Interventions for Early-Stage Pericoronitis: Systematic Review of Randomized Clinical Trials.

Tânia Oppido Schalch,Elaine Marcilio Santos,Ana Luiza Cabrera Martimbianco,Marcela Leticia Leal Gonçalves,Rebeca Boltes Cecatto,Lara Jansiski Motta,Anna Carolina Ratto Tempestini Horliana,Sandra Kalil Bussadori

doi:10.3390/antibiotics11010071

Tânia Oppido Schalch, Elaine Marcilio Santos + Show 6 more

Open Access

https://doi.org/10.3390/antibiotics11010071

Copy DOI

Abstract

Background: To investigate the efficacy and safety of interventions for early stage pericoronitis. Methods: We searched for randomized controlled trials (RCTs) in databases from inception to July 2020, without language restriction. RCTs assessing adolescents and adults were included. Results: Seven RCT with clinical diversity were included, so, it was not possible to conduct meta-analyses. Individual study data showed an improvement in oral health quality of life in favor of topical benzydamine versus diclofenac capsule (Mean difference (MD) −1.10, 95% Confidence interval (CI) −1.85 to −0.35), and no difference between topical benzydamine and flurbiprofen capsule (MD −0.55 95% CI −1.18 to 0.0). There was no difference between diclofenac and flurbiprofen capsules (MD 0.55, 95% CI −0.29 to 1.39). An imprecise estimate of effects was found for all outcomes, considering (i) oral versus topic pharmacological treatment, (ii) different oral pharmacological treatments, (iii) pharmacological treatment associated with laser versus placebo laser, (iv) pharmacological treatment associated with different mouthwashes, and (v) conventional treatment associated to antimicrobial photodynamic therapy versus conventional treatment, with low to very low certainty of evidence. Conclusions: Until future well-designed studies can be conducted, the clinical decision for early stage pericoronitis should be guided by individual characteristics, settings and financial aspects.

Highlights

Pericoronitis is the common term used to describe the inflammation of soft tissues around the dental crown in a semi-erupted lower third molar [1]
The problem is the lack of evidence-based standardized treatment for initial pericoronitis [3]
Reduction of pro-inflammatory cytokines: the levels of interleukin 6 (IL-6) presented no difference between groups (MD 2.00 pg/mL 95% Confidence interval (CI) −10.72 to 6.72, p = 0.65), the tumor necrosis factor α (TNF-α) showed a significant reduction in favors of antimicrobial photodynamic therapy (aPDT) group (MD −128.00 pg/mL 95% CI −185.47 to −70.53, p < 0.0001), with an imprecise confidence interval

Summary

Introduction

Pericoronitis is the common term used to describe the inflammation of soft tissues around the dental crown in a semi-erupted lower third molar [1]. The pseudo-pocket formed around the third molar accumulates bacterial plaque underneath the soft tissue cap, predisposing to inflammatory complications [2,3]. Quick, cheap, and no need for systemic antibiotics if detected early and appropriately treated [3]. Proper treatment of the initial phase is the local therapy over antibiotic prescribing [3]. Antibiotics should be reserved for severe cases where the spread of infection with systemic symptoms are present [5] because of the risk of developing resistance [6]. The problem is the lack of evidence-based standardized treatment for initial pericoronitis [3]

Methods

Results

Discussion

Conclusion