Pain Control in Third Molar Surgery

The sensation of pain at the surgical site may be increased and persist for long periods after the noxious stimulus has been removed. Post-operative pain from the extraction of impacted molar may cause serious discomfort to the patient resulting in considered moderate to severe in intensity. Analgesia for this surgical procedure is related to the use of nonsteroidal anti-inflammatory drugs, steroids, analgesics of central and peripheral actions used in combination or individually. The aim of this review is to show an update about the use and the physiological bases for indications of the analgesic therapy in third molar surgery.

[1]  R. Gutta,et al.  Does ketorolac have a preemptive analgesic effect? A randomized, double-blind, control study. , 2013, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[2]  Candela Reyes Botella,et al.  Update on the use of corticosteroids in third molar surgery: systematic review of the literature. , 2013, Oral surgery, oral medicine, oral pathology and oral radiology.

[3]  D. Laskin,et al.  Narcotic prescribing habits and other methods of pain control by oral and maxillofacial surgeons after impacted third molar removal. , 2013, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[4]  A. Wenzel,et al.  Efficiency of bupivacaine versus lidocaine and methylprednisolone versus placebo to reduce postoperative pain and swelling after surgical removal of mandibular third molars: a randomized, double-blinded, crossover clinical trial. , 2013, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[5]  B. Saheeb,et al.  A comparative study of the effect of suture-less and multiple suture techniques on inflammatory complications following third molar surgery. , 2012, International journal of oral and maxillofacial surgery.

[6]  D. Borsook Neurological diseases and pain. , 2012, Brain : a journal of neurology.

[7]  P. Cury,et al.  Efficacy of nimesulide versus meloxicam in the control of pain, swelling and trismus following extraction of impacted lower third molar. , 2010, International journal of oral and maxillofacial surgery.

[8]  S. Kaltman,et al.  The use of corticosteroids and nonsteroidal antiinflammatory medication for the management of pain and inflammation after third molar surgery: a review of the literature. , 2009, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[9]  P. Kam,et al.  COX-3: Uncertainties and controversies , 2009 .

[10]  E. Ding,et al.  Corticosteroids reduce postoperative morbidity after third molar surgery: a systematic review and meta-analysis. , 2008, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[11]  L. Naldi,et al.  A European study of HLA-B in Stevens–Johnson syndrome and toxic epidermal necrolysis related to five high-risk drugs , 2008, Pharmacogenetics and genomics.

[12]  O. Kaya,et al.  The effect of a single dose prednisolone with and without diclofenac on pain, trismus, and swelling after removal of mandibular third molars. , 2006, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[13]  K. Rainsford Nimesulide – a multifactorial approach to inflammation and pain: scientific and clinical consensus , 2006, Current medical research and opinion.

[14]  T. Schnitzer,et al.  Comparison of lumiracoxib with naproxen and ibuprofen in the Therapeutic Arthritis Research and Gastrointestinal Event Trial (TARGET), reduction in ulcer complications: randomised controlled trial , 2004, The Lancet.

[15]  T. Macfarlane,et al.  A double-blind randomised controlled clinical trial of the effect of preoperative ibuprofen, diclofenac, paracetamol with codeine and placebo tablets for relief of postoperative pain after removal of impacted third molars. , 2004, The British journal of oral & maxillofacial surgery.

[16]  S. Gordon,et al.  Dexamethasone suppresses peripheral prostanoid levels without analgesia in a clinical model of acute inflammation. , 2003, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[17]  H. Kehlet,et al.  Perioperative single-dose glucocorticoid administration: pathophysiologic effects and clinical implications. , 2002, Journal of the American College of Surgeons.

[18]  C. Serhan,et al.  Resolvins , 2002, The Journal of experimental medicine.

[19]  N. V. Chandrasekharan,et al.  COX-3, a cyclooxygenase-1 variant inhibited by acetaminophen and other analgesic/antipyretic drugs: Cloning, structure, and expression , 2002, Proceedings of the National Academy of Sciences of the United States of America.

[20]  Galli Giovanni,et al.  Do non-steroidal anti-inflammatory drugs and COX-2 selective inhibitors have different renal effects? , 2002, Journal of nephrology.

