Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand.
Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden.
Clin Oral Investig. 2024 Feb 29;28(3):180. doi: 10.1007/s00784-024-05578-6.
Cyanoacrylate tissue adhesive has been presented as an alternative to sutures and several studies have compared them. The objective of this meta-analysis was to evaluate the effect of cyanoacrylate tissue adhesive on postoperative pain and swelling, following mandibular third molar surgery.
Database search was conducted in MEDLINE/PubMed and Scopus, along with extensive search in the grey literature, including randomized and non-randomized clinical trials that applied cyanoacrylate adhesive for closing mandibular third molar surgical sites and compared it with silk sutures, assessing postoperative pain and swelling. The search ended on September 22, 2023.
Of 886 identified articles, six were included and meta-analyzed. Applying cyanoacrylate demonstrated a reduction in the overall postoperative pain (SMD = -0.57, 95% CI -1.00 to -0.15, p = 0.009). A similar outcome was noted when pain was evaluated on the first and last postoperative days, based on controlled clinical trials (SMD = -0.47, 95% CI -0.92 to -0.03, p = 0.04), and randomized trials (SMD = -0.97, 95% CI -1.31 to -0.62, p < 0.00001). Patients/sides received cyanoacrylate showed a decrease in postoperative swelling (SMD = -0.26, 95% CI -0.51 to -0.01, p = 0.04). Following the GRADE rating system, the quality of evidence on pain and swelling was judged as moderate and low, respectively.
The use of cyanoacrylate adhesive may offer benefit in reducing postoperative pain and swelling following mandibular third molar surgery. Nevertheless, this should be further investigated, considering the low number of included reports.
The current results could help clinicians who perform this procedure to manage postoperative pain and swelling more effectively.
氰基丙烯酸酯组织粘合剂已被提出作为缝线的替代物，并且已经有几项研究对它们进行了比较。本荟萃分析的目的是评估氰基丙烯酸酯组织粘合剂在第三磨牙下颌手术后对术后疼痛和肿胀的影响。
在 MEDLINE/PubMed 和 Scopus 数据库中进行了检索，并在灰色文献中进行了广泛检索，包括应用氰基丙烯酸酯粘合剂封闭下颌第三磨牙手术部位并将其与丝线缝合进行比较的随机和非随机临床试验，以评估术后疼痛和肿胀。检索于 2023 年 9 月 22 日结束。
在 886 篇已识别的文章中，有 6 篇被纳入并进行荟萃分析。应用氰基丙烯酸酯可减少总体术后疼痛（SMD = -0.57，95%CI-1.00 至 -0.15，p = 0.009）。基于对照临床试验（SMD = -0.47，95%CI-0.92 至 -0.03，p = 0.04）和随机试验（SMD = -0.97，95%CI-1.31 至 -0.62，p<0.00001），在术后第 1 天和最后 1 天评估疼痛时也观察到了类似的结果。接受氰基丙烯酸酯的患者/侧显示术后肿胀减少（SMD = -0.26，95%CI-0.51 至 -0.01，p = 0.04）。根据 GRADE 评级系统，疼痛和肿胀的证据质量分别评为中度和低度。
在第三磨牙下颌手术后，使用氰基丙烯酸酯粘合剂可能有助于减轻术后疼痛和肿胀。然而，鉴于纳入报告的数量较少，还需要进一步研究。
目前的结果可以帮助进行该手术的临床医生更有效地管理术后疼痛和肿胀。
