Lumiracoxib for acute postoperative dental pain: a systematic review of randomized clinical trials

Abstract

CONTEXT AND OBJECTIVE: Lumiracoxib is an anti-inflammatory drug that has been used to treat acute dental pain, mainly in postsurgical settings, in which the greatest levels of pain and discomfort are experienced during the first 24 hours. This study aimed to assess the efficacy and safety of lumiracoxib for treating acute postsurgical dental pain. DESIGN AND SETTING: Systematic review developed at the Brazilian Cochrane Centre, Universidade Federal de São Paulo. METHODS: An electronic search was conducted in the PubMed, Cochrane Library, Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde), SciELO (Scientific Electronic Library Online) and Embase databases. A manual search was also performed. Only randomized controlled trials were included, and these were selected and assessed by two researchers with regard to the risk of bias. RESULTS: Three clinical trials with 921 participants were included. Lumiracoxib 400 mg produced onset of analgesia in a shorter time than shown by lumiracoxib 100 mg, celecoxib 200 mg and ibuprofen 400 mg. There was no difference between lumiracoxib 400 mg and rofecoxib 50 mg. In two studies, the mean time taken to attain onset of analgesia for the placebo was not estimated because the number of participants who reached onset was too small. CONCLUSION: There is evidence with a moderate risk of bias that recommends the use of lumiracoxib for acute postoperative dental pain. However, the adverse effects are not completely known. Given that lumiracoxib is currently available in only three countries, further studies are likely to be rare and discouraged.reSUmO CONTEXTO E OBJETIVO: O lumiracoxibe é um anti-inflamatório que tem sido utilizado no tratamento de dor dental aguda, principalmente no cenário pós-cirúrgico, no qual níveis mais elevados de dor e desconforto são sentidos durante as primeiras 24 horas. Este estudo teve por objetivo avaliar a eficácia e a segurança do lumiracoxibe no tratamento da dor dental aguda e pós-operatória.

Steroidal and non-steroidal cyclooxygenase-2 inhibitor anti-inflammatory drugs as pre-emptive medication in patients undergoing periodontal surgery

“…The selective COX-2 inhibitor used in the present trial has analgesic and anti-inflammatory activity, may be rapidly absorbed, presenting good oral bioavailability and differs from other inhibitors in that it is acidic, which promotes its preferential distribution into inflamed tissue (4,10,11).…”

“…Crown lengthening procedures may involve the surgical removal of hard and soft periodontal tissues to gain supracrestal tooth length, allowing for longer clinical crowns and reestablishment of the biological width (1,2). Postoperative pain, discomfort and edema after surgical procedures and specifically periodontal surgery are common occurrences, especially during the first 24 h following surgery and may be considered an example of acute dental pain of mild to moderate severity (3)(4)(5).…”

Preemptive and Postoperative Medication Protocols for Root Coverage Combined with Connective Tissue Graft

“…Thus, this technique requires a longer surgical time and can cause pain, discomfort and edema in the patient, transand postoperatively. These are common occurrences after periodontal surgery that may appear, mainly in the first 24 h (11,12). Preemptive medications, aiming to prevent postsurgical pain and discomfort, are of great importance.…”

COX-2 Inhibitors in Dental Pain Management

“…celecoxib, rofecoxib, valdecoxib, parecoxib, etoricoxib and lumiracoxib) are specifically designed to inhibit the COX-2 isoenzyme, which produces the prostaglandins; almost exclusively responsible for pain, inflammation and fever, without inhibiting the constitutive COX-1. Even more, some studies suggest that selective COX-2 inhibitor reduce the incidence of gastro intestinal side effects compared with conventional NSAIDs (Chen et al, 2004;Daniels et al;Silva et al, 2011).…”