Keywords :
Preemptive analgesia, Single implant, Sublingual piroxicam
Citation Information :
Sangolikar D, Bhutani S, Pushpalatha H. Sublingual Piroxicam as Preemptive Analgesia in Single Implant Surgery. J Contemp Dent Pract 2019; 20 (6):750-753.
Aim: The aim of this study is to evaluate the efficacy of sublingual piroxicam as a preemptive analgesic agent in patients undergoing single implant surgery.
Materials and methods: This was a prospective triple-blind placebo-controlled trial that involved 40 patients presented for the placement of a single endosteal implant in the posterior maxillary arch. Patients were randomly allocated to one of the following groups. Group I (study) who received sublingual piroxicam 40 mg 1 hour prior to the surgical procedure and group II (control) received placebo 1 hour before the surgery, both the groups received sublingual piroxicam 20 mg tablet twice a day on the first and the second postoperative day and once a day on the postoperative day 3. Visual analog scores for measuring pain intensity were assessed at postoperative 1 hour, 6 hours, days 1, 3, and 5. Facial swelling was measured and evaluated during the first, third, and fifth postoperative days using the digital vernier caliper. The Mann–Whitney U test was used to make between-group comparisons. The Wilcoxon-signed rank test was used to make within-group comparisons.
Results: At all-time intervals, both mean pain and mean swelling scores were higher in controls as compared with those of cases. The difference between the two groups was also statistically significant at all-time intervals for both parameters except for pain at 1 hour
Conclusion: Our findings suggest that preoperative sublingual piroxicam is more effective for controlling postoperative pain and swelling after surgical implant placement than only postoperative administration.
Gonzalez SH, Penarrocha DM, et al. Pain and inflammation in 41 patients following the placement of 131 dental implants. Med Oral Patol Oral Cir Bucal 2005;10(3):258–263.
Hashem AA, Claffey NM, et al. Pain and anxiety following the placement of dental implants. Int J Oral Maxillofac Implants 2006;21(6):943–950.
Woolf CJ, Chong MS. Preemptive analgesia – treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg 1993;77:362–379. DOI: 10.1213/00000539-199308000-00026.
Ochroch EA, Mardini IA, et al. What is the role of NSAIDs in pre-emptive analgesia? Drugs 2003;63(24):2709–2723. DOI: 10.2165/00003495- 200363240-00002.
Yamamoto M, Sugano T, et al. Double-blind comparison of piroxicam and indomethacin in the treatment of cervicobrachial syndrome and periarthritis scapulohumeralis (stiff shoulder). Eur J Rheumatol Inflamm 1983;6(3):266–273.
Trindade PA, Giglio FP, et al. Sublingual ketorolac and sublingual piroxicam are equally effective for postoperative pain, trismus, and swelling management in lower third molar removal. Oral Surg Oral Med Oral Pathol Oral Radiol 2012 Jul;114(1):27–34. DOI: 10.1016/j.tripleo.2011.05.027.
Mohammad S, Singh V, et al. Sublingual piroxicam in the management of postoperative pain after surgical removal of impacted mandibular third molar. Indian J Dent Res 2012;23(6):839–840. DOI: 10.4103/0970- 9290.111282.
Gramke HF, Petry JJ, et al. Sublingual piroxicam for postoperative analgesia: preoperative versus postoperative administration: a randomized, double-blind study. Anesth Analg 2006;102(3):755–758. DOI: 10.1213/01.ane.0000197611.89464.98.
Shah AV, Arun KV, et al. Comparative evaluation of pre-emptive analgesic efficacy of intramuscular ketorolac versus tramadol following third molar surgery. J Maxillofac Oral Surg 2013;12(2): 197–202. DOI: 10.1007/s12663-012-0420-4.
Graziani F, Corsi L, et al. Clinical evaluation of piroxicam-fddf and azithromycin in the prevention of complications associated with impacted lower third molar extraction. Pharmacol Res 2005:52:485–
DOI: 10.1016/j.phrs.2005.07.009.
Trindade PA, Giglio FP, et al. Comparison of oral versus sublingual piroxicam during postoperative pain management after lower third molar extraction. Int J Oral Maxillofac Surg 2011;40:292. DOI: 10.1016/j. ijom.2010.10.026.
Emad A. A new two dimensional facial contour tracing method. J Bagh College Dentistry 2010;22(4):62–66.
de Santana-Santos T, de Souza-Santos aA, et al. Prediction of postoperative facial swelling, pain and trismus following third molar surgery based on preoperative variables. Med Oral Patol Oral Cir Bucal 2013;18(1):65–70.
Pedersen A, Moller OM. Volumetric determination of extraoral swelling from stereophotographs. Int J Oral Surg 1985;14:229–234. DOI: 10.1016/s0300-9785(85)80033-8.
Yip E, Smith A, et al. Volumetric evaluation of facial swelling utilizing a 3-D range camera. Int J Oral Maxillofac Surg 2004;2:179–182. DOI: 10.1054/ijom.2003.0501.