Evidence map›Paper›PMID 36631957›Full record

SynthesisJournal of dental research2023

Acute Postoperative Pain Due to Dental Extraction in the Adult Population: A Systematic Review and Network Meta-analysis.

A Miroshnychenko, S Ibrahim, M Azab, Y Roldan, J P D Martinez, D Tamilselvan, L He, J W Little, O Urquhart, M Tampi and 6 more

Open access · hybridAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of dental research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 7 pooled it
11.0field-weighted citation impact, top 1% of its field
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

30 citing papers in PubMed, 7 syntheses or guidelines pooled it, 43 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Guideline
  6. Guideline
  7. Pooled it
  8. Comparison of behavioural, physiological, and self-reported pain responses in Pakistani children with dental pain: a descriptive cross-sectional study.European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2025
    Trial
  9. Trial
  10. Trial
  11. Trial
  12. Observational
  13. Article
  14. Article
  15. Article
  16. Article
  17. Trends of Dispensed Opioids Prescribed by Australian Dentists: 2013-2022.Community dentistry and oral epidemiology · 2026
    Article
  18. Article
  19. Antinociceptive and anti-inflammatory effects of a formulation based onJournal of oral & facial pain and headache · 2025
    Article
  20. Review
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

16 authors at 5 institutions in 2 countries.

A MiroshnychenkoDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
S IbrahimFaculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
M AzabFaculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0002-3457-0533
Y RoldanDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
J P D MartinezDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
D TamilselvanFaculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
L HeFaculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
J W LittleDivision of Oral and Craniofacial Health Sciences, Adams School of Dentistry, Chapel Hill, NC, USA.
O UrquhartADA Science and Research Institute, Chicago, Illinois, USA.ORCID 0000-0003-0517-1266
M TampiDepartment of Cariology, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
D E PolkDepartment of Dental Public Health, University of Pittsburgh, Pittsburgh, PA, USA.ORCID 0000-0002-1402-4068
P A MooreDepartment of Dental Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
E V HershDepartment of Oral Surgery and Pharmacology, University of Pennsylvania, Philadelphia, PA, USA.
B ClaytorN.C. Caring Dental Professionals, Aberdeen, NC, USA.
A Carrasco-LabraDepartment of Preventative and Restorative Sciences, University of Pennsylvania, Philadelphia, PA, USA.
R Brignardello-PetersenDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Impact · CAMcMaster University · CAUniversity of Pennsylvania · USUniversity of Pittsburgh · USUniversity of Michigan · US

Funding

Evidence-based Clinical Practice Guideline for the Management of Acute Dental Pain: Development, Implementation, and Evaluation Using Data Analytics to Target An Implementation StrategyU01FD007151 · FDA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CARRASCO-LABRA, ALONSO, POLK, DEBORAH E · 2020 to 2020
$1.5M
FDA HHS U01 FD007151
6 · The paper itself

Abstract

This study compares the effectiveness of pharmacological treatments to develop guidelines for the management of acute pain after tooth extraction. We searched Medline, EMBASE, CENTRAL, and US Clinical Trials registry on November 21, 2020. We included randomized clinical trials (RCTs) of participants undergoing dental extractions comparing 10 interventions, including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and combinations to placebo. After duplicate screening and data abstraction, we conducted a frequentist network meta-analysis for each outcome at 6 h (i.e., pain relief, total pain relief [TOTPAR], summed pain intensity difference [SPID], global efficacy rating, rescue analgesia, and adverse effects). We assessed the risk of bias using a modified Cochrane RoB 2.0 tool and the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. We implemented the analyses in RStudio version 3.5.3 and classified interventions from most to least beneficial or harmful. We included 82 RCTs. Fifty-six RCTs enrolling 9,095 participants found moderate- and high-certainty evidence that ibuprofen 200 to 400 mg plus acetaminophen 500 to 1,000 mg (mean difference compared to placebo [MDp], 1.68; 95% confidence interval [CI], 1.06-2.31), acetaminophen 650 mg plus oxycodone 10 mg (MDp, 1.19; 95% CI, 0.85-1.54), ibuprofen 400 mg (MDp, 1.31; 95% CI, 1.17-1.45), and naproxen 400-440 mg (MDp, 1.44; 95% CI, 1.07-1.80) were most effective for pain relief on a 0 to 4 scale. Oxycodone 5 mg, codeine 60 mg, and tramadol 37.5 mg plus acetaminophen 325 mg were no better than placebo. The results for TOTPAR, SPID, global efficacy rating, and rescue analgesia were similar. Based on low- and very low-certainty evidence, most interventions were classified as no more harmful than placebo for most adverse effects. Based on moderate- and high-certainty evidence, NSAIDs with or without acetaminophen result in better pain-related outcomes than opioids with or without acetaminophen (except acetaminophen 650 mg plus oxycodone 10 mg) or placebo.

Indexed as

AcetaminophenAcute PainAdultAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalHumansIbuprofenOxycodonePostoperative PainTooth ExtractionAcetaminophenAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalIbuprofenOxycodoneacute painevidence-based dentistryoral surgerypharmacologypublic health dentistrysystematic review

Identifiers

PMID36631957
PMCPMC10031629
OpenAlexW4315640814

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.