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Complementary and alternative therapies for managing postoperative pain after lower third molar surgery: a systematic review and network meta-analysis

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Abstract

Objective

The objective of this study was to evaluate the impact of complementary and alternative treatments on postoperative pain following lower third molar surgeries.

Methods

A comprehensive search of Electronic databases (Embase, MEDLINE via PubMed, and Cochrane Library) and grey literature was conducted up until May 2022. Randomized clinical trials investigating the effect of acupuncture, ozone therapy, laser (LLLT), drainage tube, kinesio-taping, ice therapy, and compressions on pain after LTM surgeries were included. The estimated mean differences (MD) for alternative therapies were pooled using the frequentist approach to random-model network meta-analysis NMA.

Results

Eighty-two papers were included in the qualitative analysis; 33 of them were included in the quantitative analyzes. NMA revealed that drainage tube and kinesio-taping were superior in controlling pain 24-hours postoperatively than no-treatment. At 48-hours follow-up, kinesio-taping and LLLT more effective than placebo and drainage tube; and kinesio-taping and LLLT were superior to no treatment. At 72 h postoperatively, ozone therapy was superior to placebo; and drainage tube, kinesio-taping, and LLLT were better than no treatment. At 7-days follow-up, ozone and LLLT were superior to placebo; and LLLT and kinesio-taping were superior to no treatment. The SUCRA-ranking placed drainage tube as top-ranking intervention at 48-hours (98.2%) and 72-hours (96%) follow-ups, and ozone (83.5%) at 7-days follow-up.

Conclusion

The study findings suggest that these alternative and complementary therapies may be useful in reducing postoperative pain after LTM surgeries, and may offer advantages when combined to traditional pain management methods. Clinical relevance: Non-pharmacological therapies are gaining popularity among healthcare professionals and patients. This study found that some of these therapies, specifically kinesio-taping and drainage tube were effective in controlling postoperative pain after third molar surgeries. These findings have important implications for clinical practice, as they highlight the potential benefits of incorporating these therapies into postoperative pain management plans.

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Data availability

No datasets were generated or analysed during the current study.

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Acknowledgements

We offer our deepest thanks to Parsa Firoozi, which provided technical support for the development and implementation of this study.

Funding

Partial financial support was received from CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior)-Brazil (finance code 001) and the National Council for Scientific and Technological Development (CNPQ). We offer our deepest thanks to the Programa de Pós-graduacão em Odontologia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, and Parsa Firoozi, which provided technical support for the development and implementation of this study.

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Authors and Affiliations

  1. Department of Dentistry, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil

    Saulo Gabriel Moreira Falci, Ighor Andrade Fernandes, Marco Túllio Becheleni Ávila Guimarães & Glaciele Maria de Souza

  2. Department of Physiotherapy, Federal University of Vales do Jequitinhonha e Murcuri, Diamantina, Minas Gerais, Brazil

    Endi Lanza Galvão

  3. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Dhamar, Yemen

    Essam Ahmed Al-Moraissi

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  1. Saulo Gabriel Moreira Falci
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Contributions

S.G.M.F wrote the main manuscript I.A.F and M.T.B.A.G collected and extracted the data E.L.G performed statistics and prepared figures G.M.S did risk of bias and certainty of evidence E.A.A. supported statistics and revised the final version of the manuscript.

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Correspondence to Saulo Gabriel Moreira Falci.

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Falci, S.G.M., Fernandes, I.A., Guimarães, M.T.B.Á. et al. Complementary and alternative therapies for managing postoperative pain after lower third molar surgery: a systematic review and network meta-analysis. Clin Oral Invest 28, 231 (2024). https://doi.org/10.1007/s00784-024-05625-2

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