Pharmacological management of pain after periodontal surgery: a systematic review with meta-analysis.

OBJECTIVES: To assess and compare the pharmacological effect of different drugs on pain relief after periodontal surgery. MATERIALS AND METHODS: Five databases were searched up to September 2019. The eligible studies comprised randomized clinical trials, involving only adult individuals that received any periodontal surgery and presenting two distinct groups of therapeutic regimens to control postoperative pain. Placebo groups could be included. The risk of bias was assessed with the RoB 2 Cochrane tool and the GRADE system. Meta-analyses were performed using different follow-up and drug comparisons. RESULTS: Overall, 2398 studies were identified, of which 35 were included. Low risk of bias was determined for the majority of the studies. The meta-analyses showed that the comparison of dexamethasone or non-steroidal anti-inflammatory drugs (NSAID) versus placebo favored the use of both interventions in a follow-up of 1 to 8 h for open flap procedures (OFP). However, no statistical difference was found for the comparison between NSAID and dexamethasone for OFP. CONCLUSIONS: Patients may benefit from several pharmacological schemes for pain relief after periodontal surgeries. However, due to the high heterogeneity among studies, no fixed pharmacological protocol could be proposed. CLINICAL RELEVANCE: There is not enough evidence to recommend one therapeutic scheme. However, untreated pain is harmful to the patients and it is not advisable.

Physical and Biological Properties of a High-Plasticity Tricalcium Silicate Cement.

INTRODUCTION: Mineral Trioxide Aggregate (MTA) is a tricalcium-based silicate, dicalcium silicate matrix. Despite its good biologic properties, some clinicians still claim to have difficulties in handling MTA after its preparation due to its sandy consistency. The aim of the present study was to evaluate the physicochemical properties and cytotoxicity of MTA Repair HP (Angelus, Londrina, PR, Brazil) compared with MTA Angelus (Angelus, Londrina, PR, Brazil). MATERIALS AND METHOD: The properties assessed were particle size, setting time, flow, film thickness, radiopacity, water solubility, compressive strength, and cytotoxicity. Statistical analysis was performed considering p < 0.05 as statistically significant. RESULTS: For radiopacity, water absorption and solubility MTA Repair HP were statistically similar to MTA Angelus. The MTA Angelus had statistically different film thickness values, higher than MTA Repair HP (p < 0.05). Besides, MTA Angelus showed a lower and statistically different compressive strength after 28 days than MTA Repair HP (p<0.05). Additionally, MTA Repair HP set more slowly (p < 0.05). Relative to cell viability, MTA Repair HP was statistically similar to MTA Angelus after 24 and 48 h in cell viability. CONCLUSIONS: The MTA Repair HP presented similar cell viability, lower film thickness, higher flow, setting time, and compressive strength values after 28 days than MTA Angelus. In general, the MTA Repair HP presented physicochemical and biological properties similar to the MTA Angelus.

Polypropylene glycol phosphate methacrylate as an alternative acid-functional monomer on self-etching adhesives.

OBJECTIVES: The aim of this study was to synthesize an alternative acidic monomer (polypropylene glycol phosphate methacrylate--Poly-P) to constitute experimental two-step self-etch adhesive systems and also to evaluate its influence on the pH and microshear bond strength (µSBS) to enamel. METHODS: Primers containing Poly-P (10, 15, 30 or 50wt.%), HEMA, ethanol, and water were prepared and allocated in subgroups according to a buffered or non-buffered pH. One experimental control and one commercial (Clearfill™ SE Bond) references were used. µSBS protocol was performed at human enamel, followed by mechanical testing. Scanning electron microscopy (SEM) was performed after each primer application. Data was analysed by one-way Kruskal-Wallis and Student-Newman-Keuls tests (p<0.05) and by linear regression predictive models. RESULTS: As greater the Poly-P content, the lower the primer's pH. Buffered groups showed lower µSBS values than non-buffered groups. Groups with Poly-P content equal or higher than 30wt.% showed similar µSBS results when compared to the controls. SEM images demonstrated that primers with high Poly-P content etched enamel with prisms exposure. CONCLUSIONS: The pH of the primer was directly influenced by the concentration of acidic monomer, which directly affected the adhesion to enamel. Both the acidity and the type of acid-functional monomer present in the adhesive influenced the bond strength results. CLINICAL SIGNIFICANCE: Poly-P synthesis was easy and effective, and considering the good bond strength results obtained, this acid-functional monomer may be potentially used in the formulation of self-etch dental adhesive systems.