Effectiveness of Multimodal Pain Management Protocolsin Oral and Maxillofacial Surgical Procedures
Multimodal analgesia, oral and maxillofacial surgery, implantology, opioid-sparing anaesthesia, postoperative pain
European Journal of Prosthodontics and Restorative Dentistry (2026) 34(3s), 39–49
Effectiveness of Multimodal Pain Management Protocols Dr. Sukriti Tripathi Reader, Department of Oral Medicine & Dental Radiology, Specialisation in Oral Medicine & Dental in Oral and Maxillofacial Radiology, SGT Dental College, Hospital, and Research Institute, Gurugram, Haryana-122505, India, Surgical Procedures Email ID: drsukrititripathi@gmail.com
AuthorsAbstractPain during the first postoperative period of oral and maxillofacial surgery has long been the primary obstacle to immediate functional healing and predictable restorative processes, especially in implantology and those that involve prosthodontics. This comprehensive review synthesizes contemporary evidence on multimodal pain management strategies that address the multifactorial biology of postoperative pain, including inflammatory mediator release, peripheral and central sensitization, and selected neuropathic pain mechanisms. Pharmacological components reviewed include non-opioid analgesics, optimized local and regional anaesthesia techniques, perioperative corticosteroids, centrally acting adjuvants in selected high-risk scenarios, and opioid-sparing or opioid-free anaesthetic pathways. Adjunctive non-pharmacological measures, such as cryotherapy, photo-biomodulation, platelet concentrates, enhanced recovery principles, and patient-centred digital follow-up, are examined for their roles in improving comfort and supporting early return to function. Procedurespecific considerations are emphasized for flapless guided full-arch rehabilitation, open-flap implant placement, sinus augmentation, zygomatic implant surgery, and peri-implant soft tissue management, where surgical invasiveness and biomaterial-tissue interactions influence pain trajectories. Risk stratification is highlighted for elderly and medically compromised patients, individuals receiving antiplatelet therapy, opioid-tolerant patients, and those with heightened perioperative anxiety. Newer technologies, such as algorithm-based clinical pathways, artificial intelligence-based decision support, and novel biomaterials or targeted delivery platforms, are described as the means of more accurate, opioid-sparing analgesics. Collectively, a structured, patient-centred multimodal approach offers a practical framework to improve postoperative comfort, reduce opioid exposure, and align analgesic strategy with restorative outcomes in contemporary oral and maxillofacial practice. 1. Introduction Oral and maxillofacial surgical (OMFS) procedures are central to the modern rehabilitation of prosthodontic, placement of implants, treatment of pathology and reconstructive procedures. These processes often entail significant handling of both the osseous and soft tissues, which causes acute postoperative pain that can affect the ability to masticate, phonate, and sleep, as well as the quality of recovery.1 There is an ongoing surge in the demand for OMFS services across the globe, especially in low and middle-income countries, where delayed access to care can lead to more complex surgery interventions and, therefore, postoperative morbidity. 2 Inefficient pain management not only has consequences for patient distress. Pain after surgery can disrupt oral hygiene maintenance, undermine nutritional eating, slow down the process of rehabilitation of the prosthesis, and even lead to the occurrence of secondary complications, such as surgical-site infections.3 Proper management of pain during the perioperative period is thus the key to the short-term effects of recovery and long-term restorative effects. The conventional OMFS postoperative pain management has regularly depended on the unimodal •••••••••••••••••••••••••••••••• ejprd.org- Published by Riset Publishing Services LLC.
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