Banner Portal
Fixed and on-demand regimens of acetaminophen in periodontal surgery
PDF

Keywords

Pain, postoperative
Randomized controlled trials as topic
Periodontal diseases
Acetaminophen

How to Cite

1.
Piardi CC, Vaz CG, Ferreira MBC, Pilger D, Fernandes MI, Weidlich P. Fixed and on-demand regimens of acetaminophen in periodontal surgery: randomized clinical trial. Braz. J. Oral Sci. [Internet]. 2023 May 16 [cited 2024 Jul. 22];22(00):e238329. Available from: https://periodicos.sbu.unicamp.br/ojs/index.php/bjos/article/view/8668329

Abstract

Aim: to evaluate the clinical efficacy of an acetaminophen analgesic by comparing its prescription in fixed versus ondemand schedules after periodontal surgery. The hypothesis of the study was that the fixed regimen would be more effective than the on-demand regimen for postoperative analgesics following periodontal surgery. Methods: An open randomized clinical trial was conducted. The 68 patients who needed total flap surgery to restore supracrestal tissue attachment or surgical treatment of periodontitis were randomized”. Visual Analogue Scale was used to assess pain. The fixed group (n = 34) received 500 mg of acetaminophen every 4 hours for 2 days. The on-demand group (n = 34) was instructed to use the acetaminophen “as needed,” at intervals of no less than 4 hours between doses. Ibuprofen was the rescue medication for both groups. Pain scores and medication use were recorded 2, 6, 12, 24 and 48 hours after the surgical procedure. The study was registered at the Brazilian Registry of Clinical Trials under RBR-7wv259. Results: The two groups did not differ in relation to the frequency or the intensity of pain in a 48-hour period (n=20 in the fixed group, and n=22 in the on-demand group), or even in the intention-to-treat (n=34 in each group). Individuals who experienced moderate to severe pain used rescue medication more frequently in both groups. No adverse events were reported. Conclusion: Both regimens were effective in controlling postoperative pain after periodontal surgery.

https://doi.org/10.20396/bjos.v22i00.8668329
PDF

References

Graziani F, Karapetra D, Mardas N, Leow N, Donos N. Surgical treatment of the residual periodontal pocket. Periodontol 2000. 2018 Feb;76(1):150-63. doi: 10.1111/prd.12156.

Graziani F, Karapetsa D, Alonso B, Herrera D. Nonsurgical and surgical treatment of periodontitis: how many options for one disease? Periodontol 2000. 2017 Oct;75(1):152-88. doi: 10.1111/prd.12201.

Curtis JW, Mclain JB, Hutchinson RA. The incidence and severity of complications and following periodontal surgery. J Periodontol. 1985 Oct;56(10):597-601. doi: 10.1902/jop.1985.56.10.597.

Mei CC, Lee FY, Yeh HC. Assessment of pain perception following periodontal and implants surgeries. J Clin Periodontol. 2016 Dec;43(12):1151-9. doi: 10.1111/jcpe.12618.

Al-Hamdan K. Pain perception following different periodontal procedures. Pak Oral Dent J. 2009;29(1):63-8.

Beaudette RJ, Fritz CP, Sullivan JP, Piccini A, Ward EW. Investigation of factors that influence pain experienced and the use of pain medication following periodontal surgery. J Clin Periodontol. 2018 May;45(5):578-85. doi: 10.1111/jcpe.12885.

Fardal Ø, McCulloch CA. Impact of anxiety on pain perception associated with periodontal and implant surgery in a private ractice. J Periodontol. 2012 Sep;83(9):1079-85. doi: 10.1902/jop.2011.110562.

Schirmer C, dos Santos GO, Rost JF, Ferreira MBC, Weidlich P. Factors associated with pain and analgesic consumption following non-surgical periodontal therapy under local anaesthesia and carried out by dental students. J Clin Periodontol. 2018 Jan;45(1):68-77. doi: 10.1111/jcpe.12833.

Tan WC, Krishnaswamy G, Ong MMA, Lang NP. Patient-reported outcome measures after routine periodontal and implant surgical procedures. J Clin Periodontol. 2014 Jun;41(6):618-24. doi: 10.1111/jcpe.12248.

Caporossi SL, Dos Santos SC, Calcia BBT, Cenci SM, Muniz GMWF, Lima SG. Pharmacological manageent of pain after periodontal suegery: a systemantic review with meta-analysis. Clin Oral Investig. 2020 Aug;24(8):2559-78. doi: 10.1007/s00784-020-03401-6.

Toms L, McQuay HJ, Derry S, Moore RA. Single dose oral paracetamol (acetaminophen) for postoperative pain in adults. Cochrane database Syst Rev. 2008 Oct;2008(4):CD004602. doi: 10.1002/14651858.CD004602.pub2

Bailey E, Worthington HV, van Wijk A, Yates JM, Coulthard P, Afzal Z. Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth. Cochrane Database Syst Rev. 2013 Dec;(12):CD004624. doi: 10.1002/14651858.CD004624.pub2.

Laskarides C. Update on analgesic medication for adult and pediatric detal patients. Dent Clin North Am. 2016 Apr;60(2):347-66. doi: 10.1016/j.cden.2015.11.006.

