1
|
Salaberry DR, Bruno LH, Cirisola RWC, Longo PL, Chavantes MC, Navarro RS, Gonçalves MLL, Sobral APT, Gimenez T, Duran CCG, Motta LJ, Bussadori SK, Horliana ACRT, Mesquita Ferrari RA, Fernandes KPS. Assessment of the pre-emptive effect of photobiomodulation in the postoperative period of impacted lower third molar extractions: A randomized, controlled, double-blind study protocol. PLoS One 2024; 19:e0300136. [PMID: 38885236 PMCID: PMC11182519 DOI: 10.1371/journal.pone.0300136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 02/20/2024] [Indexed: 06/20/2024] Open
Abstract
Photobiomodulation is a safe option for controlling pain, edema, and trismus when applied postoperatively in third molar surgery. However, administration prior to surgery has been under-explored. This study aims to explore the effectiveness of pre-emptive photobiomodulation in reducing postoperative edema in impacted lower third molar extractions. Two groups of healthy individuals undergoing tooth extraction will be randomly assigned: Control group receiving pre-emptive corticosteroid and simulated photobiomodulation, and Photobiomodulation Group receiving intraoral low-intensity laser and extraoral LED cluster application. The primary outcome will be postoperative edema after 48 h. The secondary outcomes will be pain, trismus dysphagia, and analgesic intake (paracetamol). These outcomes will be assessed at baseline as well as two and seven days after surgery. Adverse effects will be recorded. Data will be presented as means ± SD and a p-value < 0.05 will be indicative of statistical significance.
Collapse
Affiliation(s)
- Daniel Rodríguez Salaberry
- Postgraduate Program in Biophotonics Medicine, Nove de Julho University, Sao Paulo, Sao Paulo, Brazil
- Dentistry School, Universidad Católica del Uruguay, Montevideo, Montevideo, Uruguay
| | - Laura Hermida Bruno
- Postgraduate Program in Biophotonics Medicine, Nove de Julho University, Sao Paulo, Sao Paulo, Brazil
- Dentistry School, Universidad Católica del Uruguay, Montevideo, Montevideo, Uruguay
| | - Rolf Wilhem Consolandich Cirisola
- Postgraduate Program in Biophotonics Medicine, Nove de Julho University, Sao Paulo, Sao Paulo, Brazil
- Dentistry School, Universidad Católica del Uruguay, Montevideo, Montevideo, Uruguay
| | - Priscila Larcher Longo
- Postgraduate Program in Biophotonics Medicine, Nove de Julho University, Sao Paulo, Sao Paulo, Brazil
- Postgraduate Program in Aging Science, São Judas Tadeu University, Sao Paulo, Sao Paulo, Brazil
| | - Maria Cristina Chavantes
- Postgraduate Program in Biophotonics Medicine, Nove de Julho University, Sao Paulo, Sao Paulo, Brazil
| | | | | | - Ana Paula Taboada Sobral
- Postgraduate Program in Health and Environment, Metropolitana de Santos University, Santos, Sao Paulo, Brazil
| | - Thais Gimenez
- Postgraduate Program in Health and Environment, Metropolitana de Santos University, Santos, Sao Paulo, Brazil
| | | | - Lara Jansiski Motta
- Postgraduate Program in Biophotonics Medicine, Nove de Julho University, Sao Paulo, Sao Paulo, Brazil
| | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Medicine, Nove de Julho University, Sao Paulo, Sao Paulo, Brazil
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University, Sao Paulo, Sao Paulo, Brazil
| | | | - Raquel Agnelli Mesquita Ferrari
- Postgraduate Program in Biophotonics Medicine, Nove de Julho University, Sao Paulo, Sao Paulo, Brazil
- Postgraduate Program in Rehabilitation Sciences, Nove de Julho University, Sao Paulo, Sao Paulo, Brazil
| | | |
Collapse
|
2
|
Pimenta RP, Takahashi CM, Barberato-Filho S, McClung DCF, Moraes FDS, de Souza IM, Bergamaschi CDC. Preemptive use of anti-inflammatories and analgesics in oral surgery: a review of systematic reviews. Front Pharmacol 2024; 14:1303382. [PMID: 38328575 PMCID: PMC10847331 DOI: 10.3389/fphar.2023.1303382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/22/2023] [Indexed: 02/09/2024] Open
Abstract
