Abstract
The coxibs are nonsteroidal anti-inflammatory drugs (NSAIDs) highly selective for COX-2, an enzyme related to inflammatory processes. At first, their use should present advantages over nonselective NSAIDs, since the inflammatory efficacy would be present but with minimal adverse effects. However, its widespread use showed significant cardiovascular risk and, in treatment over 6 months, predisposition to ulceration, bleeding and stomach pain. The coxibs should be used in patients over 60 years, with a history of peptic ulcer or gastrointestinal bleeding, chronic users of corticosteroids and anticoagulants without concomitant cardiovascular risk. Moreover, they are more expensive and have similar analgesic efficacy to non-selective NSAIDs. In dentistry, the main indications are related to the control of pain and inflammation for a maximum of 3 days or preemptively in oral surgery to control pain and swelling. However, there is no major evidence of the benefits of using these drugs compared to traditional NSAIDs in dentistry.
Highlights
Clinical management of inflammatory symptoms constitutes one of the most common actions in the dental routine, and control of clinical symptoms, especially pain and fever, is based on the use of non-steroidal anti-inflammatory drugs (NSAIDs)
The NSAIDs are anample group of drugs with antiinflammatory, antipyretic and analgesic properties, which appeared around the 60s as an alternative to aspirin
NSAIDs work by inhibiting the cyclooxygenase (COX) enzyme, responsible for the synthesis of prostaglandins (PGs) from arachidonic acid
Summary
Clinical management of inflammatory symptoms constitutes one of the most common actions in the dental routine, and control of clinical symptoms, especially pain and fever, is based on the use of non-steroidal anti-inflammatory drugs (NSAIDs). The authors note that recommendations for pain management and inflammation in dentistry endorse its use for a maximum of 4 to 5 days, which rarely triggers adverse effects in healthy individuals. There is no evidence of a greater benefit from its use compared to other NSAIDs, and its risks and benefits, as well as the clinical profile of the patient need to be considered when prescribing these drugs [8].
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