graft harvesting at the palatal area: A randomized placebo-controlled study. J Periodontol 2018; 89:1174-1183. [DOI: 10.1002/jper.17-0381] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 01/06/2018] [Accepted: 01/30/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Sila Cagri Isler
- Department of Periodontology; Faculty of Dentistry; Gazi University; Ankara Turkey
| | - Nihal Eraydin
- Department of Periodontology; Faculty of Dentistry; Gazi University; Ankara Turkey
| | - Habibe Akkale
- Department of Periodontology; Faculty of Dentistry; Gazi University; Ankara Turkey
| | - Burcu Ozdemir
- Department of Periodontology; Faculty of Dentistry; Gazi University; Ankara Turkey
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Evaluating the effect of photobiomodulation with a 940-nm diode laser on post-operative pain in periodontal flap surgery. Lasers Med Sci 2018; 33:1639-1645. [DOI: 10.1007/s10103-018-2492-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 03/21/2018] [Indexed: 12/15/2022]
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Giorgetti APO, Matos RD, Casarin RCV, Pimentel SP, Cirano FR, Ribeiro FV. Preemptive and Postoperative Medication Protocols for Root Coverage Combined with Connective Tissue Graft. Braz Dent J 2018; 29:23-29. [DOI: 10.1590/0103-6440201801452] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/06/2017] [Indexed: 11/22/2022] Open
Abstract
Abstract This trial evaluated the preemptive and postoperative effect of dexamethasone and ibuprofen on prevention of pain/discomfort, edema and interference in daily life in patients undergoing root coverage combined with subepithelial connective tissue graft (CAF + CTG). Twenty patients were randomly assigned as follows: NSAID Group: 400mg Ibuprofen 60 min preemptive + 400mg Ibuprofen postoperative; or SAID Group: 4mg Dexamethasone 60 min preemptive + 4mg Dexamethasone postoperative. The postoperative medication was administered 8 and 16 h post-surgery. Each patient received questionnaires based on a numeric scale (101-point numeric scale rate [NRS-101]) and multiple choice questions (four-point verbal rating scale [VRS-4]) about trans-operative pain/discomfort, hourly for 8 h after surgery and once a day for three days. A Visual Analogue Scale (VAS) for edema and interference in daily life during the 1st, 2nd, 3rd and 7th day was also answered. The degree of anxiety was rated statistically by the Chi-square test. The Mann-Whitney and Friedman tests were used for the other questionnaires. The surgery time and number of analgesic pills consumed were compared using Student’s t-test. Patients who used dexamethasone presented a trend toward less pain when compared to individuals who ingested ibuprofen, with a significant difference observed 3 h after the procedure (p<0.05). The use of dexamethasone also promoted less edema until the 2nd day and lower interference in daily life on the third day when compared with ibuprofen (p<0.05). We concluded that the use of dexamethasone as a preemptive and postoperative medication was more suitable as a drug therapeutic protocol for CAF + CTG.
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Taba M. Postsurgical Care Following Recession Coverage Procedures. GINGIVAL RECESSION MANAGEMENT 2018:147-157. [DOI: 10.1007/978-3-319-70719-8_11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Iranmanesh F, Parirokh M, Haghdoost AA, Abbott PV. Effect of Corticosteroids on Pain Relief Following Root Canal Treatment: A Systematic Review. IRANIAN ENDODONTIC JOURNAL 2017; 12:123-130. [PMID: 28496516 PMCID: PMC5421265 DOI: 10.22037/iej.2017.26] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 02/02/2017] [Accepted: 03/04/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Post-operative pain and flare-up may occur in up to 58% of patients following root canal treatment. The aim was to conduct a systematic review and a possible meta-analysis to determine the effect of glucocorticosteroid (GCS) on pain following root canal treatment. METHODS AND MATERIALS Scopus, MEDLINE and CENTRAL databases were searched up to 30th January 2017 with broad key words. In addition, the reference lists in eligible papers and text books were hand-searched. Assessment of the eligibility of papers and data extraction were performed by two independent reviewers. RESULTS Of 9891 articles, 18 were recruited as eligible papers. Most of these papers showed pain reducing effect of GCS on post-endodontic pain. Because of wide heterogeneity among the recruited papers, it was not possible to perform meta-analysis. CONCLUSION Based on the results of this systematic review, there is a vast heterogeneity amongst articles regarding the use of GCS and their effect on post-operative pain after endodontic treatment. Further investigations with similar methods and materials are needed before meta-analysis on the effect of GCS on post-operative pain following root canal treatment can be performed.
