Observational study of the use of Symphytum 5CH in the management of pain and swelling after dental implant surgery

Objective: To assess the effect of Symphytum 5CH on the postoperative pain and swelling after placement of a titanium dental implant.

Material and methods: Data on pain and swelling following pure titanium implants were reviewed. Patients were treated postoperatively with ketoprofen only or ketoprofen and Symphytum 5CH, according to the treating dentist's usual practice. Demographics and baseline characteristics were recorded and compared. Pain and swelling were compared between the two treatment groups using the Wilcoxon rank sum test and ordinal logistic regression, estimating odds ratios and confidence intervals.

Results: 100 implants in 57 patients (28 males, 29 females) were treated with ketoprofen alone; 100 implants in 60 patients (14 males, 46 females) with ketoprofen and Symphytum. The group treated with ketoprofen and Symphytum appeared to have a better response in terms of both pain and swelling. Ordinal logistic regression: pain 0.23, 95% CI 0.13–0.41; swelling 0.24, 95% CI 0.13–0.44. Correction for demographics and implant characteristics greatly widened the confidence intervals so that the results were no longer statistically significant (pain: OR = 0.15, 95% CI 0.07–34.56; swelling OR = 0.18, 95% CI 0.07–46.78).

Conclusions: Adding Symphytum 5CH to conventional analgesia may reduce pain and swelling after minor dental implant surgery. No firm conclusion can be drawn since the results are confounded by baseline differences, principally gender. Further, randomized, studies should be conducted.

