Use of etoricoxib and dexamethasone for postoperative pain prevention and control in mucogingival surgery: a randomized parallel double-blind clinical trial

AIM: To compare the use of etoricoxib and dexamethasone for postoperative pain prevention and control after mucogingival surgery. METHODS: Fifty-eight patients with indication for mucogingival surgery took part in this randomized parallel double-blind clinical trial. They were divided into three groups (G): G1 - placebo 1 h before surgery; G2 - 8 mg dexamethasone 1 h before surgery; G3 - 90 mg etoricoxib 1 h before surgery. Pain intensity was assessed in donor and recipient sites separately using the 101-point numerical rating scale NRS - 101, every hour for the first 8 h after surgery and three times a day on the following 3 days. RESULTS: there was a statistically significant difference in the postoperative pain intensity in the donor site between G1 and G3 after 1 h, 2 h, 3 h, 7 h, 8 h and on the second day - in the evening after 32 h; between G1 and G2 after 2 h and 3 h, and between G2 and G3 only after the first hour. Pain intensity in the recipient site was statistically significant between G1 and G3 after 1 and 2 h (p<0.05). In addition, there was a lower ingestion of rescue medication in G2 and in G3 than in G1 (p=0.002). CONCLUSIONS: the use of a pre-emptive single dose of etoricoxib or dexamethasone may be considered an effective protocol for postoperative pain prevention and control after mucogingival surgery.

Doença periodontal x estresse: revisão de literatura / Periodontal disease versus stress: literature review

A resposta ao estresse parece estar relacionada a um mecanismo mediador entre condições psicológicas desfavoráveis e doença periodontal inflamatória. Todavia, essa relação pode ser desencadeada através de dois modelos: modelo comportamental, em que ocorre aumento no consumo de nicotina, higiene bucal menos efetiva, mudanças nos hábitos nutricionais; ou modelo biológico, através da redução do fluxo salivar, alteração da circulação gengival e alterações na resposta imune-inflamatória. Vários estudos têm realizado a associação entre a severidade da doença periodontal e fatores comportamentais como o estresse. O presente estudo teve por objetivo fazer um levantamento da literatura sobre os principais estudos envolvendo fatores psicológicos e a resposta dos tecidos periodontais frente a patógenos. Os estudos mostram, em grande parte os de corte transversal, uma tendência de relação positiva entre estresse e doença periodontal, porém uma pesquisa mais representativa é necessária para determinar o impacto do estresse e de fatores psicológicos como fatores de risco para a doença periodontal.

The stress response appears to be related to a mediating mechanism between unfavorable psychological conditions and inflammatory periodontal disease. However, this relationship can be triggered through two models: behavioral model, in which there is an increase in nicotine intake, less effective oral hygiene, changes in nutritional habits: or biological model, by reducing salivary flow, changes in gingival circulation and changes in immune-inflammatory response. Several studies have made the association between periodontal disease severity and behavioral factors such as stress. This study aimed to survey the literature on the major studies involving psychological factors and the response of periodontal tissues due to pathogens. Studies show, in large part the cross-sectional, a trend of positive relationship between stress and periodontal disease. A more representative research is necessary to determine the impact of stress and psychological factors as risks factors of periodontal disease.