Post-operative pain management in dental implant surgery: a systematic review and meta-analysis of randomized clinical trials.
Analgesics
Dental implant
Nonsteroidal anti-inflammatory drugs
Pain
Surgery
Journal
Clinical oral investigations
ISSN: 1436-3771
Titre abrégé: Clin Oral Investig
Pays: Germany
ID NLM: 9707115
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
received:
18
11
2020
accepted:
22
02
2021
pubmed:
12
4
2021
medline:
24
4
2021
entrez:
11
4
2021
Statut:
ppublish
Résumé
To evaluate the clinical efficacy of various analgesic medications in mitigating orofacial pain following dental implant surgery. A systematic search was conducted to identify randomized controlled clinical trials (RCTs). The primary outcomes examined were post-operative pain (POP) and consumption of rescue analgesics following implant placement; secondary outcomes included adverse effects, post-operative inflammation, infection, swelling, bleeding, patient satisfaction, and quality of life. Random effects meta-analysis was conducted for risk ratios of dichotomous data. Nine RCTs fulfilled the eligibility criteria. Individual studies and meta-analysis of two studies indicated that nonsteroidal anti-inflammatory drugs (NSAIDs) significantly reduced POP and consumption of rescue analgesics after dental implant placement compared to placebo. Transdermal administration of NSAIDs may be superior to the oral route as it was similarly effective for POP control and resulted in fewer side effects. Glucocorticoids administered as primary analgesics or NSAID adjuvants resulted in comparable pain sensation compared to NSAIDs alone. Caffeine-containing analgesics were reported as acceptable and effective for the treatment of POP and swelling when compared to codeine adjuvants. With regard to analgesic dosing schedules, pain modulation may be most critical during the first 72 h following dental implant placement. Risk of bias assessment indicated an overall low risk of bias across the included trials. Within the limitations of this review, POP following implant surgery may be effectively treated with the short-term use of analgesic medications. However, given the heterogeneity in the available RCTs, there is insufficient evidence to recommend an analgesic regimen following dental implant surgery. Short-term use of analgesic medications may be sufficient for post-operative pain management in dental implant surgery. Ultimately, the clinician's analgesic prescription should be directed by a patient's medical history, in order to increase the success of pain management in a short period of time and decrease potential adverse effects. CRD42018099324.
Identifiants
pubmed: 33839939
doi: 10.1007/s00784-021-03859-y
pii: 10.1007/s00784-021-03859-y
doi:
Substances chimiques
Analgesics
0
Anti-Inflammatory Agents, Non-Steroidal
0
Dental Implants
0
Types de publication
Journal Article
Meta-Analysis
Review
Systematic Review
Langues
eng
Pagination
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