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Affiliation(s)
- Foad Iranmanesh
- Department ofEndodontics, Dental School, Rafsanjan University of Medical Sciences, Rafsanjan, Iran;
| | - Masoud Parirokh
- Endodontology Research Center, Dental School, Kerman University of Medical Sciences, Kerman, Iran;
| | - Ali Akbar Haghdoost
- Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, Iran;
| | - Paul V. Abbott
- Dental School, University of Western Australia, Perth, Australia
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Bahammam MA, Kayal RA, Alasmari DS, Attia MS, Bahammam LA, Hassan MH, Alzoman HA, Almas K, Steffens JP. Comparison Between Dexamethasone and Ibuprofen for Postoperative Pain Prevention and Control After Surgical Implant Placement: A Double-Masked, Parallel-Group, Placebo-Controlled Randomized Clinical Trial. J Periodontol 2016; 88:69-77. [PMID: 27562219 DOI: 10.1902/jop.2016.160353] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Postoperative pain is a potential adverse side effect of oral surgeries, and attempts should be made to prevent or minimize it. This study compares efficacy of preemptive ibuprofen and dexamethasone protocols for pain prevention or control after surgical implant placement. METHODS This prospective, double-masked, parallel-group, placebo-controlled, randomized clinical trial included 117 patients with planned dental implant placement. Patients were assigned to receive one of three different protocols: 1) 600 mg ibuprofen 1 hour before surgery and another 600 mg 6 hours after the first dose; 2) 4 mg dexamethasone 1 hour before surgery and another 4 mg 6 hours after the first dose; or 3) placebo. Rescue medication (1,000 mg acetaminophen) was made available to each patient, and they were instructed to take it as necessary. Pain intensity was evaluated via a 101-point numeric rating scale and a visual analog scale, and discomfort was evaluated using a four-point verbal rating scale hourly for the first 8 hours after surgery and three times daily for the following 3 days. RESULTS Ibuprofen and dexamethasone significantly reduced pain (Kruskal-Wallis; P <0.05) up to 3 days after surgery and discomfort (P <0.05) up to 2 days after surgery compared with placebo treatment. Both treatments reduced the number of painkillers taken and increased time before the first painkiller was taken (P <0.01). CONCLUSION Steroidal dexamethasone is as effective as non-steroidal ibuprofen for preventing or controlling postoperative pain and discomfort after surgical implant placement.
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Affiliation(s)
- Maha A Bahammam
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Rayyan A Kayal
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Dhafer S Alasmari
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.,Department of Periodontology, Faculty of Dentistry, Qassim University, Qassim, Kingdom of Saudi Arabia
| | - Mai S Attia
- Department of Periodontology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.,Department of Periodontology, Faculty of Dentistry, Qassim University, Qassim, Kingdom of Saudi Arabia.,Radiology Department, Al Azhar University
| | - Laila A Bahammam
- Endodontics Department, Faculty of Dentistry, King Abdulaziz University
| | - Mona H Hassan
- Dental Public Health Department, Faculty of Dentistry, King Abdulaziz University.,Department of Biostatistics, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Hamad A Alzoman
- Department of Periodontics and Community Dentistry, King Saud University College of Dentistry, Riyadh, Kingdom of Saudi Arabia
| | - Khalid Almas
- Preventive Dental Science Department, University of Dammam College of Dentistry, Dammam, Kingdom of Saudi Arabia
| | - Joao Paulo Steffens
- Department of Stomatology, Federal University of Paraná, Curitiba, Paraná, Brazil
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Metri M, Hegde S, Bhandi S. Effect of pretreatment diclofenac sodium on postendodontic pain: A randomised controlled trial. J Conserv Dent 2016; 19:7-10. [PMID: 26957785 PMCID: PMC4760019 DOI: 10.4103/0972-0707.173183] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Effective management of endodontic pain represents a continuing challenge. Many of the dental professionals are facing significant problems associated with postendodontic pain. Hence, the postendodontic pain has to be prevented at its primary stage without waiting for its occurrence. This trial was carried out to evaluate the use of a preoperative, single oral dose of diclofenac sodium for the prevention and control of postendodontic pain. MATERIALS AND METHODS Fifty patients were randomly assigned to two groups, placebo and diclofenac sodium (100 mg). The medications were administered 30 min before the start of standard endodontic treatment. Postoperative pain was assessed after 6, 12, and 24 h by using a visual analog scale. RESULTS Postendodontic pain showed a statistically significant difference between both groups at 6 and 12 h (P < 0.05) and there was no significant difference at 24 h. CONCLUSION Postendodontic pain was substantially reduced by preoperative administration of single oral dose of diclofenac sodium. It is thus possible to conclude that these favorable results might help to prevent postendodontic pain, especially in patients with a low pain threshold.
