Post-operative pain management in dental implant surgery should consider nonsteroidal anti-inflammatory drugs as best practice
Editorial Commentary

种植牙术后疼痛管理应优先考虑使用非甾体抗炎药

Craig S. Miller1, Doug R. Oyler2

1Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, KY, USA; 2Department of Pharmacy Practice and Science, College of Pharmacy, University of Kentucky, Lexington, KY, USA

Correspondence to: Craig S. Miller. Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, KY, USA. Email: cmiller@uky.edu.

Comment on: Khouly I, Braun RS, Ordway M, et al. Post-operative pain management in dental implant surgery: a systematic review and meta-analysis of randomized clinical trials. Clin Oral Investig 2021;25:2511-36.

Received: 17 November 2021; Accepted: 30 November 2021; Published: 30 September 2022.

doi: 10.21037/joma-21-21

在此感谢Khouly等人发表的优秀研究成果——《种植牙术后疼痛管理：随机临床试验的系统综述和荟萃分析》[1]。这篇详尽的系统综述增进了人们对种植牙术后疼痛和患者感知需求的理解。该研究的一个主要发现是，使用非甾体抗炎药（nonsteroidal anti-inflammatory drugs，NSAIDs）可以有效控制与种植牙相关的疼痛，尽管作者的结论中没有强调这一点。显然，许多研究和知名组织（如美国牙医协会、美国口腔颌面外科医生协会、美国疾病控制和预防中心、美国国家医学院）支持减少牙科手术后的阿片类药物处方，以减少与阿片类药物滥用有关的死亡病例[1-5]。令人遗憾的是，由于牙科医生继续遵守旧的急性牙痛管理处方习惯和思维模式，这些研究成果和相关组织的努力并未产生实际的影响。同时，从Khouly等人回顾的临床研究中可以看出，社区牙科治疗中阿片类药物处方的使用状况仍不清楚[1]。对这一问题的理解需要借助一些考察与牙科中阿片类药物处方有关的因素和行为的研究，其中包括感知需求、惯性思维和“以防万一”的处方[6-21]。然而，改变医生的行为十分困难，而且思想转变也需要时间[14,22,23]。牙科教学正在发挥自身的作用，即教导从业人员使用NSAIDs作为一线镇痛疗法，有禁忌证的情况除外[24-27]。同时，国家的强制规定和处方药监测项目有助于促进口腔手术后非阿片类镇痛药的使用[16,27]。牙科界正处于转折期，如果想要取得预期的进展，则需要从文献中及认知和执行科学家处学习如何最好地改变人类行为。我们希望负责拔牙和种植牙的医生能够如这篇文章所建议的那样在实践中限制阿片类药物的使用，转而使用NSAIDs。这一建议有大量证据支持，同时也是被许多人所倡导的。希望在十年后，我们不会回过头来质问为什么情况没有改变。

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Journal of Oral and Maxillofacial Anesthesia. The article did not undergo external peer review.

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://joma.amegroups.com/article/view/10.21037/joma-21-21/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

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译者介绍
姬宁宁
医学博士，上海交通大学医学院附属第九人民医院麻醉科。累计发表期刊论文24篇，其中以第一作者身份在领域内有一定影响力的期刊发表SCI论文9篇（其中6篇发表在JCR分区为Q1的学术期刊上）。主持省教育厅项目2项，作为主要成员参与国家自然科学基金面上项目2项。已授权实用新型专利3项。参译专著1部。（更新时间：2022-11-15）
审校介绍
夏明
上海交通大学医学院附属第九人民医院麻醉科副主任医师，副教授，硕士研究生导师，人工智能课题组长。Journal of Medical Artificial Inteligence（JMAI）主编，Journal of Oral and Maxillofacial Anesthesia（JOMA）执行主编、中华口腔医学会口腔麻醉专业委员会全国常务委员。（更新时间：2022-11-15）

（本译文仅供学术交流，实际内容请以英文原文为准。）

doi: 10.21037/joma-21-21
Cite this article as: Miller CS, Oyler DR. Post-operative pain management in dental implant surgery should consider nonsteroidal anti-inflammatory drugs as best practice. J Oral Maxillofac Anesth 2022;1:25.

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