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牙科疼痛的药理学管理。

The pharmacological management of dental pain.

机构信息

NEMA Research Group, Inc, Naples, FL, USA.

Centre for Research and Development, Uppsala/Region, Sweden.

出版信息

Expert Opin Pharmacother. 2020 Apr;21(5):591-601. doi: 10.1080/14656566.2020.1718651. Epub 2020 Feb 6.

Abstract

: Dental pain is primarily treated by dentists and emergency medicine clinicians and may occur because of insult to the tooth or oral surgery. The dental impaction pain model (DIPM) has been widely used in clinical studies of analgesic agents and is generalizable to many other forms of pain.: The authors discuss the DIPM, which has allowed for important head-to-head studies of analgesic agents, such as acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and combinations. Postsurgical dental pain follows a predictable trajectory over the course of one to 3 days. Dental pain may have odontic origin or may be referred pain from other areas of the body.: Pain following oral surgery has sometimes been treated with longer-than-necessary courses of opioid therapy. Postsurgical dental pain may be moderate to severe but typically resolves in a day or two after the extraction. Opioid monotherapy, rarely used in dentistry but combination therapy (opioid plus acetaminophen or an NSAID), was sometimes used as well as nonopioid analgesic monotherapy. The dental impaction pain model has been valuable in the study of analgesics but does not address all painful conditions, for example, pain with a neuropathic component.

摘要

牙痛主要由牙医和急诊医学临床医生治疗,可能是由于牙齿受伤或口腔手术引起的。牙齿嵌塞痛模型(DIPM)已广泛应用于镇痛药的临床研究中,并且可推广应用于许多其他形式的疼痛。

作者讨论了 DIPM,它允许对镇痛药(如对乙酰氨基酚、非甾体抗炎药(NSAIDs)、阿片类药物和联合用药)进行重要的头对头研究。术后牙齿疼痛在 1 至 3 天的过程中呈现出可预测的轨迹。牙齿疼痛可能有牙源性,也可能是身体其他部位的牵涉痛。

口腔手术后的疼痛有时会用阿片类药物治疗较长时间。术后牙齿疼痛可能是中度到重度,但通常在拔牙后一天或两天内消退。阿片类药物单药治疗在牙科中很少使用,但联合治疗(阿片类药物加对乙酰氨基酚或 NSAID)有时也与非阿片类镇痛药单药治疗一起使用。牙齿嵌塞痛模型在镇痛药研究中非常有价值,但不能解决所有疼痛情况,例如伴有神经病理性成分的疼痛。

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