Preemptive use of oral nonsteroidal anti-inflammatory drugs for the relief of inflammatory events after surgical removal of lower third molars: A systematic review with meta-analysis of placebo-controlled randomized clinical trials

2020 ◽  
Vol 48 (3) ◽  
pp. 293-307 ◽  
Author(s):  
Edson Luiz Cetira Filho ◽  
Francisco Samuel Rodrigues Carvalho ◽  
Paulo Goberlânio de Barros Silva ◽  
Daniel Almeida Ferreira Barbosa ◽  
Karuza Maria Alves Pereira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Surgical Removal ◽  
Third Molars ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals Does the Preemptive Use of Oral Nonsteroidal Anti-inflammatory Drugs Reduce Postoperative Pain in Surgical Removal of Third Molars? A Meta-analysis of Randomized Clinical Trials

2015 ◽  
Vol 62 (2) ◽  
pp. 57-63 ◽  
Author(s):  
Fábio Wildson Gurgel Costa ◽  
Diego Felipe Silveira Esses ◽  
Paulo Goberlânio de Barros Silva ◽  
Francisco Samuel Rodrigues Carvalho ◽  
Carlos Diego Lopes Sá ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Third Molar ◽  
Preemptive Analgesia ◽  
Surgical Removal ◽  
Third Molars ◽  
Inflammatory Drugs ◽  
Cox 2 ◽  
Anti Inflammatory

Abstract The purpose of this study was to investigate the effectiveness of preemptive analgesia with nonsteroidal anti-inflammatory drugs (NSAIDs) in third-molar surgery. A PubMed literature search was conducted for articles restricted to the English language using the following terms (DeCS/MeSH) or combinations: analgesia, third molar, and preemptive. From a total of 704 articles, 6 (n = 420 subjects) were selected. All studies presented a low risk of bias (Cochrane criteria) but exhibited high heterogeneity of methods. Two studies were excluded from the meta-analysis because they did not have adequate numeric values (dichotomous data) for the calculations. Preemptive analgesia showed no significant benefit (n = 298, P = .2227, odds ratio: 2.30, 0.60–8.73) in reducing postoperative pain after removal of lower impacted third molars. However, there was a probable direct relationship between the effectiveness of NSAIDs in preemptive analgesia for removal of third molars and its selectivity for the cyclooxygenase-2 (COX-2). Preemptive analgesia did not have a significant effect in reducing postoperative pain after removal of lower impacted third molars. More homogeneous and well-delineated clinical studies are necessary to determine a possible association between NSAIDs' selectivity for COX-2 and treatment effectiveness.

scholarly journals The Effectiveness of the Cold Therapy (cryotherapy) in the Management of Inflammatory Parameters after Removal of Mandibular Third Molars: A Meta-Analysis

2019 ◽  
Vol 23 (02) ◽  
pp. 221-228 ◽  
Author(s):  
Ighor Andrade Fernandes ◽  
Anna Catharina Vieira Armond ◽  
Saulo Gabriel Moreira Falci
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Third Molar ◽  
Cochrane Library ◽  
Control Group ◽  
Surgical Removal ◽  
Third Molars ◽  
Cold Therapy ◽  
Mandibular Third Molar

Introduction Cold therapy (cryotherapy) is a common procedure recommended by dental surgeons after surgical removal of third molars, which is an invasive intervention that often deals with an expressive inflammatory response. Objective To investigate whether cryotherapy interferes with clinical outcomes such as pain, edema, and trismus in the postoperative period of mandibular third molar surgeries. Data Synthesis An electronic search was conducted in the OVID, PubMed, VHL, Science Direct, Cochrane Library, and Web of Science databases, through March 2018. The eligibility criteria included clinical trials that evaluated the effect of cryotherapy in at least one of the following variables: pain, swelling, and trismus.Two independent reviewers assessed the studies. The methodological quality of each article was analyzed. The search strategy resulted in 1,088 articles. Following the selection process, 11 studies were included in the systematic review and 4 of them in the meta-analysis. High risk of bias was found in most of the studies according to the Cochrane Handbook assessment. Patients receiving cryotherapy had less edema than patients in the control group at second day follow-up (mean difference [MD]: -0.94; 95%CI [-1.49; -0.39]). There were no statistically significant results when comparing trismus between experimental and control group (MD: 0.43; 95%CI [-0.34;1.20]). There were insufficient available data to support influences in postoperative pain. Conclusions Cryotherapy applied on the first day after mandibular third molar removal can manage edema in the patients. Well-designed randomized clinical trials to test the efficacy of cryotherapy after surgical removal of third molars are needed to justify its indication.

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