Pulpal anaesthesia for symptomatic irreversible pulpitis in mandibular molars

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Colin Levey takes a look at this network meta-analysis of 46 RCTs assessing techniques and drugs for achieving pulpal anaesthesia for the non-surgical endodontic treatment of mandibular molars.

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Fixed orthodontic appliances: What is the most effective debonding technique?

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This review of different methods for reducing pain and discomfort during removal of fixed orthodontic appliances included 6 RCTs providing weak evidence for pre-debonding analgesia and other approaches.

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Pain during orthodontic treatment –pharmacological treatments

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This Cochrane review of drug interventions for pain during orthodontic treatment including 32 RCTs find that analgesics were effective in reducing pain. However, low quality evidence did not show a difference in effectiveness between systemic NSAIDs compared with paracetamol, or topical NSAIDs compared with local anaesthetic.

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Pre-operative analgesia for patients with pulpitis improved anaesthetic success

Many drugs are licensed for use in Generalised Anxiety Disorder (GAD), but it is unclear what works best.

16 RCTs involving 1900 patients were included in this review of pre-op analgesia for patients with pulpitis . The findings suggest that premedication with analgesics improves the success rate of local anaesthesia.

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Endodontic postoperative pain: which non-steroidal anti-inflammatory drug?

Many drugs are licensed for use in Generalised Anxiety Disorder (GAD), but it is unclear what works best.

The review of NSAIDs for endodontic postoperative pain suggests that NSAIDs are effective. A combination of ibuprofen 600 mg and acetaminophen 1000 mg and Ibuprofen 600 mg were both effective. More studies are need to assess teh most effective NSAIDs dosages and does intervals.

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Do analgesics before dental treatment reduce post treatment pain in children?

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This Cochrane review found 5 RCTs of pre-op analgesics prior to dental treatment for children under local anaesthetic. The evidence as insufficient to determine a benefit but there may be a benefit prior to orthodontic band placement. Further high quality studies are needed.

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Little evidence for antibiotic use in irreversible pulpitis

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This is the latest update of this Cochrane review of the effectiveness of antibiotics for irreversible pulpitis. Only 1 small RCTs is available which provides insufficient evidence to determine whether antibiotics reduce pain or not compared to not having antibiotics

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Wealth of reliable evidence on efficacy of single dose oral analgesics

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This overview includes 39 Cochrane reviews with data from around 460 studies and about 50,000 patients providing a wealth of reliable evidence on the analgesic efficacy of single dose oral analgesics.

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Few adverse events with single dose oral analgesics for acute postoperative pain

This overview of adverse event rates associated with single dose oral analgesics includes data from 39 Cochrane reviews, and provides evidence that adverse events rates are generally similar with active drug and placebo.

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Ibuprofen more effective than paracetamol for postoperative pain following third molar removal

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Surgical removal of third molars is a very common procedure and postoperative pain is a major concern for patients. Non-steroidal anti-inflammatory drugs are (NSAIDs) frequently recommended to manage this pain.   Ibuprofen and paracetamol commonly used and recently a combination analgesic containing both paracetamol and ibuprofen has become available in the UK. The aim of this [read the full story…]