de Paiva Thais Teixeira, Barros Daniella Mascarenhas Calixto, Bittencourt Rafael Cunha, Savelli Marcella Baitelli Bruno, Lorenzoni Diego Coelho, de Alcantara Cury-Saramago Adriana, Mattos Claudia Trindade
Department of Orthodontics, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil.
Faculdade de Odontologia, Disciplina de Ortodontia, Rua Mário Santos Braga, 30, 2° andar, sala 214, Centro, Niterói, CEP 24020-140, Brazil.
Clin Oral Investig. 2023 Dec;27(12):7029-7043. doi: 10.1007/s00784-023-05311-9. Epub 2023 Oct 21.
The aim of this systematic review was to compare the expectation and perception of pain reported by patients before and after the installation of interradicular mini-implants.
Electronic search was performed in six databases. Inclusion criteria were randomized controlled trials (RCTs) or non-randomized controlled clinical trials (nRCTs); studies using mini-implants in the interradicular region; assessment of pain intensity by visual analogue or numerical scale. The risk of bias assessment was based on the Rob 2 tool and Robins-I.
A total of 1566 articles were retrieved, and 21 met the eligibility criteria. Six were classified as high risk, one as critical and the other one as uncertain, according to the Robins-I tool. In articles evaluated by the Rob2 tool, ten were classified as serious risk and three as moderate risk. A meta-analysis was also performed. Weighted means were calculated among the studies using the random-effects model and forest plots were generated. Heterogeneity was assessed through the Q test and I statistics. It was observed, with moderate evidence, that on a scale of 0 to 10, the pain expectation (effect size 4.75) is higher than that effectively pain generated by the procedure (effect size 1.94).
Pain expectation was greater than that actually generated by the procedure, being almost non-existent 7 days postoperatively.
This study may help the clinician to reassure the patient regarding the sensations that could be experienced during and after the installation.
本系统评价的目的是比较患者在植入根间微型种植体前后报告的疼痛预期和感知。
在六个数据库中进行电子检索。纳入标准为随机对照试验（RCT）或非随机对照临床试验（nRCT）；在根间区域使用微型种植体的研究；通过视觉模拟或数字量表评估疼痛强度。偏倚风险评估基于Rob 2工具和Robins-I。
共检索到1566篇文章，21篇符合纳入标准。根据Robins-I工具，6篇被归类为高风险，1篇为临界风险，另1篇为不确定风险。在使用Rob2工具评估的文章中，10篇被归类为严重风险，3篇为中度风险。还进行了荟萃分析。使用随机效应模型计算各研究的加权均值，并生成森林图。通过Q检验和I统计量评估异质性。有中等证据表明，在0至10分的量表上，疼痛预期（效应量4.75）高于该手术实际产生的疼痛（效应量1.94）。
疼痛预期大于手术实际产生的疼痛，术后7天疼痛几乎不存在。
本研究可能有助于临床医生就植入过程中和植入后可能经历的感觉向患者作出保证。