Objectives: This review of systematic reviews evaluated the effectiveness and safety of the preemptive use of anti-inflammatory and analgesic drugs in the management of postoperative pain, edema, and trismus in oral surgery. Materials and methods: The databases searched included the Cochrane Library, MEDLINE, EMBASE, Epistemonikos, Scopus, Web of Science, and Virtual Health Library, up to March 2023. Pairs of reviewers independently selected the studies, extracted the data, and rated their methodological quality using the AMSTAR-2 tool. Results: All of the 19 studies reviewed had at least two critical methodological flaws. Third molar surgery was the most common procedure (n = 15) and the oral route the most frequent approach (n = 14). The use of betamethasone (10, 20, and 60 mg), dexamethasone (4 and 8 mg), methylprednisolone (16, 20, 40, 60, 80, and 125 mg), and prednisolone (10 and 20 mg) by different routes and likewise of celecoxib (200 mg), diclofenac (25, 30, 50, 75, and 100 mg), etoricoxib (120 mg), ibuprofen (400 and 600 mg), ketorolac (30 mg), meloxicam (7.5, 10, and 15 mg), nimesulide (100 mg), and rofecoxib (50 mg) administered by oral, intramuscular, and intravenous routes were found to reduce pain, edema, and trismus in patients undergoing third molar surgery. Data on adverse effects were poorly reported. Conclusion: Further randomized clinical trials should be conducted to confirm these findings, given the wide variety of drugs, doses, and routes of administration used.
Collapse
Affiliation(s)
- Régis Penha Pimenta
- Pharmaceutical Sciences Graduate Course, University of Sorocaba, Sorocaba, São Paulo, Brazil
| | | | - Silvio Barberato-Filho
- Pharmaceutical Sciences Graduate Course, University of Sorocaba, Sorocaba, São Paulo, Brazil
| | | | - Fabio da Silva Moraes
- Pharmaceutical Sciences Graduate Course, University of Sorocaba, Sorocaba, São Paulo, Brazil
| | | | | |
Collapse
|
3
|
Costa MDMDA, Paranhos LR, de Almeida VL, Oliveira LM, Vieira WDA, Dechichi P. Do blood concentrates influence inflammatory signs and symptoms after mandibular third molar surgery? A systematic review and network meta-analysis of randomized clinical trials. Clin Oral Investig 2023; 27:7045-7078. [PMID: 37884621 DOI: 10.1007/s00784-023-05315-5] [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: 03/31/2023] [Accepted: 10/04/2023] [Indexed: 10/28/2023]
Abstract
OBJECTIVES To investigate, through a network meta-analysis, the effectiveness of blood concentrates in reducing pain perception, trismus, and edema after mandibular third molar extraction. MATERIALS AND METHODS An electronic search was performed in nine databases to locate randomized clinical trials comparing blood concentrate use after mandibular third molar extraction. Two authors selected and extracted the data independently. The individual risk of bias in the studies was assessed with the RoB v2.0 tool. A network meta-analysis compared postoperative pain and trismus scores after applying different blood concentrates, using the mean difference (MD) as an effect estimate. The GRADE approach assessed the certainty of evidence. RESULTS Thirty-one randomized clinical trials were included in the review and 18 in the meta-analysis. Leukocyte- and platelet-rich fibrin (L-PRF) was the most used blood concentrate, followed by platelet-rich plasma (PRP). The network meta-analysis, depending on the analyzed period, evaluated up to 1240 surgeries. Among the analyzed blood concentrates, advanced platelet-rich fibrin (A-PRF) performed better among the analyzed blood concentrates, decreasing postoperative pain in 1, 2, 3, and 7 days and reducing trismus up to the inflammatory peak compared to blood clots. Only two studies had a low risk of bias. CONCLUSIONS Based on very low certainty of evidence, using concentrates seemed efficient compared to blood clots in reducing pain and trismus after mandibular third molar surgeries. A-PRF decreased postoperative pain throughout the evaluated time and trismus during the acute inflammatory peak. CLINICAL RELEVANCE A-PRF after mandibular third molar extractions performed better among the analyzed blood concentrates and seemed efficient in improving postoperative quality by decreasing inflammatory signs and symptoms.
