Analgesics for Dental Implants: A Systematic Review

Abstract

Postsurgical pain is commonly associated with dental and oral surgery, and the use of analgesics has been investigated in the management of postoperative pain. This systematic review summarizes available evidence on analgesics used to manage dental implant surgery postoperative pain, to identify best therapeutic protocols and knowledge gap. A comprehensive search was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, clinicaltrials.gov, and the Cochrane Database of Systematic Reviews through May 2020. Only randomized controlled trials were included. PRISMA guidelines were followed, and risk of bias was appraised using Cochrane RoB2 tool. Eleven trials (762 patients overall) were included. Some aspects limited the feasibility of a meaningful meta-analysis; thus, a narrative synthesis was conducted. Risk of bias was low in four studies and high in two studies, while five studies raised some concerns due to the randomization process. Analgesic use seemed to be associated with improved postoperative outcomes (pain, patient’s satisfaction, and need for rescue medication) when compared to placebo. Overall, this review suggests that the administration of analgesics may provide some advantages in the management of postoperative outcomes after dental implant placement, while indications about the best analgesics cannot be provided.

Preemptive use of anti-inflammatories and analgesics in oral surgery: a review of systematic reviews

“…The results showed that ibuprofen (600 mg) and dexketoprofen (25 mg) were superior to placebo for reducing pain. Further RCTs with an adequate sample size comparing standardized implant approaches are needed to inform best practices in this domain ( Melini et al, 2021 ).…”

A Randomized, Double-Blind Trial of the Analgesic and Anti-Inflammatory Effects of Naproxen Sodium and Acetaminophen Following Implant Placement Surgery

“…Nonaddictive analgesics, including NSAIDs and acetaminophen, are recommended as first-line agents in the management of pain following outpatient dental procedures (Hersh et al, 2020). Prior studies have demonstrated that prescription doses of NSAIDs are superior to placebo in reducing post-operative pain and swelling following implant placement surgery (Khouly et al, 2021;Mattos-Pereira et al, 2021;Melini et al, 2020). However, to our knowledge, this is the first study to compare the analgesic and anti-inflammatory effects of OTC doses of an NSAID and acetaminophen following implant placement surgery.…”

“…Numerous placebo-controlled studies support the use of non-steroidal anti-inflammatory drugs (NSAIDs) as first-line agents in managing pain following outpatient dental procedures due to their effectiveness and lack of addictive potential (Hersh et al, 2020;Moore & Hersh, 2013). Most of these studies have been performed in patients undergoing surgical extraction of bony impacted mandibular third molars, but similar results have been observed in studies of implant placement (Khouly et al, 2021;Mattos-Pereira et al, 2021;Melini et al, 2020). Pre-emptive administration of dexketoprofen 25 mg (Sanchez-Perez et al, 2018), ibuprofen 600 mg (Pereira et al, 2020), or piroxicam 40 mg (Bhutani et al, 2019), 15-60 minutes prior to surgery, resulted in less post-operative pain compared to placebo.…”

A randomized, double-blind pilot study of analgesic and anti-inflammatory effects of naproxen sodium and acetaminophen following dental implant placement surgery

“…Non-addictive analgesics, including NSAIDs and acetaminophen, are recommended as first-line agents in the management of pain following outpatient dental procedures ( Hersh et al, 2020 ). Prior studies have demonstrated that prescription doses of NSAIDs are superior to placebo in reducing post-operative pain and swelling following implant placement surgery ( Melini et al, 2020 ; Khouly et al, 2021 ; Mattos-Pereira et al, 2021 ). However, to our knowledge, this is the first study to compare the analgesic and anti-inflammatory effects of OTC doses of an NSAID and acetaminophen following implant placement surgery.…”