Pharmacological control of complications in third molar surgery through the use of non-steroidal anti-inflammatory drugs combined or isolated with opioids

Authors

DOI:

https://doi.org/10.33448/rsd-v11i6.28807

Keywords:

Oral Surgery; Serotine Tooth; Non-Steroidal Anti-Inflammatory Drugs; Opioid Analgesics; Teaching.

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are used in third molar extraction due to their anti-inflammatory, analgesic and antipyretic effects in the control of postoperative pain, swelling and trismus. Therefore, this study aimed to describe the effectiveness of NSAIDs as drug therapy, combined or isolated with opioids in the preoperative period in oral surgery of third molars. This is an integrative review study. For this, descriptors registered in DeCS/MeSH were applied in the indexed databases of PubMed, LILACS, IBECS and BBO and later interconnected through the Boolean operator “and”. A total of 109 studies over a 5-year period (2018 to 2022) were retrieved. After analysis, 13 clinical trials with or without randomization were included. The literature shows promising effects on the therapeutic action of NSAIDs when administered preemptively for tooth extraction of third molars, showing a reduction in anti-inflammatory responses, contributing to a faster recovery of patients. Sodium diclofenac, meloxicam, nimesulide, ibrupofen, trometamol and flurbiprofen were efficient in controlling inflammatory events, contributing to the reduction of redness, edema, trismus and pain in the observed studies. The combination or not of NSAIDs with opioids significantly reduces pain, swelling and trismus in third molar extraction. However, new clinical trials with prolonged periods and significant samples should be designed in order to conceptualize which combinations and their respective pharmacological dosages may present better analgesic efficacy.

References

Akinbade, A. O, Ndukwe, K. C, & Owotade, F. J. (2019). Comparative analgesic efficacy and tolerability of celecoxib and tramadol on postoperative pain after mandibular third molar extraction: A double blind randomized controlled trial. Niger J Clin Pract. 22(6), 796-800. https://doi.org/10.4103/njcp.njcp_544_18.

Andrade, E. D, Ranali, J, & Volpato, M. C. (2002). Pacientes que requerem cuidados especiais. In: Terapêutica medicamentosa em odontologia. 4. ed. São Paulo: Artes médicas, 93-140.

Barbalho, J. C, Vasconcellos, R. J. H, Morais, H. H, Santos, L. A. M, Almeida, R. A. C, Rêbelo, H. L, Lucena, E. E, & Araújo, S. Q. (2017). Effects of co-administered dexamethasone and nimesulide on pain, swelling, and trismus following third molar surgery: a randomized, triple-blind, controlled clinical trial. Int J Oral Maxillofac Surg. 46(2), 236-242. https://doi.org/10.1016/j.ijom.2016.10.011.

Cigerim, L., & Eroglu, C. (2018). Comparison of Clinical Efficacies of Preoperatively Initiated Naproxen Sodium-Codeine Phosphate in Combination, Diclofenac Potassium, and Benzydamine Hydrochloride for Pain, Edema, and Trismus After Extraction of Impacted Lower Third Molar: A Randomized Double-Blind Study. J Oral Maxillofac Surg. 76(3):495-502. https://doi.org/10.1016/j.joms.2017.08.041.

Costa-Araújo, F. A, Santos, T. S, Morais, H. H. A, Laureano-Filho, J. R, Silva, E. D. O, & Vasconcellos, R. J. H. (2012). Comparative analysis of preemptive analgesic effect of tramadol chlorhydrate and nimesulide following third molar surgery. Journal of Cranio-Maxillofacial Surgery, 40(8), e346-e349. https://doi.org/10.1016/j.jcms.2012.01.018.

Damiani, D., Kuperman, H, Dichtchekenian, V, Manna, T. D, & Setian, N. (2001). Corticoterapia e suas repercussões: a relação custo– benefício. Pediatria, 23(1), 71-82.

Đanić, P., Salarić, I., & Macan, D. (2017). New Findings on Local Tramadol Use in Oral Surgery. Acta Stomatologica Croatica, 51(4), 336-344. https://doi.org/10.15644/asc51/4/9.

Derry, C., Derry, S., Moore, R.A, McQuay, H. J. (2009). Single dose oral naproxen and naproxen sodium for acute postoperative pain. Cochrane Database of Systematic Reviews, 1(4). https://doi.org/10.1002/14651858.cd004234.pub3.

Espinoza, I., Bologna-Molina, R. E, Hernández-Miramontes, Y. A, Zapata-Morales, J. R, Alonso-Castro, A. J, Martínez-Morales, F, Sánchez-Enriquez, S, Serafín-Higuera, N. A, Pérez-Cortez, G, & Torre, L. F. (2019). Pharmacological Control of Complications Following to Third Molar Removal: Evidence Based on A Meta-Analysis. Drug Res (Stuttg). 69(1), 5-11. https://doi.org/10.1055/a-0637-8948.

