Melini Matteo, Forni Andrea, Cavallin Francesco, Parotto Matteo, Zanette Gastone
Scholar at Oral Surgery and Implantology - Department of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna, Italy.
Private Practice in Lodi, Bologna, Italy.
Front Pharmacol. 2021 Jan 27;11:634963. doi: 10.3389/fphar.2020.634963. eCollection 2020.
Postsurgical pain is commonly associated with dental and oral surgery, and the use of analgesics has been investigated in the management of postoperative pain. This systematic review summarizes available evidence on analgesics used to manage dental implant surgery postoperative pain, to identify best therapeutic protocols and knowledge gap. A comprehensive search was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, clinicaltrials.gov, and the Cochrane Database of Systematic Reviews through May 2020. Only randomized controlled trials were included. PRISMA guidelines were followed, and risk of bias was appraised using Cochrane RoB2 tool. Eleven trials (762 patients overall) were included. Some aspects limited the feasibility of a meaningful meta-analysis; thus, a narrative synthesis was conducted. Risk of bias was low in four studies and high in two studies, while five studies raised some concerns due to the randomization process. Analgesic use seemed to be associated with improved postoperative outcomes (pain, patient's satisfaction, and need for rescue medication) when compared to placebo. Overall, this review suggests that the administration of analgesics may provide some advantages in the management of postoperative outcomes after dental implant placement, while indications about the best analgesics cannot be provided.
术后疼痛通常与牙科和口腔外科手术相关,并且已经对镇痛药在术后疼痛管理中的应用进行了研究。本系统评价总结了用于管理牙种植手术术后疼痛的镇痛药的现有证据,以确定最佳治疗方案和知识空白。通过检索截至2020年5月的MEDLINE/Pubmed、EMBASE、SCOPUS、clinicaltrials.gov和Cochrane系统评价数据库进行了全面搜索。仅纳入随机对照试验。遵循PRISMA指南,并使用Cochrane RoB2工具评估偏倚风险。纳入了11项试验(共762例患者)。一些因素限制了有意义的荟萃分析的可行性;因此,进行了叙述性综合分析。4项研究的偏倚风险较低,2项研究的偏倚风险较高,而5项研究由于随机化过程存在一些问题。与安慰剂相比,使用镇痛药似乎与术后结局(疼痛、患者满意度和急救药物需求)改善相关。总体而言,本评价表明,在牙种植术后结局的管理中,使用镇痛药可能具有一些优势,但无法提供关于最佳镇痛药的指征。