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Pharmacological management of pain after periodontal surgery: a systematic review with meta-analysis

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Abstract

Objectives

To assess and compare the pharmacological effect of different drugs on pain relief after periodontal surgery.

Materials and methods

Five databases were searched up to September 2019. The eligible studies comprised randomized clinical trials, involving only adult individuals that received any periodontal surgery and presenting two distinct groups of therapeutic regimens to control postoperative pain. Placebo groups could be included. The risk of bias was assessed with the RoB 2 Cochrane tool and the GRADE system. Meta-analyses were performed using different follow-up and drug comparisons.

Results

Overall, 2398 studies were identified, of which 35 were included. Low risk of bias was determined for the majority of the studies. The meta-analyses showed that the comparison of dexamethasone or non-steroidal anti-inflammatory drugs (NSAID) versus placebo favored the use of both interventions in a follow-up of 1 to 8 h for open flap procedures (OFP). However, no statistical difference was found for the comparison between NSAID and dexamethasone for OFP.

Conclusions

Patients may benefit from several pharmacological schemes for pain relief after periodontal surgeries. However, due to the high heterogeneity among studies, no fixed pharmacological protocol could be proposed.

Clinical relevance

There is not enough evidence to recommend one therapeutic scheme. However, untreated pain is harmful to the patients and it is not advisable.

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Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior-Brasil (CAPES)-Finance Code 001.

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Author notes

  1. Leonardo Stephan Caporossi and Cinthia Studzinski dos Santos contributed equally to this work.

Authors and Affiliations

  1. Graduate Program in Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, Rio Grande do Sul, Brazil

    Leonardo Stephan Caporossi & Cinthia Studzinski dos Santos

  2. Faculty of Medicine, Arthur Sá Earp Neto School, 1003, Barão do Rio Branco Ave., Petrópolis, Rio de Janeiro, Brazil

    Thayanne Brasil Barbosa Calcia

  3. Department of Operative Dentistry, Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves, St., Pelotas, Rio Grande do Sul, Brazil

    Maximiliano Sergio Cenci & Giana da Silveira Lima

  4. Department of Periodontology, Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, 457, Gonçalves Chaves St., Pelotas, Rio Grande do Sul, Brazil

    Francisco Wilker Mustafa Gomes Muniz

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  1. Leonardo Stephan Caporossi
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  2. Cinthia Studzinski dos Santos
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  3. Thayanne Brasil Barbosa Calcia
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  4. Maximiliano Sergio Cenci
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  5. Francisco Wilker Mustafa Gomes Muniz
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  6. Giana da Silveira Lima
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Correspondence to Giana da Silveira Lima.

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Caporossi, L.S., dos Santos, C.S., Calcia, T.B.B. et al. Pharmacological management of pain after periodontal surgery: a systematic review with meta-analysis. Clin Oral Invest 24, 2559–2578 (2020). https://doi.org/10.1007/s00784-020-03401-6

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