Pharmacological Control of Complications Following to Third Molar Removal: Evidence Based on A Meta-Analysis

Isiordia-Espinoza, Mario Alberto; Bologna‐Molina, Ronell; Hernández-Miramontes, Ycenna Ailed; Zapata-Morales, Juan Ramón; Alonso-Castro, Ángel Josabad; Martinez-Morales, Flavio; Sánchez‐Enríquez, Sergio; Serafín-Higuera, Nicolás; Pérez-Cortéz, Guillermo; Torre, Lorenzo Franco‐de la

doi:10.1055/a-0637-8948

Cited by 11 publications

(15 citation statements)

References 24 publications

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“…Mandibular third molar surgeries can lead to significant postoperative morbidity due to pain, extraoral edema, and reduced mouth opening which can greatly hamper the quality of life of the patient. Consequently, administration of corticosteroids has become standard practice with third molar surgeries ( 9 , 10 ). Corticosteroids act by inhibiting the enzyme phospholipase A2 which reduces the production of arachidonic acid at the inflammation site.…”

Section: Discussionmentioning

confidence: 99%

“…Other than dexamethasone, corticosteroids like methylprednisolone (MP) and triamcinolone have also been used after third molar surgeries ( 10 ). However, there is a paucity of evidence on the influence of different routes of administration of other corticosteroid drugs on mandibular third molar surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…A variety of mouthwashes, antibiotics, analgesics, topical gels, cryotherapy, ozone therapy, and corticosteroids have also been used to reduce pain, swelling, and trismus after third molar surgeries ( 8 ). Of these various agents, the use of corticosteroids, especially dexamethasone is a popular intervention to improve outcomes of third molar surgery ( 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Submucosal With Intramuscular or Intravenous Administration of Dexamethasone for Third Molar Surgeries: A Systematic Review and Meta-Analysis

Hou¹,

Li²,

Liu³

2021

Front. Surg.

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Objective: The study aimed to review evidence on the efficacy of submucosal (SM) administration vs. intravenous (IV) or intramuscular (IM) route of injections of dexamethasone for improving outcomes after mandibular third molar surgery.Methods: PubMed, Embase, CENTRAL, and Google Scholar were searched for randomized controlled trials (RCTs) up to 20th May 2021. Early (2–3 days) and late (7 days) outcomes were compared between SM vs. IV or IM dexamethasone. Quality of evidence was assessed based on GRADE.Results: Thirteen trials were included in the systematic review and 10 in the meta-analysis. Meta-analysis indicated a significant reduction in early pain with IV dexamethasone but no such difference for late pain compared to the SM group. There was no difference in early and late swelling scores between the SM and IV groups. Pooled analysis indicated no significant difference in early and late trismus between SM and IV groups. Comparing SM with IM dexamethasone, there was no significant difference in early and late pain scores. Swelling in the early and late postoperative periods was not significantly different between the two groups. There was no significant difference in early and late trismus between SM and IM groups. The quality of evidence was low for all outcomes.Conclusion: Low-quality evidence suggests that SM infiltration of dexamethasone results in similar outcomes as compared to IV or IM administration of the drug after third molar surgeries. Further high-quality RCTs are needed to corroborate the current conclusions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of Submucosal With Intramuscular or Intravenous Administration of Dexamethasone for Third Molar Surgeries: A Systematic Review and Meta-Analysis

Hou¹,

Li²,

Liu³

2021

Front. Surg.

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“…25 Os pacientes que recebem anti -inflamatório no pré--operatório relatam menores índices de dor que o grupo controle em cirurgias de terceiro molar. 26 Embora alguns estudos optem pelo uso de anti -inflamatórios não -esteroidais, 17,27 com finalidade de obter analgesia pré -operatória, há evidências de que os anti -inflamatórios esteroidais se mostram superiores para tal efeito. [29][30] No presente estudo, o anti -inflamatório Prednisona foi administrado, o que talvez poderia ter influenciado na classificação de dor pós -operatória.…”

Section: Discussionunclassified

Avaliação da dor pós-operatória com administração de midazolam em exodontias de terceiros molares inclusos mandibulares

