Escobar Mario, Brum Renata Scheeren, Apaza-Bedoya Karin, Patrícia Pauletto, Benfatti Cesar Augusto Magalhães, Cruz Ariadne Cristiane Cabral, Henriques Bruno Alexandre Pacheco Castro
Centre of Education and Research on Dental Implants (CEPID), Department of Dentistry, Federal University of Santa Catarina; FlorianópolisBrazil.
Dentistry Faculty, University of Southern Santa Catarina, Palhoça, SCBrazil.
J Oral Maxillofac Res. 2022 Sep 30;13(3):e1. doi: 10.5037/jomr.2022.13301. eCollection 2022 Jul-Sep.
The aim of the present systematic review was to evaluate the dimensional influence of the epithelialized tissue graft harvested from the palate in the postoperative pain.
Research was conducted in electronic databases Cochrane Library, Embase, LILACS, PubMed, Scopus, and Web of Science upwards May 15, 2022. Studies that reported the influence of graft dimensions of palatal epithelized harvesting on postoperative pain were eligible. The evaluation was made using the methodological quality assessment by Joanna Briggs Institute Critical Appraisal Checklist for randomized clinical trials and non-randomized studies and the level of evidence according to GRADE.
Four studies were included. The clinical and methodological heterogeneity among studies led to an analysed narrative. The postoperative pain was assessed during the period of 1 to 28 postoperative days. It was determined by using visual analog scale in three studies, while the evaluation was performed indirectly based on analgesics intake in one study. According to three studies, bigger graft sizes were associated with higher postoperative pain. The methodological quality assessment categorized two study as high (one randomized control trial and one non-randomized), and two as moderate (one randomized control trial and one non-randomized). The data was considered moderate.
Based on the moderate certainty level, bigger graft sizes of palatal epithelized harvesting appear to promote more postoperative pain. Understanding the postoperative pain as a response to a graft extension may assist some clinical decisions regarding the surgical periodontal and peri-implant planning.
本系统评价的目的是评估取自腭部的上皮化组织移植物的尺寸对术后疼痛的影响。
于2022年5月15日前在电子数据库Cochrane图书馆、Embase、LILACS、PubMed、Scopus和Web of Science中进行检索。报告腭部上皮化组织移植物尺寸对术后疼痛影响的研究符合纳入标准。采用乔安娜·布里格斯研究所随机临床试验和非随机研究批判性评价清单进行方法学质量评估，并根据GRADE标准确定证据水平。
纳入4项研究。研究之间的临床和方法学异质性导致采用描述性分析。术后疼痛在术后1至28天内进行评估。三项研究使用视觉模拟量表进行测定，而一项研究基于镇痛药摄入量进行间接评估。根据三项研究，移植物尺寸越大，术后疼痛越严重。方法学质量评估将两项研究归类为高质量（一项随机对照试验和一项非随机研究），两项归类为中等质量（一项随机对照试验和一项非随机研究）。数据质量被认为中等。
基于中等确定性水平，取自腭部的较大尺寸上皮化组织移植物似乎会导致更严重的术后疼痛。将术后疼痛理解为对移植物扩展的一种反应，可能有助于在牙周手术和种植体周围手术规划方面做出一些临床决策。
