Preemptive use of oral nonsteroidal anti-inflammatory drugs for the relief of inflammatory events after surgical removal of lower third molars: A systematic review with meta-analysis of placebo-controlled randomized clinical trials.

Abstract

PURPOSE:

To investigate the effectiveness of preemptive analgesia with nonsteroidal anti-inflammatory drugs (NSAIDs) for the relief of inflammatory events (pain, edema, and trismus) after surgical removal of third molars.

MATERIALS AND METHODS:

A two-phase PROSPERO-registered systematic review was conducted in accordance with the PRISMA statement. PubMed, Scopus, Web of Science, COCHRANE, LILACS, DOSS, and gray literature were searched using the following terms (MeSH) or their combinations: molar, third; anti-inflammatory agents, non-steroidal; analgesia; preoperative period; pain management.

RESULTS:

From a total of 2903 articles, 31 (n = 2184 subjects) were selected. All studies presented a low risk of bias but exhibited high heterogeneity in methodology. Ten studies were selected for the meta-analysis. Preemptive analgesia for removal of third molars reduced average pain scores, especially those 1 h and 6 h after surgery (n = 151, p < 0.001, 95% CI = -2.81 to -0.97), reduced the average consumption of medication, and decreased the number of patients requiring medication without affecting the average time for its first consumption.

CONCLUSION:

In summary, most NSAIDs showed good results for inflammatory events and reduced average pain scores and consumption of rescue medication. However, more homogeneous and well-delineated clinical studies are necessary to determine a possible association between NSAIDs and the relief of inflammatory events.

• Authors: Edson Luiz Cetira Filho, Francisco Samuel Rodrigues Carvalho, Paulo Goberlânio de Barros Silva, Daniel Almeida Ferreira Barbosa, Karuza Maria Alves Pereira, Thyciana Rodrigues Ribeiro, Fábio Wildson Gurgel Costa
• Journal: Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery (J Craniomaxillofac Surg) Vol. 48 Issue 3 Pg. 293-307 (Mar 2020) ISSN: 1878-4119 [Electronic] Scotland
• PMID: 32070661 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)
• Copyright: Copyright © 2020. Published by Elsevier Ltd.

Chemical References

• Anti-Inflammatory Agents
• Anti-Inflammatory Agents, Non-Steroidal

Topics

• Anti-Inflammatory Agents (therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Humans
• Molar, Third
• Pain, Postoperative (drug therapy)
• Randomized Controlled Trials as Topic
• Trismus