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.
Collapse