Falci, S. G. M, Lima, T. C, Martins, C. C, Santos, C. R. R, & Pinheiro, M. L. P. (2017). Preemptive Effect of Dexamethasone in Third-Molar Surgery: A Meta-Analysis. Anesth Prog. 64(3), 136-143. https://dx.doi.org/10.2344%2Fanpr-64-05-08.

Galvão, T. F, Pansani, T. S. A, & Harrad, D. (2015). Principais itens para relatar Revisões sistemáticas e Meta-análises: A recomendação PRISMA. Epidemiologia e serviços de saúde, 24(1), 335-342. https://doi.org/10.1002/jcph.1998.38.s1.46.

Gorecki, P., Rainsford, K.D., Taneja, P., Bulsara, Y., Pearson, D., Saund, D., Ahmed, B., & Dietrich, T. (2018). Submucosal Diclofenac for Acute Postoperative Pain in Third Molar Surgery: A Randomized, Controlled Clinical Trial. J Dent Res. 97(4), 381-387. https://doi.org/10.1177/0022034517744207.

Isiordia-Espinoza, M. A., Pozos-Guillen, A., Martinez-Rider, R., & Perez-Urizar, J. (2016). Comparison of the analgesic efficacy of oral ketorolac versus intramuscular tramadol after third molar surgery: A parallel, double-blind, randomized, placebo-controlled clinical trial. Medicina oral, patologia oral y cirugia bucal, 21(5), e637–e643. https://doi.org/10.4317/medoral.21077.

Isola, G., Matarese, G., Alibrandi, A., Dalessandri, D., Migliorati, M., Pedullà, E., & Rapisarda, E. (2019). Comparison of Effectiveness of Etoricoxib and Diclofenac on Pain and Perioperative Sequelae After Surgical Avulsion of Mandibular Third Molars: A Randomized, Controlled, Clinical Trial. Clin J Pain. 35(11), 908-915. https://doi.org/10.1097/ajp.0000000000000748.

Kaplan, V., & Eroglu, C.N. (2016). Comparison of the Effects of Daily Single-Dose Use of Flurbiprofen, Diclofenac Sodium, and Tenoxicam on Postoperative Pain, Swelling, and Trismus: A Randomized Double-Blind Study. J Oral Maxillofac Surg. 74(10), 1-6. https://doi.org/10.1016/j.joms.2016.05.015.

Lanzoni, G. M. M. & Meirelles, B. H. S. (2011). Liderança do enfermeiro: uma revisão integrativa da literatura. Revista Latino-Americana de Enfermagem, 19(3), 1-8.

Lima, T. C, Bagordakis, E, Falci, S. GM, Santos, C. R. R, & Pinheiro, M. L. P. (2018). Pre-Emptive Effect of Dexamethasone and Diclofenac Sodium Associated With Codeine on Pain, Swelling, and Trismus After Third Molar Surgery: A Split-Mouth, Randomized, Triple-Blind, Controlled Clinical Trial. J Oral MaxillofacSurg.76(1), 60-66.

Martins, L. D, Rezende, M, Chibinski, A. C, Loguercio, A. D, Bortoluzzi, M. C, Araújo, J, & Reis, A. (2021). Does Ketorolac reduce the intensity of postoperative pain after impacted third molars surgery in adults compared to the use of tramadol? A systematic review and meta-analysis. Research, Society and Development, 10(3), e19410313137. https://doi.org/10.33448/rsd-v10i3.13137.

Martins, L. D, Rezende, M, Loguercio, A. D, Bortoluzzi, M. C, Reis, A. (2019). Analgesic efficacy of ketorolac associated with a tramadol/acetaminophen combination after third molar surgery - a randomized, triple-blind clinical trial. Med Oral Patol Oral Cir Bucal. 24(1), e96-e102.

Mendes, K. D. S, Silveira, R. C. C. P, & Galvão, C. M. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm. 17 (4), 758-764. https://doi.org/10.1590/S0104-07072008000400018.

Orozco-Solís, M., García-Ávalos, Y., Pichardo-Ramírez, C., Tobías-Azúa, F., Zapata-Morales, J.R., Aragon-Martínez, O.H., & Isiordia-Espinoza, M.A. (2016). Single dose of diclofenac or meloxicam for control of pain, facial swelling, and trismus in oral surgery. Med Oral Patol Oral Cir Bucal, 21(1), e127-134.https://doi.org/10.4317/medoral.20925.

