The objective of this systematic review and meta-analysis was to evaluate the analgesic efficacy of COX-2 inhibitors versus other drugs in periodontal surgery. Two researchers searched PubMed, Google Scholar, ACM Digital, BASE, EBSCOhost, Scopus, or Web of Science for clinical trials using various combinations of words. All articles that met the selection criteria were assessed using the Cochrane Collaboration’s risk of bias tool. For data analysis, the inverse variance and mean difference statistical method was used with Review Manager 5.3 software for Windows. According to the conclusion of each study (qualitative evaluation), only one clinical trial had results in favor of a COX-2 inhibitor when compared to placebo, one clinical study informed that a COX-2 was better that an active control, four studies showed similar analgesic efficacy to active controls, and one clinical study informed the analgesic effect of one celecoxib-caffeine combination in comparison with celecoxib alone and placebo (n = 337). The COX-2 inhibitors showed a decrease in the rescue analgesic consumption (n = 138; I² = 15%; mean difference = −0.31; 95%CIs = −0.6 to −0.01), and lower pain intensity at four hours (n = 178; I2 = 0%; mean difference = −2.25; 95%CIs = −2.94 to −1.55; p = 0.00001) when compared to active controls after periodontal surgery. In conclusion, the data indicate that COX-2 agents produce better pain relief in comparison to placebo and other drugs after periodontal surgery.

Objectives: This study aimed to determine the number needed to treat (NNT) of ketorolac in comparison to placebo after third molar surgery. Methods: Studies located in PubMed, Scopus, and Web of Science were evaluated with the Cochrane Risk of Bias assessment tool. Data on the onset of analgesia, the number of patients requiring rescue medication, the global or general evaluation of the study medication, and adverse effects were extracted. Data analysis was performed using Review Manager 5.3 software for Windows. Results: The qualitative assessment of the included studies showed that ketorolac was more effective than a placebo and the quantitative evaluation on the onset of analgesia (NNT = 1.6 (95%CIs = 1.4, 1.9), n = 301), the number of patients who took rescue analgesics (NNT = 3.6 (95%CIs = 2.8 to 4.9), n = 563), and the global evaluation of the treatments (NNT = 1.7 (95%CIs = 1.5 to 1.9), n = 475) showed estimates of analgesic efficacy with a statistical difference in favor of ketorolac when compared with a placebo. No statistical difference was observed in adverse effects between ketorolac and placebo (n = 739). Conclusions: There is scientific evidence of moderate quality that allows estimators of the analgesic efficacy of ketorolac to be calculated, which will significantly help the clinician who performs pharmacological treatment after third molar surgery.

Purpose: The aim of this study is to determine the analgesic efficacy of ibuprofen 200, 400, and 600 mg after lower third molar surgery. Material and Methods: Clinical trials that included patients undergoing third molar surgery comparing ibuprofen with placebo were included. The only exclusion criteria was loss of postoperative patient follow-up greater than 20%. PubMed, Wiley, Science Direct, EBSCOhost, Scopus, and Web of Science databases were used to search for clinical trials. The risk of bias of the included articles was assessed using the Cochrane Collaboration’s seven-point risk of bias tool, and dichotomous data for the most important variables for determining analgesic efficacy and adverse effects were then concentrated into one database for statistical analysis. Results: The qualitative analysis was performed with 57 clinical trials and a total of n = 7735 patients. Moreover, the number of patients who took rescue analgesics and the global evaluation of the studied drugs showed statistical differences in favor of ibuprofen 200 (n = 797 and n = 694, respectively), 400 (n = 2803 and n = 2407, respectively), and 600 mg (n = 1149 and n = 291, respectively) compared to placebo. Adverse effects, such as nausea, vomiting, and headache, resulted in statistical differences in favor of ibuprofen 200 (n = 1461, n = 1319, and n =1342, respectively), 400 (n = 3917, n = 3124, and n = 2477, respectively), and 600 mg (n = 716) in comparison to placebo. The numbers needed to treat indicated high efficacy of ibuprofen in controlling pain after third molar surgery, while the numbers needed to harm were high, indicating the good safety profile of this drug. Conclusions: Ibuprofen has high analgesic efficacy and a good safety profile when used after third molar surgery.

Background/Objectives: The objective of this study was to determine the secondary metabolites of the aqueous fraction of a methanolic extract of Salvia brandegeei root and their antimicrobial, antioxidant, anti-inflammatory and antinociceptive properties. Methods: Fifteen reference compounds were evaluated by HPLC-UV, of which nine were tentatively identified in the aqueous fraction of the methanolic extract of Salvia brandegeei root. The antimicrobial effect of Salvia brandegeei 100, 50, 25, and 12.5 mg/mL and the vehicle (saline solution) against four ATCC bacterial and three fungal ATCC strains was analyzed. The DPPH, ABTS, and FRAP methods were used to evaluate antioxidant action. To evaluate the anti-inflammatory action, the topical application of TPA to the ear of mice was used, while to evaluate the antinociceptive effect, formalin and acetic acid models were used. In these animal models, Salvia brandegeei 100, 50, 25, and 12.5 mg/kg and the vehicle (saline solution) were administered orally. In addition, the antinociceptive mechanisms of action of Salvia brandegeei were evaluated with L-NAME (5 mg/kg), naloxone (2 mg/kg), and glibenclamide (10 mg/kg). Results: A total of 9 secondary metabolites were tentatively identified in the aqueous fraction of a methanolic root extract of Salvia brandegeei. Salvia brandegeei inhibited the growth of all ATCC species against which it was tested and showed an antioxidant effect through all three methods used. Salvia brandegeei produced a dose-dependent antinociceptive effect in both animal models. Conclusions: This study presents the first evidence of preliminary biological activities, including antimicrobial, antioxidant, anti-inflammatory, and antinociceptive effects, of an aqueous fraction of a methanolic root extract of Salvia brandegeei.