A randomized, double-blind pilot study of analgesic and anti-inflammatory effects of naproxen sodium and acetaminophen following dental implant placement surgery

Frontiers in Pharmacology

Pharmacology

Claire H. Mitchell¹  Elliot V. Hersh²  Katherine N. Theken²  Mengxiang Chen²  Stacey A. Secreto²  D. Lucas Wall²  Truongan Pham²  Thomas H. Yoo³  Yu-Cheng Chang³  Jonathan M. Korostoff³  Allison N. Rascon³ 

[1] Department of Basic and Translational Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States;Department of Oral and Maxillofacial Surgery and Pharmacology, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States;Department of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, United States;

关键词: dental implant;    analgesia;    post-operative (post op) pain;    inflammation;    non-steroidal anti-inflammatory drugs;    cytokine;    prostaglandin;    non-prescription drugs;   

DOI  :  10.3389/fphar.2023.1199580

 received in 2023-04-03, accepted in 2023-05-05,  发布年份 2023

来源: Frontiers

【 摘 要 】

Introduction: Post-surgical pain following dental implant placement surgery is typically managed with non-opioid analgesics, including non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. However, the comparative analgesic efficacy of over-the-counter doses of non-steroidal anti-inflammatory drugs and acetaminophen in implant patients is unknown. Therefore, we compared the analgesic and anti-inflammatory effects of naproxen sodium and acetaminophen after surgical placement of one or two dental implants.Methods: Adult patients were treated with naproxen sodium (440 mg loading dose +220 mg q8h, n = 15) or acetaminophen (1,000 mg q6h—max daily dose 3,000 mg, n = 15) for 3 days after implant placement in a randomized, double-blind design. Pain was assessed on a 0–10 scale every 20 min for 6 h after study medication treatment. Tramadol (50 mg) was available as a rescue medication. Plasma and gingival crevicular fluid (GCF) were collected prior to the surgery and 0, 1, 2, 4, 6, 24, and 72 h after surgery for quantification of interleukin (IL)-6, IL-8, and IL-1β levels.Results: Pain scores were significantly lower in patients treated with naproxen sodium compared to those treated with acetaminophen. Inflammatory mediator levels in plasma and gingival crevicular fluid increased after surgery and returned to near baseline levels by 72 h. Plasma IL-6 levels were significantly lower 6 h after surgery in patients treated with naproxen sodium compared to acetaminophen. No differences in inflammatory mediator concentrations in gingival crevicular fluid were observed between the treatment groups. The number of implants placed and body mass index (BMI) influenced inflammatory mediator concentrations in plasma and gingival crevicular fluid, respectively.Discussion: Naproxen sodium was more effective than acetaminophen in reducing post-operative pain and systemic inflammation following surgical placement of one or two dental implants. Further studies are needed to determine whether these findings are applicable to more complex implant cases and how they affect clinical outcomes following implant placement.Clinical Trial Registration: ClinicalTrials.gov, identifier NCT04694300

【 授权许可】

Unknown   
Copyright © 2023 Theken, Chen, Wall, Pham, Secreto, Yoo, Rascon, Chang, Korostoff, Mitchell and Hersh.