scholarly journals Does the Preemptive Use of Oral Nonsteroidal Anti-inflammatory Drugs Reduce Postoperative Pain in Surgical Removal of Third Molars? A Meta-analysis of Randomized Clinical Trials

2015 ◽  
Vol 62 (2) ◽  
pp. 57-63 ◽  
Author(s):  
Fábio Wildson Gurgel Costa ◽  
Diego Felipe Silveira Esses ◽  
Paulo Goberlânio de Barros Silva ◽  
Francisco Samuel Rodrigues Carvalho ◽  
Carlos Diego Lopes Sá ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Third Molar ◽  
Preemptive Analgesia ◽  
Surgical Removal ◽  
Third Molars ◽  
Inflammatory Drugs ◽  
Cox 2 ◽  
Anti Inflammatory

Abstract The purpose of this study was to investigate the effectiveness of preemptive analgesia with nonsteroidal anti-inflammatory drugs (NSAIDs) in third-molar surgery. A PubMed literature search was conducted for articles restricted to the English language using the following terms (DeCS/MeSH) or combinations: analgesia, third molar, and preemptive. From a total of 704 articles, 6 (n = 420 subjects) were selected. All studies presented a low risk of bias (Cochrane criteria) but exhibited high heterogeneity of methods. Two studies were excluded from the meta-analysis because they did not have adequate numeric values (dichotomous data) for the calculations. Preemptive analgesia showed no significant benefit (n = 298, P = .2227, odds ratio: 2.30, 0.60–8.73) in reducing postoperative pain after removal of lower impacted third molars. However, there was a probable direct relationship between the effectiveness of NSAIDs in preemptive analgesia for removal of third molars and its selectivity for the cyclooxygenase-2 (COX-2). Preemptive analgesia did not have a significant effect in reducing postoperative pain after removal of lower impacted third molars. More homogeneous and well-delineated clinical studies are necessary to determine a possible association between NSAIDs' selectivity for COX-2 and treatment effectiveness.

Preemptive use of oral nonsteroidal anti-inflammatory drugs for the relief of inflammatory events after surgical removal of lower third molars: A systematic review with meta-analysis of placebo-controlled randomized clinical trials

2020 ◽  
Vol 48 (3) ◽  
pp. 293-307 ◽  
Author(s):  
Edson Luiz Cetira Filho ◽  
Francisco Samuel Rodrigues Carvalho ◽  
Paulo Goberlânio de Barros Silva ◽  
Daniel Almeida Ferreira Barbosa ◽  
Karuza Maria Alves Pereira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Surgical Removal ◽  
Third Molars ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

scholarly journals The Effectiveness of the Cold Therapy (cryotherapy) in the Management of Inflammatory Parameters after Removal of Mandibular Third Molars: A Meta-Analysis

2019 ◽  
Vol 23 (02) ◽  
pp. 221-228 ◽  
Author(s):  
Ighor Andrade Fernandes ◽  
Anna Catharina Vieira Armond ◽  
Saulo Gabriel Moreira Falci
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Third Molar ◽  
Cochrane Library ◽  
Control Group ◽  
Surgical Removal ◽  
Third Molars ◽  
Cold Therapy ◽  
Mandibular Third Molar

Introduction Cold therapy (cryotherapy) is a common procedure recommended by dental surgeons after surgical removal of third molars, which is an invasive intervention that often deals with an expressive inflammatory response. Objective To investigate whether cryotherapy interferes with clinical outcomes such as pain, edema, and trismus in the postoperative period of mandibular third molar surgeries. Data Synthesis An electronic search was conducted in the OVID, PubMed, VHL, Science Direct, Cochrane Library, and Web of Science databases, through March 2018. The eligibility criteria included clinical trials that evaluated the effect of cryotherapy in at least one of the following variables: pain, swelling, and trismus.Two independent reviewers assessed the studies. The methodological quality of each article was analyzed. The search strategy resulted in 1,088 articles. Following the selection process, 11 studies were included in the systematic review and 4 of them in the meta-analysis. High risk of bias was found in most of the studies according to the Cochrane Handbook assessment. Patients receiving cryotherapy had less edema than patients in the control group at second day follow-up (mean difference [MD]: -0.94; 95%CI [-1.49; -0.39]). There were no statistically significant results when comparing trismus between experimental and control group (MD: 0.43; 95%CI [-0.34;1.20]). There were insufficient available data to support influences in postoperative pain. Conclusions Cryotherapy applied on the first day after mandibular third molar removal can manage edema in the patients. Well-designed randomized clinical trials to test the efficacy of cryotherapy after surgical removal of third molars are needed to justify its indication.

