Paracetamol may lower anxiety after computer guided dental implant surgeries: Study

This study is published in the Journal of Dental Sciences.

Dental implants insertion can be a major factor in stress and anxiety. It was also found that paracetamol is able to decrease the unpleasantness when patients are subjected to noise blasts. This may suggest a great benefit when used before dental operations, as we continuously need to work with noisy tools.

Till date no other study has investigated the effect of paracetamol on stress reduction in implant surgeries. Thus, Mahmoud Sedky Adly and associates from the Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt conducted the present study with the aim to assess the ability of paracetamol to lower stress and anxiety when compared with ibuprofen during and after a minimally traumatic computer guided flapless implant surgery with immediate loading protocol using one-piece dental implant.

The authors enrolled a total of thirty patients in a crossover study design having bilateral missing lower molars. Patients were randomized into 2 equal groups with the first assigned for dental implant insertion in the lower molar area on one side with the administration of paracetamol (with 7-day follow-up) followed by 2-week washout period, then another implant was inserted on the contra-lateral side with ibuprofen. The second group received the same drugs but in reversed order. Salivary cortisol level was used to measure anxiety and a computer vision system was used to measure swelling. Visual-Analogue-Scale pain score from 0-to-100 was also utilized.

The following results were observed-

4. Stress and anxiety was found to be significantly lower in paracetamol group (4.1 ± 1.08 ng/mL and 6.2 ± 0.94 ng/mL for paracetamol/ibuprofen respectively).
5. Pain score was 13.1 ± 1.1 and 12.9 ± 2.3 in paracetamol/ibuprofen groups respectively with no significant differences.
6. Swelling showed significant difference favoring the paracetamol group (0.91 ± 0.41 and 0.61 ± 0.31 for paracetamol/ibuprofen respectively).

Hence, the authors concluded that "paracetamol can be regarded as a safe and effective stress-reducing drug that may allow the patient to tolerate pain with minimal anxiety especially if used with computer guided minimally invasive flapless implant surgeries."

However, paracetamol failed to control swelling when compared with ibuprofen. On the other hand, ibuprofen was significantly less effective in controlling stress and anxiety when compared with paracetamol. Computer guided flapless implant surgery with immediate loading protocol following administration of paracetamol can be recommended for fearful and low pain threshold patients especially if patients are suffering from gastro-intestinal disturbances, they further added.