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Three Newly Approved Analgesics: An Update
Mana SaraghiDMD and
Elliot V. HershDMD, MS, PhD
Article Category: Other
Volume/Issue: Volume 60: Issue 4
Online Publication Date: Jan 01, 2013
DOI: 10.2344/0003-3006-60.4.178
Page Range: 178 – 187

, improved healing, reduced health care costs, and improved patient satisfaction, but it may play a role in preventing the progression of chronic pain. 4 – 6 Opioids have traditionally been the most common analgesic for treating moderate to severe postoperative pain. 2 However, their utility is hampered by undesirable side effects, which are sometimes intolerable to the patient. These side effects include central nervous depression, respiratory depression, pruritus, nausea, vomiting, ileus, tolerance, and opioid-induced hyperalgesia. 4 – 6 By treating pain with

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Drug Therapy in Dental Practice: Nonopioid and Opioid Analgesics
Daniel E. BeckerDDS and
James C. PheroDMD
Article Category: Other
Volume/Issue: Volume 52: Issue 4
Online Publication Date: Jan 01, 2005
DOI: 10.2344/0003-3006(2005)52[140:DTD]2.0.CO;2
Page Range: 140 – 149

Analgesic drugs interrupt nociceptive pathways that transmit impulses to be interpreted as pain in the central nervous system. Conventional analgesics inhibit ascending impulses and/or their interpretation. Figure 1 offers a basic schematic of nociceptive transmission. A variety of so-called ‘‘analgesic adjuncts’’ have proven efficacy for managing chronic pain, but will not be addressed in this article. They include various antidepressants and anticonvulsants that either enhance descending inhibitory pathways or modulate excitatory neural traffic, which

Assessing the Effectiveness of Combined Analgesics for Bilateral Ramus Osteotomies
Shigeru MaedaDDS, PhD,
Hitoshi HiguchiDDS, PhD,
Maki FujimotoDDS,
Saki MiyakeDDS,
Yuka Honda-WakasugiDDS, PhD, and
Takuya MiyawakiDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 67: Issue 3
Online Publication Date: Sep 29, 2020
DOI: 10.2344/anpr-67-01-05
Page Range: 140 – 145

, face, and neck. Thus, the level of surgical invasiveness of a ramus osteotomy is typically considered to be intermediate, somewhere between minor and major surgeries. Ideal evidence-based protocols designed to provide postoperative analgesia specifically for ramus osteotomy procedures have not yet been established. Presently there are various analgesics available for administration in the perioperative period, such as NSAIDs, acetaminophen, and opioid agonists. Although combined use of these analgesics is typically expected to be appropriate for managing

A Comparative Study of Oral Analgesics for Postoperative Pain After Minor Oral Surgery
Atsushi HanzawaDDS, PhD,
Toshiyuki HandaDDS, PhD,
Yoshihiko KohkitaDDS, PhD,
Tatsuya IchinoheDDS, PhD, and
Ken-Ichi FukudaDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 65: Issue 1
Online Publication Date: Jan 01, 2018
DOI: 10.2344/anpr-65-01-02
Page Range: 24 – 29

Minor oral surgical procedures, such as dissection and detachment of the gingival mucosa and periosteum or removal of bone tissue, are relatively invasive, with a high incidence of postoperative pain, the level of which is frequently high. 1 – 3 Postoperative pain may be caused by postsurgical inflammation secondary to invasive stimulation, and it markedly affects patient recovery and satisfaction. 4 – 6 Therefore, postoperative pain relief is important and drugs having not only a strong analgesic effect but also anti-inflammatory effects

Opioid Use Disorder in Dental Patients: The Latest on How to Identify, Treat, Refer and Apply Laws and Regulations in Your Practice
Bryan NackDMD,
Steven E. HaasDMD, JD, MBA, and
Jason PortnofDMD, MD, FACS
Article Category: Research Article
Volume/Issue: Volume 64: Issue 3
Online Publication Date: Jan 01, 2017
DOI: 10.2344/anpr-64-03-09
Page Range: 178 – 187

% of all opioid prescriptions in the United States are related to dental procedures. 9 Wong et al 10 reported that opioids were prescribed 27.5% of the time following dental procedures where analgesic use was recommended. According to the Substance Abuse and Mental Health Services Administration, the most commonly misused prescription drugs include oxycodone, hydrocodone, hydromorphone, methadone, morphine, and codeine. 4 These compounds are contained in various brand name formulations, including Tylenol #2-4, Vicodin, Norco, Percocet, Percodan, Oxycontin

Figure 5; Relationships between analgesic efficacy of fentanyl (%MPE) and A118G genotypes.
Ken-ichi Fukuda,
Masakazu Hayashida,
Kazutaka Ikeda,
Yoshihiko Koukita,
Tatsuya Ichinohe, and
Yuzuru Kaneko
Figure 5
Figure 5

Relationships between analgesic efficacy of fentanyl (%MPE) and A118G genotypes.