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Affiliation(s)
- Malasiddappa Metri
- Department of Conservative Dentistry and Endodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Swaroop Hegde
- Department of Conservative Dentistry and Endodontics, M S Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India
| | - Shilpa Bhandi
- Department of Conservative Dentistry and Endodontics, M S Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India
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Pre-Emptive Analgesia With Pregabalin and Celecoxib Decreases Postsurgical Pain Following Maxillomandibular Advancement Surgery: A Randomized Controlled Clinical Trial. J Oral Maxillofac Surg 2014; 72:1909-14. [DOI: 10.1016/j.joms.2014.05.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 04/28/2014] [Accepted: 05/03/2014] [Indexed: 02/06/2023]
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Fardal Ø, McCulloch CA. Impact of Anxiety on Pain Perception Associated With Periodontal and Implant Surgery in a Private Practice. J Periodontol 2012; 83:1079-85. [DOI: 10.1902/jop.2011.110562] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Peres MFS, Ribeiro FV, Ruiz KGS, Nociti-Jr FH, Sallum EA, Casati MZ. Steroidal and non-steroidal cyclooxygenase-2 inhibitor anti-inflammatory drugs as pre-emptive medication in patients undergoing periodontal surgery. Braz Dent J 2012; 23:621-8. [DOI: 10.1590/s0103-64402012000600001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 11/26/2012] [Indexed: 11/22/2022] Open
Abstract
The aim of the present study was to compare the pre-emptive use of a cyclooxygenase-2 (COX-2) inhibitor with a well established steroidal anti-inflammatory drug for pain and edema relief following periodontal surgery for crown lengthening. Thirty patients requiring periodontal surgery were randomly assigned to receive one of the following medications: selective COX-2 inhibitor or steroidal anti-inflammatory drug, 60 min before the surgical procedure. To examine patient anxiety, a Corah's dental anxiety scale was applied before surgery. Using a visual analog scale, the extent of pain/discomfort during the trans-operative period and immediately after the surgery was measured. Additionally, intensity of pain/discomfort and edema were examined 4, 8, 12 and 24 h postoperatively. With regard to anxiety, no statistical differences between the groups were observed (p>0.05). With respect to the extent of pain/discomfort during the trans-operative, immediate and late postoperative period, data demonstrated no significant differences (p>0.05) between the COX-2 inhibitor and steroidal groups. With regard to edema, intragroup analysis did not reveal any statistically significant difference (p>0.05) during the 24 h following surgery in either group. In conclusion, both anti-inflammatory drugs presented a similar potential for pain and edema relief following periodontal surgery.