Efficacy and safety of selective COX-2 inhibitors for pain management after third molar removal: a meta-analysis of randomized clinical trials

2019 ◽  
Vol 24 (1) ◽  
pp. 79-96 ◽  
Author(s):  
Albert González-Barnadas ◽  
Octavi Camps-Font ◽  
Pablo Martín-Fatás ◽  
Rui Figueiredo ◽  
Cosme Gay-Escoda ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Pain Management ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Third Molar ◽  
Efficacy And Safety ◽  
Cox 2 ◽  
Cox 2 Inhibitors

Pharmacological Control of Complications Following to Third Molar Removal: Evidence Based on A Meta-Analysis

Drug Research ◽  
2018 ◽  
Vol 69 (01) ◽  
pp. 5-11 ◽  
Author(s):  
Mario Isiordia-Espinoza ◽  
Ronell Bologna-Molina ◽  
Ycenna Hernández-Miramontes ◽  
Juan Zapata-Morales ◽  
Angel Alonso-Castro ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Third Molar ◽  
Qualitative Evaluation ◽  
Clinical Effectiveness ◽  
Cochrane Library ◽  
Third Molar Surgery ◽  
P Value ◽  
Facial Swelling ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Abstract Aims The purpose of this meta-analysis was to evaluate the clinical efficacy of non-steroidal anti-inflammatory drugs and dexamethasone on the trismus, postsurgical pain, facial swelling, as well as the analgesic consumption after third molar surgery. Material and Methods The reports were identified in the most important medical databases. Those studies that met the requirements were fully assessed according to the inclusion and exclusion criteria. The quality of each report was evaluated with the Oxford Quality Scale and using the Cochrane Collaboration’s risk of bias tool. Each meta-analysis was done using the technique of mean difference and 95% confidence intervals employing a random effects model with the Review Manager 5.3., from the Cochrane Library. Significant statistical difference was accepted when the p value was less than 0.05 on the test of overall effect (Z value). Results Qualitative evaluation was done using the data of 330 patients extracted from seven articles and the quantitative assessment with data of 200 patients from three reports. It was not observed difference among non-steroidal anti-inflammatory drugs and dexamethasone in any of the clinical effectiveness indicators. Conclusion The outcomes of our meta-analysis indicate that non-steroidal anti-inflammatory drugs and dexamethasone have good therapeutic effect for the management of inflammatory complications following to third molar surgery.

scholarly journals Role of Anti-inflammatory Drugs in the Colorectal Cancer

2019 ◽  
Vol 55 (3) ◽  
pp. 168-180
Author(s):  
Oumer Sada ◽  
Kemal Ahmed ◽  
Aliye Jeldo ◽  
Mensur Shafi
Keyword(s):  
Colorectal Cancer ◽  
Relative Risk ◽  
Meta Analysis ◽  
Data Sources ◽  
High Dose ◽  
Adjusted Relative Risk ◽  
Inflammatory Drugs ◽  
Cox 2 ◽  
Anti Inflammatory ◽  
Cox 2 Inhibitors