Figure 2; Frequency of need for postoperative analgesics following sagittal split mandibular osteotomy (SSMO) compared with that following oral soft tissue surgery.
Ken-ichi Fukuda,
Masakazu Hayashida,
Kazutaka Ikeda,
Yoshihiko Koukita,
Tatsuya Ichinohe, and
Yuzuru Kaneko
Figure 2
Figure 2

Frequency of need for postoperative analgesics following sagittal split mandibular osteotomy (SSMO) compared with that following oral soft tissue surgery.

Figure 3.; Analgesic Doses Taken During the First 72 Hours Postoperatively in Opioid-Using and Opioid-Naïve Patients. Patients with chronic pain on opioid therapy used more analgesics (mean, SD) during the first 72 hours postoperatively vs opioid-naïve patients without chronic pain.
Peggy Compton,
Steven Wang,
Camron Fakhar,
Stacey Secreto,
Olivia Halabicky Arnold,
Brian Ford, and
Elliot V. Hersh
Figure 3.
Figure 3.

Analgesic Doses Taken During the First 72 Hours Postoperatively in Opioid-Using and Opioid-Naïve Patients.

Patients with chronic pain on opioid therapy used more analgesics (mean, SD) during the first 72 hours postoperatively vs opioid-naïve patients without chronic pain.

Figure 2.; Response to use of nonsteroidal analgesics. *Ibuprofen and celecoxib, respectively, were considered analgesics separately. †There was no information available about the choice of patient by better response to NSAID or placebo used. Data represent the number of patients who did not make use of supplementary rescue analgesia.
Fábio Wildson Gurgel Costa,
Diego Felipe Silveira Esses,
Paulo Goberlânio de Barros Silva,
Francisco Samuel Rodrigues Carvalho,
Carlos Diego Lopes Sá,
Assis Filipe Medeiros Albuquerque,
Tácio Pinheiro Bezerra,
Thyciana Rodrigues Ribeiro,
Cristiane Sá Roriz Fonteles, and
Eduardo Costa Studart Soares
Figure 2.
Figure 2.

Response to use of nonsteroidal analgesics. *Ibuprofen and celecoxib, respectively, were considered analgesics separately. †There was no information available about the choice of patient by better response to NSAID or placebo used. Data represent the number of patients who did not make use of supplementary rescue analgesia.

Figure 2; Analgesic efficacy. This graph illustrates a typical dose-response curve for orally administered (PO) analgesics. The dose-response curve for opioids such as morphine demonstrates unlimited efficacy in which greater doses provide greater analgesia. At equipotent doses, all opioids demonstrate a similar dose response. In contrast, nonopioids demonstrate a “ceiling” effect that generally is adequate for relief of mild to moderate pain (pain relief rating of 4–5 in this scale). For ibuprofen, doses greater than 400 mg do not provide further analgesia. For aspirin (ASA) and acetaminophen (APAP), this ceiling effect is achieved at 1000 mg and is somewhat lower than that provided by nonsteroidal anti-inflammatory drugs (NSAIDs).
Daniel E. Becker
Figure 2
Figure 2

Analgesic efficacy. This graph illustrates a typical dose-response curve for orally administered (PO) analgesics. The dose-response curve for opioids such as morphine demonstrates unlimited efficacy in which greater doses provide greater analgesia. At equipotent doses, all opioids demonstrate a similar dose response. In contrast, nonopioids demonstrate a “ceiling” effect that generally is adequate for relief of mild to moderate pain (pain relief rating of 4–5 in this scale). For ibuprofen, doses greater than 400 mg do not provide further analgesia. For aspirin (ASA) and acetaminophen (APAP), this ceiling effect is achieved at 1000 mg and is somewhat lower than that provided by nonsteroidal anti-inflammatory drugs (NSAIDs).