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Mandibular trauma trials need more pain outcomes, quality of life reporting

Greater attention needs to be paid to the assessment of postoperative pain within studies on treatment of mandibular fractures, according to researchers in JAMA Facial Plastic Surgery.

Researchers searched PubMed/MEDLINE, EMBASE, Cochrane CENTRAL, and clinicaltrials.gov for randomized clinical trials of mandibular fracture management in patients older than 16 years..

They identified 38 trials encompassing 1,808 patients.

The procedures included maxillomandibular fixations 16% of the studies, open reduction with internal fixation in 53% and both in 32% of patients.

Only five of the 38 studies reported the specific analgesics prescribed. Three used a combination of nonsteroidal anti-inflammatory drugs and acetaminophen (paracetamol).

Pain assessments were reported in 13 studies and five included quality-of-life measures.

High pain attentiveness scores were found in studies from Asia and Europe.

The researchers explained that reporting pain levels during postoperative care provides guidance for surgeons on how long analgesics should be used/required.

This type of disclosure would allow surgeons to better dose patients without under- or overprescribing.

None of the trials reported opioid use.

According to the researchers, patients with mandibular fractures are more likely to be impoverished or have mental illness, more likely to be malnourished and abuse alcohol, tobacco, or illicit drugs than patients undergoing other orofacial procedures.

In conclusion, the researchers encouraged providing more patient-centered outcomes like oral health-related quality of life instruments to improve care in this patient population. – by Abigail Sutton

Disclosure: The researchers reported no relevant financial disclosures.