Efficacy of adjuvant ozone therapy in reducing postsurgical complications following impacted mandibular third-molar surgery: A systematic review and meta-analysis.
Impacted mandibular third molar
ozone
pain
swelling
systematic review
trismus
Journal
Journal of the American Dental Association (1939)
ISSN: 1943-4723
Titre abrégé: J Am Dent Assoc
Pays: England
ID NLM: 7503060
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
08
06
2020
revised:
05
05
2021
accepted:
14
05
2021
entrez:
28
9
2021
pubmed:
29
9
2021
medline:
21
10
2021
Statut:
ppublish
Résumé
Results from several randomized controlled trials have shown a beneficial effect of ozone in reducing postsurgical complications after impacted mandibular third-molar surgery, but the literature is lacking a systematic review and meta-analysis. The authors conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines after exclusion and inclusion criteria were applied and the following outcome parameters were evaluated: pain, swelling, trismus, quality of life, number of analgesics consumed, and adverse events. RevMan Cochrane Collaboration software, Version 5.3, was used to perform meta-analysis and the Grading of Recommendation Assessment, Development and Evaluation approach was used to rate the certainty of evidence. Patients who underwent adjuvant ozone application reported lower pain scores than patients in the control group at 24 hours after surgery (95% CI, -3.94 to -1.56) and at 7 days (95% CI, -1.67 to -0.78). Pooled analysis of all 4 included trials revealed a standardized mean difference (SMD) in swelling of -0.44 at 24 hours, 0.63 at 72 hours, and -0.87 at 7 days after surgery in the experimental group. Higher mean estimates in mouth opening were experienced by patients who received ozone at 24 hours (SMD, 2.74; 95% CI, -1.93 to 7.41; 4 studies, 133 patients), 72 hours (SMD, 2.77; 95% CI, -0.63 to 6.17; 4 studies, 133 patients), and 7 days after surgery (SMD, 1.42 SMD; 95% CI, -1.34 to 4.18; 4 studies, 133 patients). Evidence suggests that adjuvant ozone application can offer some benefit for reducing pain, improving quality of life, and decreasing mean intake of analgesics after impacted mandibular third-molar surgery, but it is not effective in reducing facial swelling and trismus, which paves the way for future research.
Sections du résumé
BACKGROUND
BACKGROUND
Results from several randomized controlled trials have shown a beneficial effect of ozone in reducing postsurgical complications after impacted mandibular third-molar surgery, but the literature is lacking a systematic review and meta-analysis.
METHODS
METHODS
The authors conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines after exclusion and inclusion criteria were applied and the following outcome parameters were evaluated: pain, swelling, trismus, quality of life, number of analgesics consumed, and adverse events. RevMan Cochrane Collaboration software, Version 5.3, was used to perform meta-analysis and the Grading of Recommendation Assessment, Development and Evaluation approach was used to rate the certainty of evidence.
RESULTS
RESULTS
Patients who underwent adjuvant ozone application reported lower pain scores than patients in the control group at 24 hours after surgery (95% CI, -3.94 to -1.56) and at 7 days (95% CI, -1.67 to -0.78). Pooled analysis of all 4 included trials revealed a standardized mean difference (SMD) in swelling of -0.44 at 24 hours, 0.63 at 72 hours, and -0.87 at 7 days after surgery in the experimental group. Higher mean estimates in mouth opening were experienced by patients who received ozone at 24 hours (SMD, 2.74; 95% CI, -1.93 to 7.41; 4 studies, 133 patients), 72 hours (SMD, 2.77; 95% CI, -0.63 to 6.17; 4 studies, 133 patients), and 7 days after surgery (SMD, 1.42 SMD; 95% CI, -1.34 to 4.18; 4 studies, 133 patients).
PRACTICAL IMPLICATIONS
CONCLUSIONS
Evidence suggests that adjuvant ozone application can offer some benefit for reducing pain, improving quality of life, and decreasing mean intake of analgesics after impacted mandibular third-molar surgery, but it is not effective in reducing facial swelling and trismus, which paves the way for future research.
Identifiants
pubmed: 34579810
pii: S0002-8177(21)00300-7
doi: 10.1016/j.adaj.2021.05.006
pii:
doi:
Substances chimiques
Ozone
66H7ZZK23N
Types de publication
Journal Article
Meta-Analysis
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
842-854.e1Informations de copyright
Copyright © 2021 American Dental Association. Published by Elsevier Inc. All rights reserved.