Document Type

Article

Publication Date

5-7-2025

Publisher

Wiley

Source Publication

Journal of Clinical Periodontology

Source ISSN

0303-6979

Original Item ID

DOI: 10.1111/jcpe.14157

Abstract

Objective

This systematic review aimed to answer the question: In patients undergoing periodontal and peri-implant surgery, gingival augmentation, implant site development or placement, are pre-emptive analgesics effective in controlling post-operative pain compared with patients not receiving pre-emptive medications?

Materials and Methods

After comprehensive electronic and manual literature searches, randomised placebo-controlled clinical trials on adults undergoing the aforementioned surgeries were included. A meta-analysis was performed comparing pain (standardised mean difference) between pre-emptive medication and placebo at post-operative hours 1, 3, 6, 8, 24 and 72.

Results

Two reviewers screened 1995 titles, included 18 studies in the systematic review (open flap debridement, osseous, mucogingival, unspecified periodontal surgery, implant placement; 1008 patients) and 7 studies in the meta-analysis. Non-steroidal anti-inflammatory drugs, acetaminophen and corticosteroids were prescribed 8 h to immediately pre-operatively and post-operatively until 12 h after the first dose. A clinically significant pain reduction peaked at 3 h (−0.81 [95% CI: −1.03, −0.58]; 9 study arms, n = 165 drug vs. n = 96 placebo patients) and was significant until 8 h (−0.54 [95% CI: −0.79, −0.28]; 7 study arms, n = 126 drug vs. n = 96 placebo patients), with moderate certainty of evidence (GRADE assessment).

Conclusion

Pre-emptive analgesia can reduce pain for up to 8 h following periodontal and implant placement surgery.

Comments

Accepted version. Journal of Clinical Periodontology, Vol. 52, No. 8 (May 7, 2025): 1167-1195. DOI. © John Wiley & Sons. Used with permission.

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Available for download on Monday, June 01, 2026

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