ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title The Prevention of Nerve Hypersensitivity with Preoperative Dipyrone and Dexamethasone
Clinical Question In adults, does taking Dipyrone and Dexamethasone reduce nerve hypersensitivity after third molar extractions compared to taking Dipyrone alone?
Clinical Bottom Line Before a third molar extraction, taking Dipyrone and Dexamethasone together prevents nerve hypersensitivity.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 15022536Barron/20048 men, 6 women Randomized Controlled Trial
Key resultsThe 14 patients were randomly divided into 2 groups. One group received only Dipyrone, while the other group received Dipyrone (analgesic and antipyretic) and Dexamethasone (glucocorticoid class of steroid drug) pre-operatively. Electrical detection thresholds were looked at pre-operatively, 2 days after surgery, and 8 days after surgery in the inferior alveolar, lingual, and infra-orbital nerve regions. Patients who took only Dipyrone had reduced nerve electrical detection thresholds 2 days after surgery. No significant reduction in threshold was found in the patients taking both drugs.
Evidence Search "Tooth Extraction"[Mesh] AND "Dexamethasone"[Mesh] AND ("humans"[MeSH Terms] AND Randomized Controlled Trial[ptyp] AND English[lang])
Comments on
The Evidence
The study design used was a randomized controlled trial, in which 14 patients were evaluated pre-operatively, after 2 days, and after 8 days. The completion rate with this was study was very high, but adequate follow up was not upheld. A bigger sample size and longer length of study would make the evidence stronger.
Applicability The relevance of this study is to see if these drugs can prevent sensory damage after a surgical procedure like a third molar extraction. The only indication in providing this type of pre-medication is if the surgeon determines there could be nerve damage in the surgery.
Specialty/Discipline (Oral Surgery)
Keywords Third molar extractions, nerve sensitivity, Dexamethasone, Dipyrone
ID# 2274
Date of submission: 04/13/2012spacer
E-mail hassana@livemail.uthscsa.edu
Author Amir Hassan
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Gregory Spackman, DDS, MBA
Faculty mentor/Co-author e-mail spackman@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Brandon Key, Angela Yang (San Antonio, TX) on 11/28/2017
A literature search conducted November 2017 found an RCT (PMID: 26572899) which compares the efficacy of Dexamethasone and Dipyrone to Ketorolac Tromethamine and Dipyrone in in regard to pain, edema, and mouth opening following extraction of third molars. Outcomes support the original bottom line of this CAT. Additionally, this new RCT supplies evidence that Dexamethasone is more suitable than Ketorolac when given alongside Dipyrone in management of third molar extractions.
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