PDF(Pubmed)
Abstract：
A guideline panel convened by the American Dental Association Council on Scientific Affairs, American Dental Association Science and Research Institute, University of Pittsburgh School of Dental Medicine, and Center for Integrative Global Oral Health at the University of Pennsylvania conducted a systematic review and meta-analyses and formulated evidence-based recommendations for the pharmacologic management of acute dental pain after 1 or more simple and surgical tooth extractions and the temporary management of toothache (that is, when definitive dental treatment not immediately available) associated with pulp and furcation or periapical diseases in children (< 12 years).
The authors conducted a systematic review to determine the effect of analgesics and corticosteroids in managing acute dental pain. They used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty of the evidence and the Grading of Recommendations Assessment, Development and Evaluation Evidence to Decision framework to formulate recommendations.
The panel formulated 7 recommendations and 5 good practice statements across conditions. There is a small beneficial net balance favoring the use of nonsteroidal anti-inflammatory drugs alone or in combination with acetaminophen compared with not providing analgesic therapy. There is no available evidence regarding the effect of corticosteroids on acute pain after surgical tooth extractions in children.
Nonopioid medications, specifically nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen alone or in combination with acetaminophen, are recommended for managing acute dental pain after 1 or more tooth extractions (that is, simple and surgical) and the temporary management of toothache in children (conditional recommendation, very low certainty). According to the US Food and Drug Administration, the use of codeine and tramadol in children for managing acute pain is contraindicated.
The authors conducted a systematic review to determine the effect of analgesics and corticosteroids in managing acute dental pain. They used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty of the evidence and the Grading of Recommendations Assessment, Development and Evaluation Evidence to Decision framework to formulate recommendations.
The panel formulated 7 recommendations and 5 good practice statements across conditions. There is a small beneficial net balance favoring the use of nonsteroidal anti-inflammatory drugs alone or in combination with acetaminophen compared with not providing analgesic therapy. There is no available evidence regarding the effect of corticosteroids on acute pain after surgical tooth extractions in children.
Nonopioid medications, specifically nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen alone or in combination with acetaminophen, are recommended for managing acute dental pain after 1 or more tooth extractions (that is, simple and surgical) and the temporary management of toothache in children (conditional recommendation, very low certainty). According to the US Food and Drug Administration, the use of codeine and tramadol in children for managing acute pain is contraindicated.
摘要：
背景：由美国牙科协会科学事务委员会召集的指南小组，美国牙科协会科学与研究所，匹兹堡大学牙科医学院,和宾夕法尼亚大学综合全球口腔健康中心进行了系统评价和荟萃分析，并为1次或更多次简单和手术拔牙后急性牙痛的药理学管理以及牙痛的临时管理制定了循证建议（即，当无法立即获得明确的牙科治疗时）与牙髓和分叉或儿童根尖疾病（<12岁）有关。
方法：作者进行了系统评价，以确定镇痛药和皮质类固醇在治疗急性牙痛中的作用。他们使用了建议评估等级，开发和评估方法，以评估证据的确定性和建议的等级评估，制定和评估决策框架的证据，以制定建议。
结果：小组在不同条件下提出了7项建议和5项良好实践声明。与不提供镇痛治疗相比,存在有利于单独使用非甾体抗炎药或与对乙酰氨基酚组合使用的小的有益净平衡。没有关于糖皮质激素对儿童手术拔牙后急性疼痛的影响的可用证据。
结论：非阿片类药物，特别是非甾体抗炎药，如布洛芬和萘普生单独或与对乙酰氨基酚联合使用，建议用于治疗1次或多次拔牙后的急性牙痛(即，简单和手术)和儿童牙痛的临时管理(有条件推荐，非常低的确定性)。根据美国食品和药物管理局，儿童使用可待因和曲马多治疗急性疼痛是禁忌的。
方法：作者进行了系统评价，以确定镇痛药和皮质类固醇在治疗急性牙痛中的作用。他们使用了建议评估等级，开发和评估方法，以评估证据的确定性和建议的等级评估，制定和评估决策框架的证据，以制定建议。
结果：小组在不同条件下提出了7项建议和5项良好实践声明。与不提供镇痛治疗相比,存在有利于单独使用非甾体抗炎药或与对乙酰氨基酚组合使用的小的有益净平衡。没有关于糖皮质激素对儿童手术拔牙后急性疼痛的影响的可用证据。
结论：非阿片类药物，特别是非甾体抗炎药，如布洛芬和萘普生单独或与对乙酰氨基酚联合使用，建议用于治疗1次或多次拔牙后的急性牙痛(即，简单和手术)和儿童牙痛的临时管理(有条件推荐，非常低的确定性)。根据美国食品和药物管理局，儿童使用可待因和曲马多治疗急性疼痛是禁忌的。
