The Journal of the American Dental Association
-
The authors conducted a systematic review and meta-analysis to determine whether arthrocentesis or arthroscopy combined with platelet-rich plasma (PRP) or platelet-rich growth factor (PRGF) injection compared with no injection or saline injection (control group) or hyaluronic acid (HA) injection reduced pain and increased maximum mouth opening (MMO) in patients with temporomandibular joint (TMJ) osteoarthritis (OA). ⋯ Although the results of the included studies showed that arthrocentesis or arthroscopy with PRP or PRGF, saline, or HA injections all reduced pain and increased mouth opening, the evidence was of very low quality. Further studies are needed to confirm these preliminary results showing that PRP or PRGF with arthrocentesis or arthroscopy significantly improved pain but did not increase MMO compared with findings in the control or HA groups.
-
Review Meta Analysis
Benefits and harms of capnography during procedures involving moderate sedation: A rapid review and meta-analysis.
Patient safety is a priority in dentistry. Evaluating the benefits and harms associated with the addition of capnography to standard monitoring during moderate sedation for adult patients in the dental practice setting is needed. ⋯ Adding capnography to standard monitoring of adults during moderate sedation may reduce the risk of developing hypoxemia, increase detection of adverse respiratory events, and is not associated with additional harms. These findings suggest routine use of capnography during moderate sedation has the potential to reduce adverse anesthetic outcomes in dental practice.
-
Review Meta Analysis
Botulinum toxin type A for the treatment of head and neck chronic myofascial pain syndrome: A systematic review and meta-analysis.
The authors conducted a systematic review to study the efficacy of botulinum toxin type A (BoTN-A) in the treatment of myofascial pain syndrome. ⋯ Pain was reduced significantly in the group that received BoTN-A compared with the placebo group at 2 to 6 months but not at 4 to 6 weeks (with moderate quality of the evidence). Additional studies with larger numbers of participants are needed to confirm these results.
-
Review Meta Analysis
Phentolamine mesylate to reverse oral soft-tissue local anesthesia: A systematic review and meta-analysis.
Knowing that patients desire reduced duration of local anesthesia, the authors performed a meta-analysis to evaluate the efficacy of phentolamine mesylate (PM) in reducing anesthesia duration and the occurrence of adverse effects. ⋯ Based on limited evidence, PM is effective in reducing the persistence of anesthesia duration on the lower lip and tongue, with infrequent adverse effects of little clinical significance.
-
Review Meta Analysis
Combining ibuprofen and acetaminophen for acute pain management after third-molar extractions: translating clinical research to dental practice.
Effective and safe drug therapy for the management of acute postoperative pain has relied on orally administered analgesics such as ibuprofen, naproxen and acetaminophen, or N-acetyl-p-aminophenol (APAP), as well as combination formulations containing opioids such as hydrocodone with APAP. The combination of ibuprofen and APAP has been advocated in the last few years as an alternative therapy for postoperative pain management. The authors conducted a critical analysis to evaluate the scientific evidence for using the ibuprofen-APAP combination and propose clinical treatment recommendations for its use in managing acute postoperative pain in dentistry. ⋯ The results of the quantitative systematic reviews indicated that the ibuprofen-APAP combination may be a more effective analgesic, with fewer untoward effects, than are many of the currently available opioid-containing formulations. In addition, the authors found several randomized controlled trials that also indicated that the ibuprofen-APAP combination provided greater pain relief than did ibuprofen or APAP alone after third-molar extractions. The adverse effects associated with the combination were similar to those of the individual component drugs. Practical Implications. Combining ibuprofen with APAP provides dentists with an additional therapeutic strategy for managing acute postoperative dental pain. This combination has been reported to provide greater analgesia without significantly increasing the adverse effects that often are associated with opioid-containing analgesic combinations. When making stepwise recommendations for the management of acute postoperative dental pain, dentists should consider including ibuprofen-APAP combination therapy.