Chandretti¹,

Medeiros²,

Vilela³

et al. 2020

j.rpemd

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Objetivos: Avaliar a utilização do midazolam, administrado no pré-operatório de exodontias de terceiros molares inclusos mandibulares, na redução da dor pós-operatória e nas alterações de pressão arterial e frequência cardíaca. Métodos: Estudo clínico, prospetivo e randomizado. Foi utilizada amostra de 14 pacientes, de ambos os géneros, com idade entre 15 e 27 anos, e indicação para exodontia de terceiro molar inferior incluso. Foram divididos em dois grupos: Grupo Midazolam (n=7), que recebeu midazolam (15 mg, via oral, 1 h antes da cirurgia) e Grupo Controle (n=7), que não recebeu a droga. Foi investigado a possível diminuição do limiar de dor através de uma Escala Visual Analógica, além das características de hipotensão e bradicardia causadas pelo midazolam, em diferentes períodos de tempo. Resultados: Houve diferença estatisticamente significativa (p=0,01) entre o limiar de dor entre os dois grupos, pelo teste não paramétrico de Mann-Whitney. Enquanto, as alterações de pressão arterial e frequência cardíaca não foram estatisticamente significativas (p>0,05), comparando os dois grupos. Conclusões: A administração do midazolam não foi efetiva na redução de dor pós-operatória de exodontia de terceiros molares inclusos mandibulares. Além disso, a pressão arterial e a frequência cardíaca não tiveram alterações significativas pela administração do medicamento.

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“…A posztoperatív fájdalom és ödéma enyhítésére az irodalomban előfordul a per secundam sebzárás javallata, ennek ellenére a per primam zárást részesítjük előnyben, mert így könnyebb a pácienseknek a megfelelő szájhigiéniát fenntartani [21]. Minden páciens ugyanazon a rehabilitációs protokollon ment keresztül, antibiotiku mot szedtek egy hétig (penicillin származékot vagy al lergia esetén clindamicint), illetve szükség esetén NSAID fájdalomcsillapítót [14,16]. A varratszedés és a posztope ratív szövődmények értékelése a műtét után egy héttel történt.…”

Section: Vizsgálati Anyag éS Módszerunclassified

Áttörésben visszamaradt bölcsességfogak ellátása az ambuláns szájsebészeti gyakorlatban egy év adatai alapján

Gyulai-Gaál

Minya

2020

fogorv-szemle

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Az áttörésben visszamaradt fogak között a leggyakoribbak a bölcsességfogak, amelyek számos patológiás elváltozást, illetve orthodonciai problémát okozhatnak. Osztályunkon egy év alatt sebészi feltárással 1048 db bölcsességfogat távolítottunk el, melyek közül 700 esetben részletes radiológiai elemzést és statisztikát készítettünk. A terápiás, preventív és orthodonciai okból eltávolított fogak száma közel megegyező volt, a terápiás indikációk közül leggyakoribb a pericoronitis és caries volt. A preventív és orthodonciai célú bölcsességfog-eltávolítás ideális ideje 16–23 éves kor, amikor méga gyökerek kevesebb mint 2/3-a fejlődött ki. Az esetek 20%-ában ebben az időpontban történt a fogeltávolítás, amia preventív szemlélet terjedését támasztja alá. Posztoperatív szövődmény az esetek 6%-ában fordult elő, köztük leggyakoribb a hosszabb ideig fennálló duzzanat és fájdalom. Súlyosabb szövődmény, mint sebszétnyílás és idegsérülés csak 1-1 esetben történt. A posztoperatív szövődmények előfordulása preoperatív radiológiai kiértékeléssel minimalizálható, illetve nehezebb esetekben CBCT-felvétel készítése is javasolt.

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Pharmacological Control of Complications Following to Third Molar Removal: Evidence Based on A Meta-Analysis

Abstract: The outcomes of our meta-analysis indicate that non-steroidal anti-inflammatory drugs and dexamethasone have good therapeutic effect for the management of inflammatory complications following to third molar surgery.

Cited by 11 publications

References 24 publications

Comparison of Submucosal With Intramuscular or Intravenous Administration of Dexamethasone for Third Molar Surgeries: A Systematic Review and Meta-Analysis

Comparison of Submucosal With Intramuscular or Intravenous Administration of Dexamethasone for Third Molar Surgeries: A Systematic Review and Meta-Analysis

Avaliação da dor pós-operatória com administração de midazolam em exodontias de terceiros molares inclusos mandibulares

Áttörésben visszamaradt bölcsességfogak ellátása az ambuláns szájsebészeti gyakorlatban egy év adatai alapján

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