Faculdade de Odontologia de Pernambuco, Universidade de Pernambuco, Av General Newton Cavalcanti 1650, Camaragibe, Pernambuco, Brazil.
J Am Dent Assoc. 2011 Oct;142(10):1154-62. doi: 10.14219/jada.archive.2011.0084.
Pain, swelling and trismus are undesirable effects of extraction of impacted mandibular third molars. The authors conducted a study to evaluate the effectiveness of the muscle relaxant cyclobenzaprine when used as a supplement to cryotherapeutic, antibiotic and steroidal anti-inflammatory treatment with the aim of reducing undesirable consequences after third-molar extraction.
The authors conducted a prospective, randomized, double-masked, placebo-controlled clinical trial involving 50 participants aged 18 to 29 years randomly assigned to receive cyclobenzaprine or the placebo. The authors used a split-mouth design, so each participant acted as his or her own control. For each participant, the authors extracted one impacted mandibular third molar on each side of the mouth at different times. Participants received 10 milligrams of cyclobenzaprine or a placebo once per day the day before surgery, the day of surgery and the first day after surgery. The authors assessed the participants' postoperative pain by means of a visual analog scale at four, six, eight, 12, 24 and 48 hours. They measured the participants' swelling and maximal interincisor distance at 48 hours and seven days.
The authors assessed both sides of each participant's mouth for differences in pain, swelling and trismus. They found no statistically significant differences between sides of the mouth regarding these three variables.
The results of this trial indicate that the influence of cyclobenzaprine over pain, swelling and trismus does not justify prescribing additional medication for patients undergoing third-molar extraction.
The muscle relaxant cyclobenzaprine was ineffective in reducing pain, swelling and trismus after third-molar extraction.
下颌第三磨牙阻生拔除术后会出现疼痛、肿胀和牙关紧闭等不良后果。作者开展了一项研究，评估肌肉松弛剂环苯扎林作为冷冻、抗生素和类固醇抗炎治疗的补充，对减少第三磨牙拔除术后不良后果的有效性。
作者开展了一项前瞻性、随机、双盲、安慰剂对照的临床试验，共纳入 50 名 18 至 29 岁的患者，随机分为环苯扎林组或安慰剂组。作者采用了分侧设计，即每位患者自身作为对照。每位患者的每侧下颌阻生第三磨牙分两次拔除。术前一天、手术当天和术后第一天，患者每天服用 10 毫克环苯扎林或安慰剂。采用视觉模拟评分法评估患者术后 4、6、8、12、24 和 48 小时的疼痛程度。术后 48 小时和 7 天，测量患者的肿胀和最大切牙间距离。
作者评估了每位患者两侧口腔的疼痛、肿胀和牙关紧闭差异。未发现这三个变量在口腔两侧存在统计学差异。
本试验结果表明，环苯扎林对疼痛、肿胀和牙关紧闭的影响并不能证明对接受第三磨牙拔除术的患者开具额外药物是合理的。
肌肉松弛剂环苯扎林不能减轻第三磨牙拔除术后的疼痛、肿胀和牙关紧闭。