Objective: The objective of this review was to systematically review and synthesize evidence regarding benefits of using nonsteroidal anti-inflammatory drugs (NSAIDs) for the treatment of colorectal cancer (CRC). Data Sources: The data sources were MEDLINE, PubMed, NEJM, Google Scholar, and Google searches of references from relevant and eligible trials. Review Methods: We screened abstracts and full-text articles of identified references for eligibility and reviewed randomized controlled trials, cohort studies, and meta-analysis for evidence on benefits of using NSAIDs in CRC treatments. For all extracted data, completeness and relevance were checked. Results: The risk of any adenoma among frequent NSAID users was 26.8% vs 39.9% among placebo subjects who later used NSAIDs sporadically (adjusted relative risk = 0.62, 95% confidence interval [CI] = 0.39-0.98; P trend with NSAID use frequency = .03). Long-term use of aspirin reduces the risk of CRC. Aspirin also reduces the incidence of colon adenomas and mortality, especially when used for >10 years. Rofecoxib is associated with the reduction of CRC; however, it was associated with cardiovascular risk (with an overall unadjusted relative risk of 1.50 [95% CI = 0.76-2.94; P = .24]). Adenoma Prevention with Celecoxib trial shows that, for patients of all genotypes, the estimated cumulative incidence of one or more adenomas by year 3 was 59.8% for those randomized to placebo as compared with 43.3% for those randomized to low-dose (200 mg, twice daily) celecoxib (relative risk [RR] = 0.68; 95% CI = 0.59-0.79; P < .001) and 36.8% for those randomized to high-dose (400 mg, twice daily) celecoxib and 60.7% in placebo group (RR = 0.54; 95% CI = 0.46-0.64; P < .001). Conclusions: The use of COX-2 inhibitors both prior to and after diagnosis of CRC seemed to be mildly associated with the reduction in mortality of patients with CRC. Some literatures state that COX-2 inhibitors might play a synergistic role in adjuvant chemotherapy of FOLFOX regimen. Celecoxib was found to increase the radiosensitization of colon cancer cells.

scholarly journals Risk of Bleeding with Exposure to Warfarin and Nonsteroidal Anti-Inflammatory Drugs: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 120 (07) ◽  
pp. 1066-1074
Author(s):  
Lorenzo Villa Zapata ◽  
Philip D. Hansten ◽  
Jennifer Panic ◽  
John R. Horn ◽  
Richard D. Boyce ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Healthcare Research ◽  
Average Treatment Effect ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
Inflammatory Drugs ◽  
Cox 2 ◽  
Anti Inflammatory

Abstract Background Warfarin use can trigger the occurrence of bleeding independently or as a result of a drug–drug interaction when used in combination with nonsteroidal anti-inflammatory drugs (NSAIDs). Objectives This article examines the risk of bleeding in individuals exposed to concomitant warfarin and NSAID compared with those taking warfarin alone (Prospero Registry ID 145237). Methods PubMed, EMBASE, Scopus, and Web of Science were searched. The primary outcome of interest was gastrointestinal bleeding and general bleeding. Summary effects were calculated to estimate average treatment effect using random effects models. Heterogeneity was assessed using Cochran's Q and I 2. Risk of bias was also assessed using the Agency for Healthcare Research and Quality bias assessment tool. Results A total of 651 studies were identified, of which 11 studies met inclusion criteria for meta-analysis. The odds ratio (OR) for gastrointestinal bleeding when exposed to warfarin and an NSAID was 1.98 (95% confidence interval [CI]: 1.55–2.53). The risk of gastrointestinal bleeding was also significantly elevated with exposure to a COX-2 inhibitor and warfarin relative to warfarin alone (OR = 1.90, 95% CI: 1.46–2.46). There was an increased risk of general bleeding with the combination of warfarin with NSAIDs (OR = 1.58, 95% CI: 1.18–2.12) or COX-2 inhibitors (OR = 1.54, 95% CI: 0.86–2.78) compared with warfarin alone. Conclusion Risk of bleeding is significantly increased among persons taking warfarin and a NSAID or COX-2 inhibitor together as compared with taking warfarin alone. It is important to caution patients about taking these medications in combination.

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