Clinical implications of prescribing nonsteroidal anti-inflammatory drugs in oral health care—a review

Nagi, Ravleen; Devi, B.L.A. Prabhavathi; Rakesh, N; Reddy, Sujatha S; Patil, Deepa Jatti

doi:10.1016/j.oooo.2014.12.002

Cited by 31 publications

(34 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…It is highlighted that, as the treatment time progresses, there is an increase of gastric risk, especially gastropathy, petechial hemorrhages, dyspepsia, abdominal pain and diarrhea [27,28]. According to Mendes et al (2012) [8], Garcia Jr. et al [29] and Hilary et al [30], the use of Coxibs in dentistry would only be justified in patients with proven medical history of gastrointestinal disorders without concomitant risk of cardiovascular disorders.…”

Section: Coxibs In Dentistry: An Updatementioning

confidence: 99%

Inibidores seletivos da cox-2 na odontologia: limitações e efeitos adversos

Souza

Caldas

Silva

2016

Rev. Odonto Ciênc. (Online)

View full text Add to dashboard Cite

The coxibs are nonsteroidal anti-inflammatory drugs (NSAIDs) highly selective for COX-2, an enzyme related to inflammatory processes. At first, their use should present advantages over nonselective NSAIDs, since the inflammatory efficacy would be present but with minimal adverse effects. However, its widespread use showed significant cardiovascular risk and, in treatment over 6 months, predisposition to ulceration, bleeding and stomach pain. The coxibs should be used in patients over 60 years, with a history of peptic ulcer or gastrointestinal bleeding, chronic users of corticosteroids and anticoagulants without concomitant cardiovascular risk. Moreover, they are more expensive and have similar analgesic efficacy to non-selective NSAIDs. In dentistry, the main indications are related to the control of pain and inflammation for a maximum of 3 days or preemptively in oral surgery to control pain and swelling. However, there is no major evidence of the benefits of using these drugs compared to traditional NSAIDs in dentistry.Key words: Dentistry; Anti-Inflammatory agents; Cyclooxygenase 2 inhibitors; Adverse effects; Therapeutic use; Contraindications Inibidores seletivos da cox-2 na odontologia: limitações e efeitos adversos ResumoOs coxibes são antiinflamatórios não-esteroidais (AINEs) altamente seletivos para a COX-2, enzima relacionada à processos inflamatórios. A princípio, seu uso deveria apresentar vantagens em relação aos não-seletivos, pois permaneceria a eficácia antiinflamatória com um mínimo de efeitos adversos. Entretanto, sua ampla utilização revelou significativo risco cardiovascular e, em tratamento acima de 6 meses, predisposição à ulcerações, hemorragias e dor gástricas. Sendo recomendado seu uso em pacientes acima de 60 anos, com histórico de úlcera gástrica ou hemorragia digestiva, usuários crônicos de corticosteóides e anticoagulantes. Além disto, são mais caros e possuem eficácia analgésica similar aos AINEs não-seletivos. Em odontologia suas principais indicações estão relacionadas ao controle da dor e da inflamação pelo período máximo de 3 dias ou preemptivamente em cirurgias orais para controle da dor e edema. Entretanto, não há evidências de maiores benefícios da utilização destes fármacos em relação aos AINES tradicionais no manejo odontológico.

show abstract

Section: Coxibs In Dentistry: An Updatementioning

confidence: 99%

Inibidores seletivos da cox-2 na odontologia: limitações e efeitos adversos

Souza

Caldas

Silva

2016

Rev. Odonto Ciênc. (Online)

View full text Add to dashboard Cite

show abstract

“…Oral nonsteroidal anti-inflammatory drugs (NSAIDs) were only conditionally recommended by both the OA Research Society International (McAlindon et al , 2014) and the American College of Rheumatology (ACR) (Hochberg et al , 2012). However, the long-term utilization of nonselective NSAIDs have been reported to increase the risk of side effects (Nagi et al , 2014). Thus, complementary and integrative therapies are heavily favored in treatments of OA.…”

Section: Introductionmentioning

confidence: 99%

Traditional Chinese Medications for Knee Osteoarthritis Pain: A Meta-Analysis of Randomized Controlled Trials

et al. 2016

View full text Add to dashboard Cite

Traditional Chinese medication (TCM) has analgesic and anti-inflammatory effects in patients with knee osteoarthritis (OA). We conducted the first systematic review of the best quantitative and qualitative evidence currently available in order to evaluate the effectiveness of TCM in relieving pain in knee OA. A comprehensive literature search was conducted using three English and four Chinese biomedical databases from their inception through March 1, 2015. We included randomized controlled trials of TCM for knee OA with intervention durations of at least two weeks. The effects of TCM on pain and other clinical symptoms were measured with the visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The total effectiveness rate, which was used to assess overall pain, physical performance and wellness, was also measured. Two researchers independently extracted data on study design, population characteristics, duration, intervention, outcomes, risk of bias, and primary results. We performed a random-effects meta-analysis when appropriate. We also explored factors that could explain the heterogeneity by conducting subgroup and meta-regression analyses. Twenty-three studies, totaling 2362 subjects, met the eligibility criteria. Treatments were formulated with an average of 8 Chinese herbs and were prescribed based on the traditional Chinese diagnostic method of syndrome differentiation. The mean treatment duration was seven weeks, with oral administration occurring one to three times a day. Compared with non-steroidal anti-inflammatory drugs and intra-articular hyaluronate injections, 18 of the studies showed significantly improved VAS pain scores (Mean Difference [MD] = 0.56; 95% confidence interval [CI], 0.18 to 0.94; p = 0.004), six of the studies showed significantly improved WOMAC pain subscale scores (MD = 2.23; 95% CI, 0.56 to 3.91; p = 0.009), and 16 of the trials showed significantly improved total effectiveness rates (risk ratio = 1.12; 95% CI, 1.05 to 1.19; p = 0.0003). In addition, TCM showed a lower risk of adverse events than standard western treatments. This evidence suggests that TCM is safe and effective for improving pain, function, and wellness in treatments of knee OA. However, there is inherent clinical heterogeneity (diverse TCM formulations, controls, and treatment regimens) among the included trials. Despite these limitations, the potential analgesic effects of TCM warrant further methodologically rigorous research to determine the clinical implications of TCM on pain management in knee OA.

show abstract

“…Managing postoperative pain is a critical component in daily dental practice and it is important for the effective use of healthcare resources 3,5 . When the pain is not adequately treated, it causes patients to worry and feel isolated, prevents sleep, leads to exhaustion and affects apetite 6 .…”

Section: Introductionmentioning

confidence: 99%

“…Due to the effectiveness of NSAIDs (nonsteroidal anti-inflammatory drugs) for reducing mild to moderate pain, they are frequently prescribed in dental practice 3 . Their mechanism of action involves the inhibition of cyclooxygenase activity (COX), thus eliminating the formation of inflammatory mediators.…”

Section: Introductionmentioning

confidence: 99%