Elsevier

Dental Abstracts

Volume 62, Issue 5, September–October 2017, Pages 294-295
Dental Abstracts

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NSAIDs for postoperative endodontic pain

https://doi.org/10.1016/j.denabs.2017.03.056Get rights and content

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Background

Although many approaches have been used over the years, pain after endodontic treatment is largely unpreventable. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most recommended class of pain relievers for dental procedures today. A systematic review was done in 2002 to clarify the role of NSAIDs for the treatment postoperative endodontic pain. Its findings showed the most effective analgesic approach was a combination of flurbiprofen and tramadol or a regimen of preoperative and

Methods

The goal of the systematic review was to evaluate the comparative efficacy of NSAIDs used alone or in combination with other analgesics and other nonnarcotic drugs to provide relief of postoperative endodontic pain in patients who have preoperative pain. Included in the literature search were articles referenced in Ovid MEDLINE, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. L’Abbe plots were done to qualitatively review the results. Fifteen

Results

Not all articles provided patient characteristics, but those that did reported subjects’ mean age was 40 years (range 18 to 80 years), with 55% men and 45% women. Eighty-three percent were white patients, 11% black patients, and 6% Hispanic or Asian patients. When all studies were included, the mean baseline pain was rated as a 59 on a 100-mm visual analog scale (VAS), with a range from 12.85 to 85.47. The results of studies reporting treated teeth by tooth and arch type showed an equal

Discussion

Ibuprofen was the most studied NSAID in the endodontic literature and was significantly better than placebo at reducing pain after 6 hours. Combining ibuprofen and acetaminophen was also significantly better at reducing pain than placebo, but not significantly more effective than ibuprofen alone at 6 hours. The limitation of this evaluation is the poor quality of the evidence, which makes it difficult to draw broadly applicable conclusions regarding the superiority of one NSAID over others.

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Smith EA, Marshall JG, Selph SS, et al: Nonsteroidal anti-inflammatory drugs for managing postoperative endodontic pain in patients who present with preoperative pain: A systematic review and meta-analysis. J Endod 43:7-15, 2017

Reprints available from CM Sedgley, Dept of Endodontology, School of Dentistry, Oregon Health and Science Univ, 2730 SW Moody Ave, Portland, OR 97201-5042; e-mail: [email protected]

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