Campana Maria Domenica, de Paolis Giulio, Sammartino Gilberto, Bucci Paolo, Aliberti Angelo, Gasparro Roberta
Department of Neuroscience, Reproductive Science and Dentistry, University of Naples Federico II, 80138 Naples, Italy.
Int J Mol Sci. 2025 Apr 16;26(8):3766. doi: 10.3390/ijms26083766.
Cannabinoids, particularly cannabidiol (CBD) and tetrahydrocannabinol (THC), have been increasingly studied for their therapeutic applications in various medical fields. This systematic review aims to explore their role in oral surgery, focusing on pain management, inflammation control, and bone regeneration. A systematic review was conducted using the PRISMA framework to identify relevant studies from the PubMed, Scopus, and Web of Science databases published up to November 2024. The review included clinical and preclinical studies investigating the effects of cannabinoids on orofacial pain, oral inflammation, and bone healing. Data on study design, cannabinoid types, and relevant outcomes were extracted and analyzed. CBD was the most commonly studied compound, with other studies evaluating CB1/CB2 receptor agonists, THC, and cannabis smoke. Clinical trials showed mixed results: some studies found CBD effective in reducing dental or myofascial pain, while others found limited or non-superior outcomes compared to standard treatments (e.g., NSAIDs, corticosteroids). Among the four RCTs, three had a low risk of bias, and one moderate; all nine animal studies had a high risk of bias. in conclusion, preclinical and clinical studies suggest that cannabinoids represent a promising non-opioid alternative for pain management and for oral inflammation. Although some evidence suggests potential benefits of cannabinoids, particularly CBD, in oral health contexts, findings are derived from heterogeneous studies-many with high risk of bias. More high-quality, standardized clinical trials are necessary before recommending cannabinoids for routine dental practice.
大麻素,尤其是大麻二酚(CBD)和四氢大麻酚(THC),在各种医学领域的治疗应用方面受到了越来越多的研究。本系统评价旨在探讨它们在口腔外科中的作用,重点关注疼痛管理、炎症控制和骨再生。使用PRISMA框架进行了一项系统评价,以识别截至2024年11月在PubMed、Scopus和科学网数据库中发表的相关研究。该评价纳入了研究大麻素对口面部疼痛、口腔炎症和骨愈合影响的临床和临床前研究。提取并分析了关于研究设计、大麻素类型和相关结果的数据。CBD是研究最普遍的化合物,其他研究评估了CB1/CB2受体激动剂、THC和大麻烟雾。临床试验结果不一:一些研究发现CBD在减轻牙齿或肌筋膜疼痛方面有效,而另一些研究发现与标准治疗(如非甾体抗炎药、皮质类固醇)相比效果有限或并无优势。在四项随机对照试验中,三项偏倚风险低,一项中等;所有九项动物研究偏倚风险高。总之,临床前和临床研究表明,大麻素是一种有前景的非阿片类药物,可用于疼痛管理和口腔炎症。虽然一些证据表明大麻素,尤其是CBD,在口腔健康方面有潜在益处,但研究结果来自异质性研究——许多研究偏倚风险高。在推荐大麻素用于常规牙科实践之前,需要更多高质量、标准化的临床试验。