Department of Dentistry, Center for Education and Research on Dental Implants, Federal University of Santa Catarina, Florianópolis, Brazil.
Department of Dentistry, Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina, Florianópolis, Brazil.
Clin Oral Investig. 2021 Jun;25(6):3609-3622. doi: 10.1007/s00784-020-03683-w. Epub 2020 Nov 17.
To critically appraise available literature concerning the effect of cyanoacrylate tissue adhesive (CTA) in postoperative palatal pain management.
Electronic databases (Cochrane, PubMed, LILACS, Scopus, and Web of Science) were searched, complemented with grey literature databases up to June 2020. Studies reporting the effect of cyanoacrylate tissue adhesive compared to any other methods in postoperative palatal pain management were considered eligible. The risk of bias among and across included studies was assessed.
Finally, four studies were considered eligible. Regarding free gingival graft (FGG), cyanoacrylate tissue adhesive with hemostatic sponge promoted less postoperative pain (PP) and analgesic consumption (AC). Also, cyanoacrylate tissue adhesive with platelet-rich fibrin produced less PP and more wound healing at the palatal area than cyanoacrylate tissue adhesive and wet gauze. Additionally, cyanoacrylate tissue adhesive promoted less PP and AC than wet gauze and suture. Concerning connective tissue graft (CTG), cyanoacrylate tissue adhesive, and suture produced similar PP, AC, and willingness for retreatment.
Based on the low certainty level, cyanoacrylate tissue adhesive appears to promote less PP and AC than wet gauze and suture regarding FGG. Additionally, cyanoacrylate tissue adhesive appears to increase the effect of hemostatic sponge, contributing to the reduction of PP and AC. Regarding CTG, cyanoacrylate tissue adhesive appears to promote similar PP, AC, and willingness for retreatment than the suture. Therefore, cyanoacrylate tissue adhesive has shown promising usefulness for PP management in FGG, but not a clear benefit for CTG.
The adoption of different agents for the protection of the palatal donor site following gingival harvesting procedures may provide better comfort to the patient.
对有关氰基丙烯酸酯组织粘合剂(CTA)在腭部术后疼痛管理中作用的现有文献进行批判性评价。
电子数据库(Cochrane、PubMed、LILACS、Scopus 和 Web of Science)进行了检索,并补充了截至 2020 年 6 月的灰色文献数据库。符合纳入标准的研究为报告比较 CTA 与任何其他方法在腭部术后疼痛管理中作用的研究。评估了纳入研究之间和跨研究的偏倚风险。
最终,有 4 项研究符合纳入标准。在游离龈移植(FGG)方面,使用含止血海绵的氰基丙烯酸酯组织粘合剂可减少术后疼痛(PP)和镇痛药的使用(AC)。此外,与使用富血小板纤维蛋白的氰基丙烯酸酯组织粘合剂和湿纱布相比,使用氰基丙烯酸酯组织粘合剂在腭部区域可产生更少的 PP 和更好的伤口愈合。此外,与湿纱布和缝线相比,氰基丙烯酸酯组织粘合剂可减少 PP 和 AC。在结缔组织移植(CTG)方面,氰基丙烯酸酯组织粘合剂和缝线的 PP、AC 和再次治疗意愿相似。
基于低确定性水平,与湿纱布和缝线相比,FGG 中使用氰基丙烯酸酯组织粘合剂似乎可减少 PP 和 AC。此外,氰基丙烯酸酯组织粘合剂似乎增加了止血海绵的作用,有助于减少 PP 和 AC。在 CTG 方面,与缝线相比,氰基丙烯酸酯组织粘合剂似乎可产生相似的 PP、AC 和再次治疗意愿。因此,氰基丙烯酸酯组织粘合剂在 FGG 的 PP 管理中显示出有希望的作用,但对 CTG 没有明显的益处。
在牙龈采集手术后,使用不同的药物保护腭部供区可能会使患者更舒适。