Evidence map›Paper›PMID 33161499›Full record

SynthesisClinical oral investigations2021

Effectiveness of anesthetic solutions for pain control in lower third molar extraction surgeries: a systematic review of randomized clinical trials with network meta-analysis.

Marco Tulio Rossi, Murilo Navarro de Oliveira, Maria Tereza Campos Vidigal, Walbert de Andrade Vieira, Cristiano Elias Figueiredo, Cauane Blumenberg, Vinicius Lima de Almeida, Luiz Renato Paranhos, Luciana Butini Oliveira, Walter Luiz Siqueira and 1 more

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Clinical oral investigations, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Injectable and topical local anesthetics for acute dental pain: 2 systematic reviews.Journal of the American Dental Association (1939) · 2023
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Marco Tulio RossiPostgraduate Program in Dentistry, Faculdade São Leopoldo Mandic, Campinas, Brazil.
Murilo Navarro de OliveiraPostgraduate Program in Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil.
Maria Tereza Campos VidigalSchool of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
Walbert de Andrade VieiraDepartment of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, State University of Campinas, UNICAMP, Piracicaba, Brazil.
Cristiano Elias FigueiredoPostgraduate Program in Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil.
Cauane BlumenbergPostgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
Vinicius Lima de AlmeidaResidency Training in Oral and Maxillofacial Surgery, School of Medicine, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
Luiz Renato ParanhosDepartment of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Campus Umuarama, Av. Pará, 1720, Bloco 2G, sala 1, Uberlândia, Minas Gerais, 38405-320, Brazil. paranhos.lrp@gmail.com.ORCID http://orcid.org/0000-0002-7599-0120
Luciana Butini OliveiraPostgraduate Program in Dentistry, Faculdade São Leopoldo Mandic, Campinas, Brazil.
Walter Luiz SiqueiraCollege of Dentistry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Rui Barbosa de Brito JúniorPostgraduate Program in Dentistry, Faculdade São Leopoldo Mandic, Campinas, Brazil.

Funding

Conselho Nacional de Desenvolvimento Científico e Tecnológico 307808/2018-1Coordenação de Aperfeiçoamento de Pessoal de Nível Superior 001
6 · The paper itself

Abstract

objectiveTo assess the effectiveness of different anesthetic solutions for pain control immediately after the extraction of lower third molars.

methodsNine databases were used to identify randomized clinical trials, without restriction of language or year of publication. The "JBI Critical Appraisal Tools for Systematic Reviews" was used to assess the risk of bias in the studies. The network meta-analysis was performed to compare the effectiveness of different anesthetics to control the pain immediately after the surgery of lower third molars, using the standardized mean difference (SMD) as the effect estimate. The GRADE approach was used to assess the certainty of evidence.

resultsThe search presented 13,739 initial results, from which 45 met the eligibility criteria and presented low to moderate risk of bias. Thirteen studies were included in the meta-analysis. The 2% lidocaine + clonidine presented the lowest pain scores (SMD = - 1.44; - 2.72 to - 0.16) compared to 4% articaine + adrenaline, followed by 0.5% bupivacaine + adrenaline (SMD = - 1.36; - 2.13 to - 0.59). The certainty of evidence varied between very low to moderate.

conclusion2% lidocaine + clonidine and 0.5% bupivacaine + adrenaline were the anesthetics with the highest probability for pain control immediately after the surgical procedure of removing impacted lower third molars. CLINICAL SIGNIFICANCE: The use of an adequate anesthetic with effective pain control can contribute to a more comfortable postoperative period.

Indexed as

Anesthetics, LocalMolar, ThirdHumansPainPostoperative PainRandomized Controlled Trials as TopicAnesthetics, LocalAnestheticsOral surgerySystematic reviewThird molar

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.