Post-operative Pain Control with Resolvin E1 and Lipoxin A4 Releasing Scaffold Following Periradicular Surgery

Abstract

Mechanical allodynia is a critical indicator of pain hypersensitivity following surgical procedures. The mechanisms underlying mechanical allodynia typically involve nerve fiber sensitization and alterations in pain processing, making it an essential target for therapeutic intervention to enhance patient outcomes post-surgery. Traditional pain management strategies, such as the use of analgesics and anti-inflammatory agents, frequently fail to provide sufficient relief and are associated with various side effects, underscoring the need for novel and more effective treatment approaches. This study aimed to assess the impact of hydrogel-based treatments on mechanical allodynia in rats that underwent mandibular osseous surgery. The Von Frey filament test was used to measure mechanical allodynia at baseline, Day 4, and Day 7 post-surgery. Fifteen rats were divided into three groups: Hydrogel (HG), Hydrogel + TCP (HG+TCP), and Hydrogel + Specialized Pro-Resolving Mediators (HG+SPM). Statistical analyses, including one-way ANOVA followed by multiple comparisons and area under the curve (AUC) analysis, revealed a significant reduction (p 0.05) in mechanical allodynia on Day 4 in the HG+SPM group compared to both the HG (p = 0.032) and HG+TCP (p = 0.041) groups. While the HG and HG+TCP groups showed moderate increases in mechanical allodynia over time, the HG+SPM group exhibited a marked reduction, as confirmed by AUC analysis. The inclusion of SPM in the hydrogel formulation likely contributed to this decrease, with SPM’s known role in resolving inflammation and promoting tissue homeostasis as a potential mechanism. These findings suggest that specialized pro-resolving mediators may enhance post-operative pain management by modulating inflammation and facilitating faster tissue recovery. Although the anti-inflammatory benefits of SPM have been well-documented in other medical fields, further research is needed to explore their clinical applications in dentistry, particularly in endodontic microsurgery, where managing post-operative pain after periradicular surgery continues to be a significant challenge.