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Ribeiro FV, Casarin RC, Palma MA, Júnior FH, Sallum EA, Casati MZ. Clinical and Patient-Centered Outcomes After Minimally Invasive Non-Surgical or Surgical Approaches for the Treatment of Intrabony Defects: A Randomized Clinical Trial. J Periodontol 2011; 82:1256-66. [DOI: 10.1902/jop.2011.100680] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Steffens JP, Santos FA, Pilatti GL. The Use of Etoricoxib and Celecoxib for Pain Prevention After Periodontal Surgery: A Double-Masked, Parallel-Group, Placebo-Controlled, Randomized Clinical Trial. J Periodontol 2011; 82:1238-44. [DOI: 10.1902/jop.2011.100682] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Steffens JP, Pochapski MT, Santos FA, Pilatti GL. Efficacy of anesthetic agents to delay pain onset after periodontal surgery. Anesth Prog 2011; 58:57-60. [PMID: 21679040 PMCID: PMC3198127 DOI: 10.2344/0003-3006-58.2.57] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Accepted: 03/02/2011] [Indexed: 11/11/2022] Open
Abstract
The aim of this study was to evaluate the influence of 2 anesthetic agents on patients' postoperative pain perception after periodontal surgery. For this parallel-group, double-blinded, randomized clinical trial, 36 open flap debridement surgeries were performed on patients who presented with periodontal disease with clinical signs of inflammation after nonsurgical treatment on at least 1 quadrant. Patients were allocated to 1 of the following groups: group 1, 2% lidocaine with 1 ∶ 100,000 epinephrine; group 2, 2% mepivacaine with 1 ∶ 100,000 norepinephrine. Pain intensity was assessed using the visual analog scale during the first 8 hours after surgery. All patients received 750-mg acetaminophen tablets, which they were instructed to take as a rescue medication if necessary. The results demonstrated that postoperative pain intensity was statistically lower in group 2 than in group 1 at the 1-, 2-, and 3-hour periods after surgery, although the pain intensity for all groups could be considered mild. In conclusion, patients in both groups reported similar mild pain after periodontal surgery.
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Hungund S, Thakkar R. Effect of pretreatment with ketorolac tromethamine on operative pain during periodontal surgery: A case-control study. J Indian Soc Periodontol 2011; 15:55-8. [PMID: 21772723 PMCID: PMC3134049 DOI: 10.4103/0972-124x.82274] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 12/29/2010] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The efficacy of a nonsteroidal anti-inflammatory agent, ketorolac tromethamine, was evaluated in pain control after periodontal surgery. This type of agent acts peripherally by inhibiting the release of prostaglandins and minimizing the local inflammatory response. Thus, there may be an advantage in pretreatment administration of ketorolac tromethamine, 10 mg, compared with placebo on operative pain during periodontal surgery. MATERIALS AND METHODS Two groups of 40 outpatients from the Department of Periodontology, Darshan Dental College and Hospital, Udaipur, were selected for this study. Patients who were to undergo periodontal surgery were randomly given either one group 10 mg ketorolac immediately before surgery or the other group placebo tablets at least 30 minutes before administration of local anesthesia (LA). All procedures were performed under LA, and the total volume of anesthetic used was recorded. The duration of surgery from the time of incision to the placement of the last suture was recorded. At the completion of the surgery, patients were supplied with printed record forms and were asked to rate their subjective operative pain intensity using a visual analog scale. STATISTICAL ANALYSIS The data were analyzed using the student t test. RESULTS Results indicated that preoperative treatment with ketorolac significantly reduced initial pain intensity of operative pain as compared with placebo. No adverse reactions related to preoperative medication were observed. CONCLUSIONS The results of this study showed that 10-mg ketorolac administered immediately before periodontal surgery was effective for alleviating the operative painful sequelae.
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Affiliation(s)
- Shital Hungund
- Department of Periodontics, Darshan Dental College, Loyara, Udaipur, Rajasthan, India
| | - Rohit Thakkar
- Department of Periodontics, Darshan Dental College, Loyara, Udaipur, Rajasthan, India
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Kara C, Süleyman H, Tezel A, Orbak R, Cadirci E, Polat B, Kara I. Evaluation of pain levels after Nd: YAG laser and scalpel incisions: an experimental study in rats. Photomed Laser Surg 2010; 28:635-8. [PMID: 20961230 DOI: 10.1089/pho.2009.2639] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Postoperative pain is a recognized sequel of periodontal surgery. The pain experience has been shown to peak in the first 24 hours following the procedure, and to decrease rapidly in subsequent days. The aim of the present study was to evaluate the pain levels following scalpel- and laser-incision of rat hind paws. METHODS The study was carried out on 10 albino Wistar male rats. Rats were randomly assigned to two groups: Group I (n = 5, laser surgery), or Group II (n = 5, conventional surgery with scalpel). For measuring mechanical hyperalgesia, the nociceptive threshold of the hind paw after mechanical stimulation was quantified using a Basile algesimeter. The measurements were done before the surgery and on the postoperative 1(st), 2(nd), 3(rd), and 7(th) days. RESULTS While the pain levels of the groups were similar before the surgical procedures, the laser-applied rats had significantly fewer nociceptive thresholds of the hind paw after mechanical stimulation compared with the scalpel-incised rats on the postoperative 1(st), 2(nd), 3(rd), and 7(th) days. Functional complications were not observed in the laser groups at three days after the surgery. CONCLUSION The results suggested that, for soft tissue surgery, Nd: YAG lasers have often led to shorter operative times, less pain, and fewer postoperative adverse events.