[21]  J. Garibaldi,et al.  Evaluation of ketorolac (Toradol) with varying amounts of codeine for postoperative extraction pain control. , 2002, International journal of oral and maxillofacial surgery.

[22]  S. Brull,et al.  Preemptive analgesia I: physiological pathways and pharmacological modalities , 2001, Canadian journal of anaesthesia = Journal canadien d'anesthesie.

[23]  S. Talwalker,et al.  A double-blind, randomized comparison of intramuscularly and intravenously administered parecoxib sodium versus ketorolac and placebo in a post-oral surgery pain model. , 2001, Clinical therapeutics.

[24]  R. Alexander,et al.  A review of perioperative corticosteroid use in dentoalveolar surgery. , 2000, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[25]  R. Botting,et al.  Mechanism of action of acetaminophen: is there a cyclooxygenase 3? , 2000, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[26]  R. Makuch,et al.  Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: A randomized controlled trial. Celecoxib Long-term Arthritis Safety Study. , 2000, JAMA.

[27]  M. Katori,et al.  Cyclooxygenase-2: its rich diversity of roles and possible application of its selective inhibitors , 2000, Inflammation Research.

[28]  E. Skovlund,et al.  Combining diclofenac with acetaminophen or acetaminophen‐codeine after oral surgery: A randomized, double‐blind single‐dose study , 1999, Clinical pharmacology and therapeutics.

[29]  W. Yuan,et al.  Analgesic efficacy of the cyclooxygenase-2-specific inhibitor rofecoxib in post-dental surgery pain: a randomized, controlled trial. , 1999, Clinical therapeutics.

[30]  J. Vane,et al.  Induction of an acetaminophen-sensitive cyclooxygenase with reduced sensitivity to nonsteroid antiinflammatory drugs. , 1999, Proceedings of the National Academy of Sciences of the United States of America.

[31]  T. Evans,et al.  Cyclooxygenase-2 as a therapeutic target , 1998, Inflammation Research.

[32]  L. Nesbitt,et al.  Minimizing complications from systemic glucocorticosteroid use. , 1995, Dermatologic clinics.

[33]  K. Lavery,et al.  Dexamethasone reduces pain and swelling following extraction of third molar teeth , 1993, Anaesthesia.

[34]  J. Gordon,et al.  Evaluation of dexamethasone for reduction of postsurgical sequelae of third molar removal. , 1992, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[35]  K. Baker,et al.  Use of corticosteroids in oral surgery. , 1992, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[36]  O. Beirne,et al.  The effect of methylprednisolone on pain, trismus, and swelling after removal of third molars. , 1986, Oral surgery, oral medicine, and oral pathology.

[37]  R. Cawson Pharmacology and therapeutics for dentistry , 1982 .

[38]  S. Woo,et al.  Adverse drug events in the oral cavity. , 2015, Oral surgery, oral medicine, oral pathology and oral radiology.

[39]  C. Alcântara,et al.  Pre-emptive effect of dexamethasone and methylprednisolone on pain, swelling, and trismus after third molar surgery: a split-mouth randomized triple-blind clinical trial. , 2014, International journal of oral and maxillofacial surgery.

[40]  K. Kowalski,et al.  Analgesic efficacy of celecoxib in postoperative oral surgery pain: a single-dose, two-center, randomized, double-blind, active- and placebo-controlled study. , 2007, Clinical therapeutics.

[41]  A. S. Trindade,et al.  Analgesic and anti-inflammatory dose-response relationship of 7.5 and 15 mg meloxicam after lower third molar removal: a double-blind, randomized, crossover study. , 2007, International journal of oral and maxillofacial surgery.

[42]  E. Valmaseda-Castellón,et al.  Morbidity of third molar extraction in patients between 12 and 18 years of age. , 2005, Medicina oral, patologia oral y cirugia bucal.

[43]  R. Schmelzeisen,et al.  Prevention of postoperative swelling and pain by dexamethasone after operative removal of impacted third molar teeth , 2004, European Journal of Clinical Pharmacology.

[44]  H. Matz,et al.  Diclofenac: a new trigger of pemphigus vulgaris? , 1997, Dermatology.