Collapse
Affiliation(s)
| | - Luiz Renato Paranhos
- Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Campus Umuarama, Av. Pará, 1720, Bloco 2G, sala 1, ZIP code, Uberlândia, Minas Gerais, 38405-320, Brazil.
| | - Vinícius Lima de Almeida
- Postgraduate Program in Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Leandro Machado Oliveira
- Division of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Walbert de Andrade Vieira
- Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Paula Dechichi
- Department of Cell Biology, Histology, and Embryology, Biomedical Science Institute, Federal University of Uberlândia, Uberlândia, Brazil
| |
Collapse
|
4
|
Akhavanakbari G, Isazadehfar K, Entezariasl M, Kamran A, Rezapour S. Examining the efficacy of intravenous ibuprofen and meperidine for preventing post-operative shivering after laparoscopic cholecystectomy with general anesthesia. J Med Life 2023; 16:1041-1046. [PMID: 37900063 PMCID: PMC10600668 DOI: 10.25122/jml-2022-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 12/22/2022] [Indexed: 10/31/2023] Open
Abstract
Postoperative shivering is a common complication that can lead to increased postoperative complications. This study aimed to compare the effectiveness of intravenous ibuprofen and meperidine in preventing shivering following laparoscopic cholecystectomy. A total of 120 patients, aged 20-70 and classified as ASA I-II, were enrolled in this triple-blind clinical trial. The participants were randomly assigned to one of three groups: ibuprofen (800mg IV), meperidine (30 mg), or placebo (normal saline 2 ml), administered 30 minutes before the end of surgery. The occurrence of postoperative shivering was assessed and recorded at regular intervals (0, 5, 10, 15, 30, and 60 minutes after surgery). Additionally, postoperative pain levels were measured using a visual analog scale (VAS), sedation levels were evaluated using the Ramsay Sedation Scale (RSS), and the incidence of postoperative nausea and vomiting was documented. The prevalence and severity of postoperative shivering were not statistically significant between groups. The VAS was significantly lower in the meperidine group than the ibuprofen group throughout the study (p <0.001). The VAS was significantly lower in the ibuprofen group than the placebo group at 0 and 15 minutes after surgery. Although the incidence of nausea was slightly higher in the meperidine group, the difference was not statistically significant (p=0.75). Sedation scores were consistently lower in the ibuprofen group and higher in the meperidine group compared to the other groups (p<0.0001) The meperidine group had a significantly higher sedation score indicative of deep sleepiness (score of 4) than the other groups. Intravenous ibuprofen demonstrated comparable efficacy to meperidine in controlling shivering. Additionally, the incidence of nausea, vomiting, and sleepiness was lower in the intravenous ibuprofen group, suggesting it is a potential alternative to meperidine.
Collapse
Affiliation(s)
- Ghodrat Akhavanakbari
- Department of Anesthesiology, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Khatereh Isazadehfar
- Social Determinants of Health Research Center (SDHRC), Ardabil University of Medical Sciences, Ardabil, Iran
- Department of Social Medicine, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Masood Entezariasl
- Department of Anesthesiology, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Aziz Kamran
- Department of Health Education and Promotion, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Sahel Rezapour
- Department of Anesthesiology, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| |
Collapse
|