Steroidal Anti-Inflammatory Drugs for Oral Surgery: A Systematic Review and Meta-Analysis

Area of Science:

• Oral surgery and pain management.
• Pharmacology of anti-inflammatory drugs.

Background:

• Postoperative pain, swelling, and trismus are common after oral surgery.
• Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed for pain relief.

Purpose of the Study:

• To compare the effectiveness of different medication regimens for mitigating acute pain after oral surgery.
• To analyze the impact of NSAIDs on pain, swelling, and trismus following oral surgical procedures.

Main Methods:

• Systematic literature search (2013-2023) in PubMed, Cochrane, and Scopus.
• Inclusion of clinical trials on NSAID prescription before or after oral surgery.
• Meta-analysis and meta-regression on pain, swelling, and trismus outcomes.

Main Results:

• Thirty-six studies (30 prospective) were included, with a female predominance.
• Medium-duration NSAIDs, propionic acid derivatives, and acetic acid derivatives showed reduced pain and swelling.
• Ibuprofen 400mg every 8h for 3 days or less was frequently prescribed.

Conclusions:

• Postoperative pain, swelling, and trismus can be managed with NSAIDs.
• Specific NSAID classes (medium-duration, propionic acid, acetic acid derivatives) are effective for pain and swelling.
• Evidence quality is low to very low; findings require cautious interpretation.