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      Efficacy of auriculotherapy in the control of pain, edema, and trismus following surgical extraction of the lower third molars: a split-mouth, randomized, placebo-controlled, and triple-blind study

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          Abstract

          Background

          The aim of this split-mouth, randomized, placebo-controlled, and triple-blind study was to evaluate whether auriculotherapy had any effect on the post-operative course after the extraction of third molars in terms of the control of pain, edema, and trismus.

          Materials and methods

          The study included 42 patients (84 teeth) who had undergone a surgical extraction of the lower third molars. In each patient, the two extractions were randomly assigned to two study groups. In the therapy group, the patients underwent auriculotherapy with vaccaria seeds applied with patches in 6 ear points. In the control group, the patches were applied, without seeds, to the same ear points. After the extraction, the patients were asked to stimulate the ear points three times a day and whenever they felt pain. The patients were asked to keep a diary in which they assessed their pain by means of the Visual Analog Scale (VAS) for 8 days. Edema and trismus were assessed 1, 2, 3, and 8 days after surgery.

          Results

          The differences between the two groups were statistically significant at the 12-h control (auriculotherapy group (AG) VAS 5.5 [IQR 4.25–6.75], placebo group (PG) VAS 6 [IQR 5–8], p = 0.040), after 24 h (AG VAS 5 [IQR 4–6], PG VAS 6 [IQR 4.25–7], p = 0.024), after 2 days (AG VAS 4 [IQR 3–5], PG VAS 4.5 [IQR 4–6], p = 0.044), and after 3 days (AG VAS 3 [IQR 0–5], PG VAS 4 [IQR 3–5], p = 0.024). Throughout the observation period, the AG took a significantly lower number of painkillers than the PG (AG 6 [IQR 4.25–7]; PG 8 [IQR 8–9], p < 0.001). There were no significant differences in the levels of edema and trismus between the two groups throughout the observation period.

          Conclusions

          On the basis of the results of the present study, auriculotherapy can be considered as a cost-effective adjuvant pain reliever treatment in patients undergoing an extraction of the lower third molars.

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          Most cited references32

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          Long-term adverse effects of paracetamol - a review

          Paracetamol (acetaminophen) is the most commonly used drug in the world, with a long record of use in acute and chronic pain. In recent years, the benefits of paracetamol use in chronic conditions has been questioned, notably in the areas of osteoarthritis and lower back pain. Over the same period, concerns over the long-term adverse effects of paracetamol use have increased, initially in the field of hypertension, but more recently in other areas as well. The evidence base for the adverse effects of chronic paracetamol use consists of many cohort and observational studies, with few randomized controlled trials, many of which contradict each other, so these studies must be interpreted with caution. Nevertheless, there are some areas where the evidence for harm is more robust, and if a clinician is starting paracetamol with the expectation of chronic use it might be advisable to discuss these side effects with patients beforehand. In particular, an increased risk of gastrointestinal bleeding and a small (~4 mmHg) increase in systolic blood pressure are adverse effects for which the evidence is particularly strong, and which show a degree of dose dependence. As our estimation of the benefits decreases, an accurate assessment of the harms is ever more important. The present review summarizes the current evidence on the harms associated with chronic paracetamol use, focusing on cardiovascular disease, asthma and renal injury, and the effects of in utero exposure.
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            The use of corticosteroids and nonsteroidal antiinflammatory medication for the management of pain and inflammation after third molar surgery: a review of the literature.

            The use of medication to relieve pain and inflammation after removal of third molars has been explored thoroughly in the literature. Narcotic analgesics, nonsteroidal antiinflammatory drugs (NSAIDs), corticosteroids, and combinations of these all have a role in the postoperative management of pain and swelling within this group of patients. This article addresses the use of NSAIDs and corticosteroids after third molar surgery, along with a review of the literature, which is incorporated to provide practitioners helpful, quick, and reliable information regarding patients undergoing third molar surgery.
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              • Article: not found

              Auriculotherapy for pain management: a systematic review and meta-analysis of randomized controlled trials.

              Side-effects of standard pain medications can limit their use. Therefore, nonpharmacologic pain relief techniques such as auriculotherapy may play an important role in pain management. Our aim was to conduct a systematic review and meta-analysis of studies evaluating auriculotherapy for pain management.
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                Author and article information

                Contributors
                lavaira@uniss.it
                Journal
                Oral Maxillofac Surg
                Oral Maxillofac Surg
                Oral and Maxillofacial Surgery
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1865-1550
                1865-1569
                3 February 2023
                3 February 2023
                2024
                : 28
                : 1
                : 279-287
                Affiliations
                [1 ]Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, ( https://ror.org/01bnjbv91) Sassari, Italy
                [2 ]Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, ( https://ror.org/01bnjbv91) Viale San Pietro 43B, Sassari, Italy
                [3 ]Studio Massaiu, Sassari, Italy
                [4 ]Department of Maxillofacial Surgery, University of Naples “Federico II”, ( https://ror.org/05290cv24) Naples, Italy
                [5 ]Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), ( https://ror.org/02qnnz951) Mons, Belgium
                [6 ]Department of Otolaryngology-Head Neck Surgery, Polyclinic of Poitiers, Elsan Hospital, Poitiers, France
                [7 ]Maxillofacial Surgery Department, San Paolo Hospital, ASST Santi Paolo E Carlo, University of Milan, ( https://ror.org/00wjc7c48) Milan, Italy
                [8 ]Dental School, University Hospital of Sassari, ( https://ror.org/05xrcj819) Sassari, Italy
                Article
                1140
                10.1007/s10006-023-01140-y
                10914868
                36735078
                f7739420-044f-456d-ada4-2f22d2947129
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 30 May 2022
                : 29 January 2023
                Funding
                Funded by: Università degli Studi di Sassari
                Categories
                Research
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2024

                Surgery
                acupuncture,auriculotherapy,third molar,tooth extraction,oral surgery,pain,edema,trismus
                Surgery
                acupuncture, auriculotherapy, third molar, tooth extraction, oral surgery, pain, edema, trismus

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