Student Research Committee, School of Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran.
Department of Dentistry, Oral and Maxillofacial Surgery Section, Federal University of Vales Do Jequitinhonha E Mucuri (UFVJM), Rua da Glória 187, Diamantina, Minas Gerais 39100-000, Brazil.
Pain Res Manag. 2022 Oct 26;2022:1816748. doi: 10.1155/2022/1816748. eCollection 2022.
To provide a nonbiased, complete assessment of what the evidence from meta-analyses informs us about complementary and nonpharmacological treatment options for the management of pain after third molar surgery, as well as highlight any discordancy, gaps, or lack of evidence among meta-analyses.
The quality of the included systematic reviews was assessed using the ROBIS tool. Corrected covered area (CCA) was calculated for pairs of similar meta-analyses to identify the amount of overlap. Reviews that were the most recent, comprehensive, and had adequate quality were considered for analyses when reviews showed a high overlap. In cases with a low amount of overlap among meta-analyses, all eligible studies were included. Also, citation matrices were constructed to address overlap. A network meta-analytical approach was adopted to rank different interventions.
Ten meta-analyses were included for quantitative synthesis. The quantitative analysis revealed that platelet-rich fibrin and its derivatives as well as ozone therapy reduce early and late pain better than the other complementary interventions compared to control (no complementary intervention).
Despite the shortcomings of included meta-analyses, consolidated evidence suggests that platelet-rich-fibrin and its derivatives as well as ozone therapy outperform the other nonpharmacological complementary interventions in reducing early and late postsurgical pain following third molar extraction. However, the results should be interpreted with caution due to an unclear risk of bias and lack of firm evidence in the included meta-analyses. Moreover, there is a need for a standard protocol for the application of nonpharmacological complementary interventions.
对元分析证据为我们提供的关于第三磨牙手术后疼痛管理的补充和非药物治疗选择进行客观、全面的评估，并强调元分析之间的任何不一致、差距或缺乏证据。
使用 ROBIS 工具评估纳入的系统评价的质量。计算相似元分析的校正覆盖面积（CCA），以确定重叠的程度。当综述显示高度重叠时，考虑最新、最全面且质量足够的综述进行分析。在元分析之间重叠程度较低的情况下，纳入所有符合条件的研究。此外，还构建了引文矩阵来解决重叠问题。采用网络荟萃分析方法对不同干预措施进行排名。
纳入了 10 项荟萃分析进行定量综合分析。定量分析表明，与对照组（无补充干预）相比，富血小板纤维蛋白及其衍生物以及臭氧疗法在减轻早期和晚期疼痛方面优于其他补充干预措施。
尽管纳入的元分析存在缺陷，但综合证据表明，富血小板纤维蛋白及其衍生物以及臭氧疗法在减轻第三磨牙拔除术后早期和晚期手术后疼痛方面优于其他非药物补充干预措施。然而，由于纳入的元分析存在偏倚风险不明确和缺乏确凿证据，结果应谨慎解释。此外，需要制定非药物补充干预措施的标准应用方案。
