Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Jul;114(1):27-34. doi: 10.1016/j.tripleo.2011.05.027. Epub 2011 Aug 26.
Lower third molar removal provides a clinical model for studying analgesic drugs. The present study's aim was to compare the clinical efficacy of sublingual ketorolac and sublingual piroxicam in managing pain, trismus and swelling after lower third molar extraction in adult volunteers.
In this double-blinded, randomized, crossover investigation, 47 volunteers received for 4 days ketorolac sublingually (10 mg 4 times daily) and piroxicam sublingually (20 mg once daily) during 2 separate appointments after lower third molar extraction of symmetrically positioned lower third molars. A surgeon evaluated objective parameters (surgery duration, mouth opening, rescue analgesic medication, and facial swelling) and volunteers documented subjective parameters (postoperative pain and global evaluation), comparing postoperative results for a total of 7 days after surgery. The means of the objective and subjective parameters were compared for statistical significance (P < .05).
Volunteers reported low pain scores during the postoperative period when treated with either sublingual ketorolac or piroxicam. Also, volunteers ingested similar amounts of analgesic rescue medication (paracetamol) when they received either drug sublingually (P > .05). Additionally, values for mouth openings measured just before surgery and immediately after suture removal 7 days later were similar among volunteers (P > .05), and the type of nonsteroidal antiinflammatory drug (NSAID) used in this study showed no significant differences between swellings on the second or seventh days after surgery (P > .05).
Pain, trismus, and swelling after lower third molar extraction, independent of surgical difficulty, were successfully controlled by sublingual ketorolac (10 mg 4 times daily) or sublingual piroxicam (20 mg once daily), and no significant differences were observed between the NSAIDs evaluated.
下颌第三磨牙拔除为研究镇痛药提供了一个临床模型。本研究旨在比较舌下给予酮咯酸和吡罗昔康用于管理成人志愿者下颌第三磨牙拔除后疼痛、牙关紧闭和肿胀的临床疗效。
在这项双盲、随机、交叉研究中，47 名志愿者在两次单独就诊时，在对称位置的下颌第三磨牙拔除后 4 天内，分别接受舌下给予酮咯酸（10 mg，4 次/天）和吡罗昔康（20 mg，1 次/天）。一位外科医生评估了客观参数（手术持续时间、张口度、解救性镇痛药物和面部肿胀），志愿者记录了主观参数（术后疼痛和总体评估），比较了手术后总共 7 天的术后结果。比较了客观和主观参数的平均值，以确定统计学意义（P <.05）。
志愿者在接受舌下酮咯酸或吡罗昔康治疗时，在术后期间报告了低疼痛评分。此外，志愿者在接受舌下给予任何一种药物时，摄入的镇痛解救药物（扑热息痛）量相似（P >.05）。此外，在手术前和 7 天后拆线时测量的张口度值在志愿者之间相似（P >.05），并且在这项研究中使用的非甾体抗炎药（NSAID）类型在手术后第 2 天或第 7 天的肿胀方面没有显示出显著差异（P >.05）。
无论手术难度如何，下颌第三磨牙拔除后疼痛、牙关紧闭和肿胀均成功地通过舌下给予酮咯酸（10 mg，4 次/天）或吡罗昔康（20 mg，1 次/天）得到控制，并且评估的 NSAIDs 之间没有观察到显著差异。
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