The efficacy of analgesics in controlling orthodontic pain: a systematic review and meta-analysis.

The efficacy of analgesics in controlling orthodontic pain: a systematic review and meta-analysis.
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镇痛药控制正畸疼痛的功效:系统评价和荟萃分析

DOI:
10.1186/s12903-020-01245-w
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发表时间:
2020-09-18
期刊:
影响因子:
2.9
通讯作者:
Wang J
Wang J
中科院分区:
医学3区
文献类型:
--
作者:
Cheng C;Xie T;Wang J

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接受正畸治疗的患者会经历疼痛和不适,这可能是治疗中断或提前终止的首要原因。因此,本综述旨在评估镇痛药在缓解正畸治疗疼痛方面的疗效。 在EMBASE(通过OVID,1974年至2019年第50周)、MEDLINE(通过OVID,1946年至2019年12月)、Cochrane对照试验中心注册库(CENTRAL)(2019年12月)等数据库中进行了计算机文献检索。本研究应用了Cochrane协作网的Review Manager 5.3软件。并使用Cochrane偏倚风险工具评估了方法学质量。 我们在19项随机对照试验中确定了12篇文献,包括587名患者。结果显示,萘普生在视觉模拟评分(VAS)中的平均差值在2小时、6小时和24小时分别为−1.45(95%置信区间为 -2.72,−0.19;P = 0.02)、−2.11(95%置信区间为 -3.96,−0.26;P = 0.03)和−1.90(95%置信区间为 -3.33,−0.47;P = 0.009)。对于布洛芬,在2小时、6小时和24小时的标准平均差值分别为−1.10(95%置信区间为 -1.49,−0.71)、−1.63(95%置信区间为 -2.32,−0.95)和−1.34(95%置信区间为 -2.12,−0.55),总体P值均<0.001。对乙酰氨基酚在三个时间点的平均差值分别为−0.68、−1.34、−1.91,总体P值均<0.01。 这项荟萃分析表明,使用镇痛药对控制正畸患者的疼痛是有效的。布洛芬和萘普生都有稳定的镇痛效果,可能在6小时达到峰值,而对乙酰氨基酚的镇痛效果从2小时到24小时稳步增强。与布洛芬和对乙酰氨基酚相比,萘普生在2小时或6小时都显示出更强的镇痛效果,并且其效果持续到24小时。
BackgroundPatients who had gone through orthodontic treatment experienced pain and discomfort which could be the highest-ranking reason for treatment disturbance or early termination. Thus, this review aimed to assess the efficacy of analgesics on the relief of pain in orthodontic treatment.MethodsA computerized literature search was conducted in the databases of EMBASE (via OVID, 1974 to 2019 Week 50), MEDLINE (via OVID, 1946 to Dec 2019), the Cochrane Central Register of Controlled Trials (CENTRAL) (December 2019). The Cochrane Collaboration’s Review Manager 5.3 software was applied in the present study. And methodological quality was evaluated by the Cochrane Risk of Bias Tool.ResultsWe identified twelve publications including 587 patients in 19 randomized controlled trials. The results showed that the mean difference of naproxen in visual analogue scale (VAS) were − 1.45 (95% CI -2.72, − 0.19;P= .02), − 2.11 (95% CI -3.96, − 0.26;P= .03) and − 1.90 (95% CI -3.33, − 0.47;P= .009) in 2 h, 6 h and 24 h respectively. As for ibuprofen, the standard mean differences were − 1.10 (95% CI -1.49, − 0.71), − 1.63(95% CI -2.32, − 0.95) and − 1.34 (95% CI -2.12, − 0.55) at 2 h, 6 h, and 24 h, with the overallPvalues all < 0.001. The mean difference of acetaminophen is − 0.68, − 1.34, − 1.91 at three time points and the overallPvalues all < 0.01.ConclusionsThis meta-analysis suggests that the use of analgesics is effective for patients in controlling orthodontic pain. Ibuprofen and naproxen are both of stable analgesic effects which could peak at 6 h, while the analgesic effect of acetaminophen increases steadily from 2 h through 24 h. Compared with ibuprofen and acetaminophen, naproxen shows a stronger analgesic effect either at 2 h or 6 h, and its effect lasts to 24 h.
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