Preemptive dexamethasone and etoricoxib for pain and discomfort prevention after periodontal surgery: a double-masked, crossover, controlled clinical trial.
BACKGROUND
Several anti-inflammatory drugs have been used to reduce pain and discomfort after periodontal surgeries. This study evaluates the efficacy of using etoricoxib and dexamethasone for pain prevention after open-flap debridement surgery.


METHODS
For this prospective, double-masked, crossover, placebo-controlled, randomized clinical trial, open-flap debridement surgeries were performed on 15 patients (eight males and seven females, age range 20 to 56 years: mean age +/- SD: 40 +/- 9.7 years) who presented with chronic periodontitis after non-surgical periodontal therapy at three quadrants. Each patient underwent three surgical procedures at intervals of 30 days and received one of the following premedication protocols 1-hour before surgery: group 1 = placebo, group 2 = 8 mg dexamethasone, and group 3 = 120 mg etoricoxib. Rescue medication (750 mg acetaminophen) was given to each patient who was instructed to take it when necessary. Pain intensity and discomfort were evaluated by a 101-point numeric rate scale and a four-point verbal rate scale, respectively, hourly for the first 8 hours after surgery and three times a day on the following 3 days.


RESULTS
The results demonstrate that groups 2 and 3 present reduced postoperative pain-intensity levels compared to group 1. There were statistically significant differences at the 4, 5, 6, 7, and 8 hour-periods after surgery (Friedman test; P <0.05). Furthermore, rescue-medication intake was significantly lower for groups 2 and 3 than for group 1 (analysis of variance; P <0.02).


CONCLUSIONS
The adoption of a preemptive medication protocol using etoricoxib or dexamethasone may be considered effective for pain and discomfort prevention after open-flap debridement surgeries.
Steffens
Joao Paulo
JP
Department of Dentistry, Ponta Grossa State University, Ponta Grossa, Paraná, Brazil.
Santos
Fábio André
FA
Sartori
Rafael
R
Pilatti
Gibson Luiz
GL
D000082:Acetaminophen / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D055113:Chronic Periodontitis / Q000601:surgery*; D018592:Cross-Over Studies; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D016854:Dental Anxiety / Q000523:psychology; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D000077613:Etoricoxib; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D010919:Placebos; D011292:Premedication; D011446:Prospective Studies; D011725:Pyridines / Q000627:therapeutic use*; D012737:Sex Factors; D013450:Sulfones / Q000627:therapeutic use*; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult
D018712:Analgesics, Non-Narcotic; D000893:Anti-Inflammatory Agents; D052246:Cyclooxygenase 2 Inhibitors; D005938:Glucocorticoids; D010919:Placebos; D011725:Pyridines; D013450:Sulfones; D000082:Acetaminophen; D003907:Dexamethasone; D000077613:Etoricoxib