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Affiliation(s)
- Cankat Kara
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey.
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Steffens JP, Santos FA, Sartori R, Pilatti GL. Preemptive Dexamethasone and Etoricoxib for Pain and Discomfort Prevention After Periodontal Surgery: A Double-Masked, Crossover, Controlled Clinical Trial. J Periodontol 2010; 81:1153-60. [DOI: 10.1902/jop.2010.100059] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Rashwan WAM. The efficacy of acetaminophen-caffeine compared to Ibuprofen in the control of postoperative pain after periodontal surgery: a crossover pilot study. J Periodontol 2009; 80:945-52. [PMID: 19485825 DOI: 10.1902/jop.2009.080637] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Previous studies showed that non-steroidal anti-inflammatory drugs (NSAIDs) have significant benefits in the control of pain after periodontal surgery. Acetaminophen (centrally acting NSAID) is believed to provide less analgesic efficacy than ibuprofen (centrally and peripherally acting NSAID). This study compared an alternative combination of acetaminophen, 500 mg, with caffeine, 30 mg, to ibuprofen, 400 mg, in pain management after periodontal surgeries. METHODS A prospective, randomized, double-masked crossover clinical trial was conducted on 15 patients. Open flap debridement was performed on two quadrants with a 3-week interval in between. Each quadrant was randomly assigned to acetaminophen, 500 mg, with caffeine, 30 mg, or ibuprofen, 400 mg, immediately after surgery and 8 hours after the first dose. Postoperative pain was assessed during the first 8 hours and on the following day using the 101-point numeric rate scale (NRS-101) and the four-point verbal rating scale (VRS-4). RESULTS Using the NRS-101, the acetaminophen-caffeine group showed statistically significantly lower mean pain scores than the ibuprofen group at 1 and 2 hours (P = 0.002), whereas at 6, 7, and 8 hours, the ibuprofen group showed statistically significantly lower mean pain scores (P <0.001). Using the VRS-4, there was no statistically significant difference between the two groups at all periods (P >0.05). CONCLUSION Acetaminophen, 500 mg, with caffeine, 30 mg, can be used efficiently in controlling postoperative pain after open flap debridement, especially in patients with gastric ulcers or bleeding tendency because acetaminophen is less hazardous than ibuprofen.
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Affiliation(s)
- Weam A M Rashwan
- Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt.
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Pochapski MT, Santos FA, de Andrade ED, Sydney GB. Effect of pretreatment dexamethasone on postendodontic pain. ACTA ACUST UNITED AC 2009; 108:790-5. [PMID: 19748294 DOI: 10.1016/j.tripleo.2009.05.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Revised: 05/05/2009] [Accepted: 05/11/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study evaluates the use of a preoperative single oral dose of dexamethasone for the prevention and control of postendodontic pain. STUDY DESIGN Forty-seven patients were randomly assigned to 2 groups: placebo and dexamethasone (4 mg). The medications were administered 1 hour before the start of endodontic treatment. Postoperative pain was assessed after 4, 12, 24, and 48 hours. RESULTS Dexamethasone resulted in a statistically significant reduction in postendodontic pain at 4 and 12 hours (P < .05). However, no statistical difference (P > .05) was observed at 24 and 48 hours (Mann-Whitney test). The placebo group exhibited higher rescue medication intake (P < .05; Student t test). No side effects were reported for any of the medications used. CONCLUSION Preoperative single oral dose of dexamethasone substantially reduced postendodontic pain. Further studies are needed to evaluate the applicability of these findings to other clinical conditions and drug regimens.
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Affiliation(s)
- Márcia Thaís Pochapski
- Department of Pharmacology, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil.
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