De Geus Juliana L, Wambier Letícia M, Boing Thaynara F, Loguercio Alessandro D, Reis Alessandra
Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Brazil.
Department of Restorative Dentistry, Guairaca Faculty, Guarapuava, Brazil.
Eur Endod J. 2018 Oct 9;3(3):123-133. doi: 10.14744/eej.2018.83803. eCollection 2018.
This systematic review aims to evaluate the effects of ibuprofen compared to other drugs on the risk and intensity of postoperative pain resulting from endodontic treatment in adult patients.
A systematic search was carried out through Medline databases (Pubmed, Scopus, Web of Science, Cochrane, Lilacs, and BBO). There was no restriction on the publication year or idiom. The gray literature was explored. The Periodicos Capes Theses Databases and ProQuest Dissertations were also searched, as well as the unpublished and ongoing trials registry and the IADR abstracts (1990-2016). Solely randomized clinical trials that compared the risk or intensity of pain resulting from endodontic treatment in adult patients were included in this systematic review. The risk of bias of the articles was evaluated using the Cochrane Collaboration's tool. A random-effect meta-analysis was conducted for ibuprofen versus placebo and ibuprofen versus other drugs at 6, 8, and 24 hours. The GRADE approach was used to assess the quality of the evidence.
A total of 1132 studies were identified, and only seven meet the eligibility criteria. No difference between the groups was detected in any of the meta-analysis. An exception was observed when one study was removed from the meta-analysis of pain intensity at 24 hours for ibuprofen versus placebo, favoring ibuprofen (SMD -0.67; 95% CI -1.05 to -0.17). The quality of evidence in all meta-analyses was graded as low or very low.
Results of the present systematic review indicate that there is no clear evidence supporting that preoperative ibuprofen is better than other drugs in reducing the risk and intensity of postendodontic pain.
本系统评价旨在评估布洛芬与其他药物相比，对成年患者牙髓治疗术后疼痛风险及强度的影响。
通过Medline数据库（PubMed、Scopus、Web of Science、Cochrane、Lilacs和BBO）进行系统检索。对出版年份或语言无限制。探索了灰色文献。还检索了Periodicos Capes论文数据库和ProQuest学位论文，以及未发表和正在进行的试验注册库和国际牙科研究协会摘要（1990 - 2016年）。本系统评价仅纳入比较成年患者牙髓治疗术后疼痛风险或强度的随机临床试验。使用Cochrane协作工具评估文章的偏倚风险。对布洛芬与安慰剂以及布洛芬与其他药物在6、8和24小时时进行随机效应荟萃分析。采用GRADE方法评估证据质量。
共识别出1132项研究，只有7项符合纳入标准。在任何荟萃分析中均未检测到组间差异。在将一项研究从布洛芬与安慰剂在24小时时疼痛强度的荟萃分析中排除后观察到一个例外情况，结果有利于布洛芬（标准化均数差 -0.67；95%可信区间 -1.05至 -0.17）。所有荟萃分析中的证据质量均被评为低或极低。
本系统评价结果表明，没有明确证据支持术前使用布洛芬在降低牙髓治疗后疼痛风险和强度方面优于其他药物。