Hobson A, Wiffen PJ, Conlon JA. As required versus fixed schedule analgesic administration for postoperative pain in children. Cochrane Database Syst Rev. 2015 Feb;2015(2):CD011404. doi: 10.1002/14651858.CD011404.pub2.

Collins SL, Moore RA, McQuay HJ. The visual analog pain intensity scale: What is moderate pain in millimeters? Pain. 1997 Aug;72(1-2):95-7. doi: 10.1016/s0304-3959(97)00005-5..

Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Hals EK, et al. Assessment of pain. Br J Anaesth. 2008 Jul;101(1):17-24. doi: 10.1093/bja/aen103.

Corah NL. Development of a Dental Anxiety Scale. J Dent Res. 1969 Jul-Aug;48(4):596. doi: 10.1177/00220345690480041801.

Hu L W, Gorentein C, Fuentes D. Portuguese version of Corah’s Dental anxiety Scale: Transcultural adaptation and reliability analysis. Depress Anxiety. 2007;24(7):467-71. doi: 10.1002/da.20258.

Kaipper MB, Chachamovich E, Hidalgo MPL, da Silva Torres IL, Caumo W. Evaluation of the structure of Brazilian State-Trait Anxiety Inventory using a Rasch psychometric approach. J Psychosom Res. 2010 Mar;68(3):223-33. doi: 10.1016/j.jpsychores.2009.09.013.

Biaggio AMB, Natalício L, Spielberger CD. [Development of the experimental form in Portuguese of Spielberger's State-Trait Anxiety Inventory (STAI)]. Arq Bras Psiq. 1977;29(3):31-44. Portuguese.

Price DD, McGrath PA, Raffi A, Buckingham B. The validation of Visual Analogue Scales as ratio Scale Measures for chronic and experimental pain. Pain. 1983 Sep;17(1):45-56. doi: 10.1016/0304-3959(83)90126-4.

Derry CJ, Derry S, Moore RA. Single dose oral ibuprofen plus paracetamol (acetaminophen) for acute postoperative pain. Cochrane database Syst Rev. 2013 Jun 24;2013(6):CD010210. doi: 10.1002/14651858.CD010210.pub2.

Steffens JP, Santos FA, Sartori R, Pilatti GL. Preemptive dexamethasone and etoricoxib for pain and discomfort prevention after periodontal surgery: a double-masked, crossover, controlled clinical trial. J Periodontol. 2010 Aug;81(8):1153-60. doi: 10.1902/jop.2010.100059.

Al-Bayati O, Font K, Soldatos N, Carlson E, Parsons J, Powell C. Evaluation of the need to prescribe opioid medication to control post-surgical pain of different periodontal/oral surgeries. J Periodontol. 2021 Jul;92(7):1030-5. doi: 10.1002/JPER.20-0315.

Tucker PW, Smith JR, Adams DF. A comparison of 2 analgesic regimens for the control of postoperative periodontal discomfort. J Periodontol. 1996 Feb;67(2):125-9. doi: 10.1902/jop.1996.67.2.125.

Pearlman B, Boyatzis S, Daly C, Evans R, Gouvoussis J, Highfield J, et al. The analgesic efficacy of ibuprofen in periodontal surgery: a multicentre study. Aust Dent J. 1997 Oct;42(5):328-34. doi: 10.1111/j.1834-7819.1997.tb00139.x..

Haanstra TM, Kamper SJ, Williams CM, Spriensma AS, Lin CC, Maher CG, et al. Does adherence to treatment mediate the relationship between patients’ treatment outcome expectancies and the outcomes of pain intensity and recovery from acute low back pain? Pain. 2015 Aug;156(8):1530-6. doi: 10.1097/j.pain.0000000000000198.

Yang MMH, Hartley RL, Leung AA, Ronksley PE, Jetté N, Casha S, et al. Preoperative predictors of poor acute postoperative pain control: a systematic review and meta-analysis. BMJ Open. 2019 Apr;9(4):e025091. doi: 10.1136/bmjopen-2018-025091.

Lin CS, Wu SY, Yi CA. Association between anxiety and pain in dental treatment: a systematic review and meta-analysis. J Dent Res. 2017 Feb;96(2):153-62. doi: 10.1177/0022034516678168..

Tickle M, Milsom K, Crawford JIF, Aggarwal RV. Predictors of pain associated with routine procedures performed in general dental pracrice. Community Dent Oral Epidemiol. 2012 Aug;40(4):343-50. doi: 10.1111/j.1600-0528.2012.00673.x.

Torres-Lagares D, Recio-Lora C, Castillo-Dalí G, Ruiz-de-León-Hernández G, Hita-Iglesias P, Serrera-Figallo MA, et al. Influence of state anxiety and trate anxiety postoperative in oral surgery. Med Oral Patol Oral Cir Bucal. 2014 Jul;19(4):e403-8. doi: 10.4317/medoral.19604.

Kim S, Lee YJ, Lee S, Moon HS, Chung MK. Assessment of pain and anxiety following surgical placement of dental implants. Int J Oral Maxillofac Implants. 2013 Mar-Apr;28(2):531-5. doi: 10.11607/jomi.2713.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2022 Carla Cioato Piardi, Cristiane Galli Vaz, Maria Beatriz Cardoso Ferreira, Diogo Pilger, Marilene Issa Fernandes , Patrícia Weidlich

Downloads

Download data is not yet available.