Pagnoncelli, R. M, & Silva C. A. G. (1999). Uso de corticosteroide para redução da resposta inflamatória após a remoção de terceiro molar: proposição de uma técnica. Rev Odonto Ciênc, 14(27), 179-191.

Quesada-Bravo, F. J., García-Carricondo, A. R., Espín-Gálvez, F., Fernández-Sánchez, C., Fernández-Ginés, D., Requena-Mullor, M., & Alarcón-Rodríguez, R. (2021). Comparative Study between the Combination of Dexamethasone and Bupivacaine for Third Molar Surgery Postoperative Pain: A Triple-Blind, Randomized Clinical Trial. Journal of clinical medicine, 10(21), 5081. https://doi.org/10.3390/jcm10215081.

Saito, K., Kaneko, A., Machii, K., Ohta, H., Ohkura, M., Suzuki, M. (2012). Efficacy and safety of additional 200-mg dose of celecoxib in adult patients with postoperative pain following extraction of impacted third mandibular molar: a multicenter, randomized, double-blind, placebo-controlled, phase II study in Japan. Clinical therapeutics, 34(2), 314-328.

Santos, C. M. C, Pimenta, C. A. M, Nobre, M. R. C. (2007). The PICO strategy for the research question construction and evidence search. Revista Latino-Americana de Enfermagem, [S.L.], 15(3), 508-511. https://doi.org/10.1590/S0104-11692007000300023.

Santos, P. L, Caldeira, J. E, Junior, I. R. G, & Aranega, A. M. (2011). Assistência cirúrgico-odontológica a pacientes imunodeprimidos por uso crônico de corticoides. RFO UPF [online], 16(2), 224-228.

Silva, R. N. F, & Pereira, L. C. G. (2016). O uso de antiinflamatórios esteroidais e não esteriodais no controle da dor e do edema em cirurgia de terceiros molares. Journal of Dentistry & Public Health, 7(1). http://dx.doi.org/10.17267/2238-2720revbahianaodonto.v7i1.769.

Simoneti, L. F, Weckwerth, G. M, Dionísio, T. J, Torres, E. A, Zupelari-Gonçalves, P, Calvo, A. M, Lauris, J. R, Faria, F. C, & Santos, C. F. (2018). Efficacy of Ketoprofen With or Without Omeprazole for Pain And Inflammation Control After Third Molar Removal. Braz Dent J. 29(2), 140-149. https://doi.org/10.1590/0103-6440201802254.

Souza, M. T, Silva, M. D, & Carvalho, R. (2010). Integrative review: what is it? how to do it?. Einstein (São Paulo), 8(1), 102-106.

Vicente, Â., Loffi, A. O. B, & Nesi, H. (2013). Uso de corticosteroide no pré-operatório em cirurgia de terceiros molares. Rev. Bras. Odontol. [online], 70(1), 22-27.

Villalpando, V. E, Bolaños, D. C, Moscoso, A. G, Ito, D. M, Rider, R. M, Espinoza, M. I, & Guillen, A. P. (2016). Comparison of the analgesic efficacy of preoperative/postoperative oral dexketoprofen trometamol in third molar surgery: A randomized clinical trial. J Craniomaxillofac Surg. 44(9), 1350-1355. https://doi.org/10.1016/j.jcms.2016.06.002.

Wilken, I. S, & Abreu, M. H. N. G. (2017). Utilização de analgésicos opioides após exodontia de terceiros molares: uma revisão da literatura científica. Arquivos em Odontologia, 53(1), 2017.

Zupelari-Goncalves, P., Weckwerth, G. M, Calvo, A. M, Simoneti, L. F, Dionisio, T. J, Brozoski, D. T, Torres, E. A, Lauris, J. R. P, Faria, F. A. C, & Santos, C. F. (2017). Efficacy of oral diclofenac with or without codeine for pain control after invasive bilateral third molar extractions. Int J Oral Maxillofac Surg. 46(5):621-627. https://doi.org/10.1016/j.ijom.2017.01.008.

Published

19/04/2022

How to Cite

MATEUS, M. M.; PEREIRA, L. D. .; SILVA, L. P. da .; DIAS, A. A. .; SAKAMOTO, S. P. da S. .; MARQUES, S. L. C. .; SOUZA, G. B. de .; ALVES, J. R. de S. .; MOREIRA, E. P. A. .; SOUSA, Z. da S. Pharmacological control of complications in third molar surgery through the use of non-steroidal anti-inflammatory drugs combined or isolated with opioids. Research, Society and Development, [S. l.], v. 11, n. 6, p. e3311628807, 2022. DOI: 10.33448/rsd-v11i6.28807. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/28807. Acesso em: 28 may. 2022.

Issue

Section

Review Article