Evaluating the efficacy of Etoricoxib in reducing post-operative pain associated with minor oral surgery. A randomized clinical trial / Avaliação da eficácia do Etoricoxibe na redução da dor pós-operatória associada à cirurgia oral menor: ensaio clínico randomizado

Etoricoxib, a new cyclooxygenase-2-selective inhibitor has demonstrated a rapid onset analgesic effect for relieving acute pain especially when prescribed as a pre-emptive medication. On these bases, this study may provide useful information and guidance for clinicians working in the field of oral surgery, as regards handling odontogenic pain and postoperative pain precisely with cyclooxygenase-2 inhibitors. Objective: the study aimed to measure the quantifiable efficacy of Etoricoxib in reducing post-extraction pain in subjects undergoing minor oral surgical intervention as compared to Naproxen (a traditional NSAID) which is commonly used to control postoperative pain. Material and Methods: a 120 mg film-coated tablet of Etoricoxib was given to each of the twenty patients representing the study group, and a 500 mg tablet of Naproxen was given to each of the other twenty subjects representing the positive control group. According to manufacturer instructions, the tablets were given to the subjects 30 minutes pre-operatively (before dental extraction). Post-operative pain was assessed for each subject using eleven points from zero to ten, visual analog scale. Results: showed no statistically significant difference between Etoricoxib and Naproxen in decreasing post-extraction odontogenic pain, suggesting that Etoricoxib is as efficient as Naproxen in the control of discomfort with dental origin taking into consideration the patient's status when prescribing the medication. Conclusion: this study suggests that Etoricoxib can be handled as a pre-emptive medication to reduce post-operative pain for subjects seeking traditional or surgical extraction of any of their teeth (AU)

O Etoricoxibe, um novo inibidor seletivo da ciclooxigenase-2, demonstrou um efeito analgésico de início rápido para aliviar a dor aguda, especialmente quando prescrito como medicação preventiva. Com base nesses fundamentos, este estudo pode fornecer informações úteis e orientação para clínicos que trabalham no campo da cirurgia oral, no que diz respeito ao manejo da dor odontogênica e da dor pós-operatória de forma precisa com inibidores da ciclooxigenase-2. Objetivo: o estudo teve como objetivo medir a eficácia quantificável do Etoricoxibe na redução da dor pós-extração em indivíduos submetidos a intervenção cirúrgica oral menor, comparado ao Naproxeno (AINE tradicional) que é comumente usado para controlar a dor pós-operatória. Material e Métodos: um comprimido revestido com um filme de 120 mg de Etoricoxibe foi administrado a cada um dos 20 pacientes representando o grupo de estudo, e um comprimido de 500 mg de Naproxeno foi administrado a cada um dos outros vinte sujeitos representando o grupo de controle positivo. De acordo com as instruções do fabricante, os comprimidos foram administrados aos indivíduos 30 minutos antes da cirurgia (antes da extração dentária). A dor pós-operatória foi avaliada para cada sujeito usando uma escala analógica visual de onze pontos, de zero a dez. Resultados: não mostraram diferença estatisticamente significativa entre o Etoricoxibe e o Naproxeno na diminuição da dor odontogênica pós-extração, sugerindo que o Etoricoxibe é tão eficiente quanto o Naproxeno no controle do desconforto de origem dentária, levando em consideração o estado do paciente ao prescrever a medicação. Conclusão: este estudo sugere que o Etoricoxibe pode ser administrado como medicação preventiva para reduzir a dor pós-operatória em indivíduos que buscam extração dentária tradicional ou cirúrgica de qualquer um de seus dentes. (AU)

Case Series and Review on Managing Abscesses Secondary to Hyaluronic Acid Soft Tissue Fillers with Recommended Management Guidelines.

With the number of aesthetic soft tissue filler treatments rapidly increasing, we have witnessed an increase in complications associated with such treatments. While rare, abscesses can arise as a result of these treatments, and current detailed guidelines do not exist detailing exactly how to manage them. OBJECTIVE: Our aim was to develop evidence-based and experience-based guidelines on how to, specifically, manage abscesses secondary to hyaluronic acid dermal fillers. METHODS: A thorough MEDLINE literature search of keywords, including abscess, abscess management/treatment, hyaluronic acid, dermal fillers, and soft tissue fillers, was completed to collect specific cases of abscesses secondary to soft tissue filler. Inclusion criteria involved papers published from 2010 to 2020 that focused specifically on soft tissue fillers in the face. In addition, we looked at papers that discussed abscesses secondary to soft tissue fillers in general and their management. We also reported three cases of abscesses secondary to hyaluronic acid dermal fillers that have been described by three different practitioners, detailing their history, examination, management, and outcomes. Experience and evidence have been collated to produce management guidelines. RESULTS and CONCLUSION: It is clear that each case is unique, but there is no current universal consensus on the risk assessment before treatment nor general management of abscesses secondary to soft tissue filler. The majority of the reports and cases discussed in the paper suggested the use of co-amoxiclav along with a macrolide or quinolone for at least two weeks. Incision and drainage are universally accepted as gold standard management. Microbiology, sensitivities, and cultures are also recommended. Hyaluronidase use, while controversial, is encouraged in effectively managing abscesses secondary to hyaluronic acid dermal filler.

Repair of surgical bone defects grafted with hydroxylapatite + ß-TCP combined with hyaluronic acid and collagen membrane in rabbits: A histological study.

OBJECTIVES: This study aimed to assess the repair of bone defects with or without grafts using biphasic synthetic micro-granular hyaluronic acid (HA) with ß-TCP and bovine type I collagen (Osteon II Collagen) with or without either hyaluronic acid or a collagen membrane in surgically created bone defects in the tibia of rabbits. METHODS: Fifteen male rabbits were divided into 3 groups, each with 5 rabbits. Two bone defects were made in each tibia. In the right tibia, the defects were either filled with clot as a control or grafted with Osteon II Collagen and hyaluronic acid. In the left tibia, the other two defects were filled with Osteon II Collagen alone or with Osteon II Collagen and a collagen membrane. The specimens were observed one, two, and four weeks after surgery. Histological examinations were used to evaluate the degree of healing according to the amount of newly formed bone. RESULTS: The combination of the bone grafting biomaterial with hyaluronic acid was found to develop into the most advanced stages of the bone repair process at the second and fourth week only (p ≤ 0.05), compared to the biomaterial with a collagen membrane, as well as the other groups. On the other hand, the biomaterial in combination with a collagen membrane showed significantly more bone formation than the biomaterial alone or the control group by the fourth week. CONCLUSIONS: The local application of hyaluronic acid and collagen membranes made a greater contribution to the bone repair process in the tibia of rabbits than the bone graft substitute (Osteon II Collagen) alone.