Therapeutic uses of non-steroidal anti-inflammatory drugs in dentistry

被引:58
作者
Dionne, RA [1 ]
Berthold, CW [1 ]
机构
[1] Natl Inst Dent & Craniofacial Res, Pain & Neurosurg Mech Branch, NIH, Bethesda, MD 20892 USA
关键词
NSAIDs; acute pain; chronic pain; edema; preventive analgesia;
D O I
10.1177/10454411010120040301
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
The non-steroidal anti-inflammatory drugs (NSATDs) are among the most widely used classes of drugs for the management of acute and chronic pain in dentistry. Their therapeutic efficacy and toxicity are well-documented and provide evidence that NSAIDs generally provide an acceptable therapeutic ratio of pain relief with fewer adverse effects than the opioid-mild analgesic combination drugs that they have largely replaced for most dental applications. The great many studies done with the oral surgery model of acute pain indicate that a single dose of an NSAID is more effective than combinations of aspirin or acetaminophen plus an opioid, with fewer side-effects, thus making it preferable for ambulatory patients. The combination of an NSAID with an opioid generally results in marginal analgesic activity but with an increased incidence of side-effects, which limits its use to patients in whom the NSAID alone results in inadequate analgesia. The selective COX-2 inhibitors hold promise for clinical efficacy with less toxicity from chronic administration and may prove advantageous for the relief of chronic orofacial pain. The use of repeated doses of NSAIDs for chronic orofacial pain should be re-evaluated in light of a lack of documented efficacy and the potential for serious gastrointestinal and renal toxicity with repeated dosing.
引用
收藏
页码:315 / 330
页数:16
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