Pre-Emptive Analgesia for Periodontal and Implant-Related Surgery: A Systematic Review and Meta-Analysis
Abstract
Objective: This systematic review aimed to answer the question: In patients undergoing periodontal and peri-implant surgery, gingival augmentation, implant site development or placement, are pre-emptive analgesics effective in controlling post-operative pain compared with patients not receiving pre-emptive medications?
Materials and methods: After comprehensive electronic and manual literature searches, randomised placebo-controlled clinical trials on adults undergoing the aforementioned surgeries were included. A meta-analysis was performed comparing pain (standardised mean difference) between pre-emptive medication and placebo at post-operative hours 1, 3, 6, 8, 24 and 72.
Results: Two reviewers screened 1995 titles, included 18 studies in the systematic review (open flap debridement, osseous, mucogingival, unspecified periodontal surgery, implant placement; 1008 patients) and 7 studies in the meta-analysis. Non-steroidal anti-inflammatory drugs, acetaminophen and corticosteroids were prescribed 8 h to immediately pre-operatively and post-operatively until 12 h after the first dose. A clinically significant pain reduction peaked at 3 h (-0.81 [95% CI: -1.03, -0.58]; 9 study arms, n = 165 drug vs. n = 96 placebo patients) and was significant until 8 h (-0.54 [95% CI: -0.79, -0.28]; 7 study arms, n = 126 drug vs. n = 96 placebo patients), with moderate certainty of evidence (GRADE assessment).
Conclusion: Pre-emptive analgesia can reduce pain for up to 8 h following…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,008 participants or records.
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