Effectiveness of Short-Term NSAIDs Protocols in Implantology: a Systematic Review

Objectives: To evaluate the analgesic efficacy of short-term use of NSAIDs for managing postoperative pain after implant placement. The primary question was (P) patients undergoing single or multiple dental implant placement, (I) short-term administration of nonsteroidal anti-inflammatory drugs for postoperative pain management, (C) placebo, and (O) postoperative pain and safety profile.
Methods: A systematic search for information with the following keywords (("NSAIDs" / “Short-term Analgesia”/ "postoperative pain" / "Analgesia" / “Ibuprofen”/ “Naproxen”/ “Acetaminophen”/ “Sulindac”/ “Etodolac”/ “Ketoprofen”/ “Celecoxib”/ “Diclofenac”/ “Meloxicam”/ “Ketorolac”/ “Flurbiprofen”/ “Etoricoxib”/ “Piroxicam”/ “Tenoxicam”/ AND "Dental implants")) ((“NSAIDs/ Osseointegration/Implant Failure)) was conducted using MEDLINE, Google Scholar, SCOPUS, Web of Science, Wiley Online Library, OVID, SCIELO, and www.clinicaltrials.gov. Subsequently, a systematic review of the studies that met the inclusion criteria, was carried out.
Results: The investigation yielded 613 non-duplicate articles. After excluding 535 studies based on title/abstract, 88 studies were retrieved for full-text review. Of these, 79 studies were excluded due to a different intervention, animal studies, study design, non-English articles, and no short-term use of NSAIDs. Finally, 9 RCTs were included in the qualitative synthesis.
Conclusions: The specific evidence-based analgesic protocol for dental implant surgery remains to be defined. The variability in implantology practice and the number of analgesic molecules and protocols available in the literature make it difficult to determine the best postoperative treatment. More clinical research is needed, including studies with adequate sample sizes comparing standardized implant approaches with short-term pain management protocols.