Comparative analysis of preemptive analgesic effect of dexamethasone and diclofenac following third molar surgery

Simone, José Leonardo; Jorge, Waldyr Antônio; Horliana, Anna Carolina Ratto Tempestini; Canaval, Talita Girio; Tortamano, Isabel Peixoto

doi:10.1590/s1806-83242013005000012

Cited by 41 publications

(41 citation statements)

References 21 publications

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“…Previous research results (16,27) showed that the use of SAID as a preemptive medication was effective in preventing pain after removal of third molars surgeries, which is consistent with the current study, despite the surgery performed and drug dosage showing a better efficacy of dexamethasone; this can be explained by the mechanism of action of this drug, since corticosteroids inhibit the phospholipase A2 enzyme reducing the release of arachidonic acid into leukotrienes and inflammatory cells. Additionally, a lower accumulation of neutrophils may justify, at least in part, the power of SAIDs (28).…”

Section: Discussionsupporting

confidence: 92%

“…For all of these evaluated aspects, no differences were observed between the SAID and NSAID groups, confirming the homogeneity of experimental groups and supporting the outcomes obtained in the study. These assessments were not carried out in other studies (16,17,(25)(26)(27)30), which could affect the interpretation of individual morbidity data.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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This trial evaluated the preemptive and postoperative effect of dexamethasone and ibuprofen on prevention of pain/discomfort, edema and interference in daily life in patients undergoing root coverage combined with subepithelial connective tissue graft (CAF + CTG). Twenty patients were randomly assigned as follows: NSAID Group: 400mg Ibuprofen 60 min preemptive + 400mg Ibuprofen postoperative; or SAID Group: 4mg Dexamethasone 60 min preemptive + 4mg Dexamethasone postoperative. The postoperative medication was administered 8 and 16 h post-surgery. Each patient received questionnaires based on a numeric scale (101-point numeric scale rate ) and multiple choice questions (four-point verbal rating scale ) about trans-operative pain/discomfort, hourly for 8 h after surgery and once a day for three days. A Visual Analogue Scale (VAS) for edema and interference in daily life during the 1st, 2nd, 3rd and 7th day was also answered. The degree of anxiety was rated statistically by the Chi-square test. The MannWhitney and Friedman tests were used for the other questionnaires. The surgery time and number of analgesic pills consumed were compared using Student's t-test. Patients who used dexamethasone presented a trend toward less pain when compared to individuals who ingested ibuprofen, with a significant difference observed 3 h after the procedure (p<0.05). The use of dexamethasone also promoted less edema until the 2nd day and lower interference in daily life on the third day when compared with ibuprofen (p<0.05). We concluded that the use of dexamethasone as a preemptive and postoperative medication was more suitable as a drug therapeutic protocol for CAF + CTG.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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“…There is a broad discussion about the best drug to minimize postoperative discomfort in dentistry and among the best drugs of choice, dexamethasone is being evaluated by several scientific studies due to its efficacy to control inflammatory complications as compared to its non-use [5][6][7] . Meechan and Seymour 28 have studied different complications that appear after impacted third molar surgery and have concluded that the observation of such complications is important to comparatively evaluate the efficacy of several therapeutic measures.…”

Section: Discussionmentioning

confidence: 99%

“…This model is an advantage for the prospective evaluation of clinical pharmacology, since patients assure the quality of their own control. Some studies suggest the systemic use of corticosteroids for impacted third molar surgeries [5][6][7]12,13 . Markiewicz et al 4 in a meta-analysis have concluded that corticosteroids administered in the preoperative period were of great value to decrease postoperative inflammatory signs and symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Several professionals have emphasized the need for better controlling the postoperative inflammatory process of such surgical procedures, and different drugs have been proposed for such. Corticosteroids may inhibit the onset of inflammatory mediators synthesis and are considered potent drugs to control pain, edema and trismus [4][5][6][7] . Dexamethasone has been widely used in dentistry in different doses and administration routes to decrease postoperative discomfort and when used for a short period presents less interference with chemotaxis for leucocytes 8,9 .…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of effects of two dexamethasone formulations in impacted third molar surgeries

et al. 2014

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BACKGROUND AND OBJECTIVES:Submucosal dexamethasone injection directly in the surgical area has been used in different dental procedures, but there are still few studies evaluating its efficacy as compared to oral route for impacted third molar surgeries. So, this study aimed to evaluate postoperative pain, edema and trismus after impacted third molar surgeries using oral or submucosal local injection of dexamethasone. METHODS:This was a prospective, controlled, crossover and randomized study involving 36 patients with indication of lower third molar surgeries, who were randomly distributed in two groups: group A -submucosal local injection of dexamethasone (4mg/1mL) after local anesthesia, and group B -oral dexamethasone tablet (4mg) one hour before procedure. Edema and trismus were clinically evaluated in the postoperative period and in the 1 st , 2 nd , 3 rd and 7 th postoperative days. Patients were oriented to record pain intensity in the visual analog scale in periods zero (preoperative), 1h, 2h, 4h, 12h, 1 day, 2 days and 3 days and one week after surgery. Data were submitted to statistical analysis with significance level of 5%. RESULTS: There were no significant differences in surgical time with regard to operated sides (p=0.4). Edema and trismus values were not statistically different between observed groups (p>0.05). Mean pain values recorded in the visual analog scale were not statistically different between groups and patients have Evaluation of effects of two dexamethasone formulations in impacted third molar surgeries* Avaliação dos efeitos de duas formulações de dexametasona em cirurgias de terceiros molares inclusos

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Complementary and alternative therapies for managing postoperative pain after lower third molar surgery: a systematic review and network meta-analysis

Falci,

Fernandes,

Guimarães

et al. 2024

Clin Oral Invest

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Comparative analysis of preemptive analgesic effect of dexamethasone and diclofenac following third molar surgery

Cited by 41 publications

References 21 publications

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

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

Evaluation of effects of two dexamethasone formulations in impacted third molar surgeries

Complementary and alternative therapies for managing postoperative pain after lower third molar surgery: a systematic review and network meta-analysis

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