Keywords

Dental implant - Observational study - Pain - Swelling - Homeopathy - Symphytum

• References

• 1 Adell R., Eriksson B., Lekholm U., Brånemark P.I., Jemt T. Long term follow-up study of osseointegrated implants in the treatment of totally edentulous jaws. Int J Oral Maxillofac Implants 1990; 5: 347-359.
• 2 Buser D., Mericske-Stern R., Bernard J.P. et al. Long-term evaluation of non-submerged ITI implants. Part 1: 8-year life table analysis of a prospective multi-center study with 2359 implants. Clin Oral Implants Res 1997; 8: 161-172.
• 3 Faehn O., Siddiqui A.A., Lazzara R., Feldman S. A four-year retrospective study of 3i threaded implants. Aust Prosthodont J 1995; 9: 9-15.
• 4 Hellem S., Karlsson U., Almfeldt I., Brunell G., Hamp S.E., Astrand P. Nonsubmerged implants in the treatment of the edentulous lower jaw: a 5-year prospective longitudinal study of ITI hollow screws. Clin Implant Dent Relat Res 2001; 3: 20-29.
• 5 Chiapasco M., Gatti C., Rossi E., Haefliger W., Markwalder T.H. Implant-retained mandibular overdentures with immediate loading. A retrospective multicenter study on 226 consecutive cases. Clin Oral Implants Res 1997; 8: 48-57.
• 6 Brånemark P.I., Engstrand P., Ohrnell L.O. et al. Brånemark Novum: a new treatment concept for rehabilitation of the edentulous mandible. Preliminary results from a prospective clinical follow-up study. Clin Implant Dent Relat Res 1999; 1: 2-16.
• 7 Dajani A.S., Taubert K.A., Wilson W. et al. Prevention of bacterial endocarditis. Recommendations by the American Heart Association. JAMA 1997; 277: 1794-1801.
• 8 Lawler B., Sambrook P.J., Goss A.N. Antibiotic prophylaxis for dentoalveolar surgery: is it indicated?. Aust Dent J 2005; 50 (4 Suppl. 2): S54-S59.
• 9 Mazzocchi A., Passi L., Moretti R. Retrospective analysis of 736 implants inserted without antibiotic therapy. J Oral Maxillofac Surg 2007; 65: 2321-2323.
• 10 Sakakura C.E., Neto R.S., Bellucci M., Wenzel A., Scaf G., Marcantonio Jr. E. Influence of homeopathic treatment with Comfrey on bone density around titanium implants. A digital subtraction radiography study in rats. Clin Oral Implants Res 2008; 19: 624-628.
• 11 Punzo A. Homeopathic medicine: an overview with specific applications for the orthopaedic patient. Tech Orthop 2003; 18: 54-61.
• 12 Albrektsson T., Zarb G., Worthington P., Eriksson A.R. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1986; 1: 11-25.
• 13 Agresti A. Categorical data analysis. New York: John Wiley & Sons; 1990. pages xv + 558.
• 14 Thornhill M.H., Dayer M.J., Forde J.M. et al. Impact of the NICE guideline recommending cessation of antibiotic prophylaxis for prevention of infective endocarditis: before and after study. BMJ 2011; 3: 342 d2392.
• 15 Laskin D.M., Dent C.D., Morris H.F., Ochi S., Olson J.W. The influence of preoperative antibiotics on success of endosseous implants at 36 months. Ann Periodontol 2000; 5: 166-174.
• 16 Andrade R.J., Lucena M.I., Fernández M.C. et al. Drug-induced liver injury: an analysis of 461 incidences submitted to the Spanish registry over a 10-year period. Gastroenterology 2005; 129: 512-521.
• 17 Kaczmarzyk T. Abuse of antibiotic prophylaxis in third molar surgeries. J Oral Maxillofac Surg 2009; 67: 2551-2552.
• 18 American Dental Association Council on Scientific Affairs. Combating antibiotic resistance. J Am Dent Assoc 2004; 135: 484-487.
• 19 Esposito M., Coulthard P., Oliver R., Thomsen P., Worthington H.V. Antibiotics to prevent complications following dental implant treatment. Cochrane Database Syst Rev 2003 (03): CD004152 Update in: Cochrane Database Syst Rev 2008; (3): CD004152.
• 20 Pjetursson B.E., Tan K., Lang N.P., Brägger U., Egger M., Zwahlen M. A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clin Oral Implants Res 2004; 15: 625-642.
• 21 Kreissl M.E., Gerds T., Muche R., Heydecke G., Strub J.R. Technical complications of implant-supported fixed partial dentures in partially edentulous cases after an average observation period of 5 years. Clin Oral Implants Res 2007; 18: 720-726.
• 22 Alsaadi G., Quirynen M., Komárek A., van Steenberghe D. Impact of local and systemic factors on the incidence of late oral implant loss. Clin Oral Implants Res 2008; 19: 670-676.
• 23 Siddiqi A., Payne A.G., De Silva R.K., Duncan W.J. Titanium allergy: could it affect dental implant integration?. Clin Oral Implants Res 2011; 22: 673-680.
• 24 Mohabbat O., Younos M.S., Merzad A.A., Srivastava R.N., Sediq G.G., Aram G.N. An outbreak of hepatic veno-occlusive disease in north-western Afghanistan. Lancet 1976; 2: 269-271.
• 25 Ridker P.M., Ohkuma S., McDermott W.V., Trey C., Huxtable R.J. Hepatic venocclusive disease associated with the consumption of pyrrolizidine-containing dietary supplements. Gastroenterology 1985; 88: 1050-1054.
• 26 Al-Ouf K., Salti L. Postinsertion pain in region of mandibular dental implants: a case report. Implant Dent 2011; 20: 27-31.
• 27 Vermeulen F. Prisma, the arcane of Materia Medica illuminated. Haarlem: Hemryss Pub; 2002.
• 28 Tyler M.L. Homeopathic drug pictures. New Delhi: B. Jain Publishers; 1997. (reprint of the original first published in 1943).
• 29 Duprat H. Théorie et technique homéopathiques. Paris: Edition Similia; 1988. (reprint of the original first published in 1932).
• 30 Voisin H. Thérapeutique et répertoire homéopathiques du praticien. Paris: Maloine & Les Laboratoires Homéopathiques de France; 1979.
• 31 Koll R., Buhr M., Dieter R. et al. Efficacy and tolerance of a Comfrey root extract (Extr. Rad. Symphyti) in the treatment of ankle distorsions: results of a multicenter, randomized, placebo-controlled, double-blind study. Phytomedicine 2004; 11: 470-477.
• 32 Predel H.G., Giannetti B., Koll R., Bulitta M., Staiger C. Efficacy of a Comfrey root extract ointment in comparison to a diclofenac gel in the treatment of ankle distortions: results of an observer-blind, randomized, multicenter study. Phytomedicine 2005; 12: 707-714.
• 33 Kucera M., Barna M., Horácek O., Kováriková J., Kucera A. Efficacy and safety of topically applied Symphytum herb extract cream in the treatment of ankle distortion: results of a randomized controlled clinical double blind study. Wien Med Wochenschr 2004; 154: 498-507.
• 34 Bach N., Thung S.N., Schaffner F. Comfrey herb tea-induced hepatic veno-occlusive disease. Am J Med 1989; 87: 97-99.
• 35 Rode D. Comfrey toxicity revisited. Trends Pharmacol Sci 2002; 23: 497-499.