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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">myrwd</journal-id><journal-title-group><journal-title xml:lang="ru">Реальная клиническая практика: данные и доказательства</journal-title><trans-title-group xml:lang="en"><trans-title>Real-World Data &amp; Evidence</trans-title></trans-title-group></journal-title-group><issn pub-type="epub">2782-3784</issn><publisher><publisher-name>Publishing House OKI</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.37489/2782-3784-myrwd-088</article-id><article-id custom-type="edn" pub-id-type="custom">LDBQXN</article-id><article-id custom-type="elpub" pub-id-type="custom">myrwd-120</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>СИСТЕМАТИЧЕСКИЙ ОБЗОР И МЕТААНАЛИЗ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>SYSTEMATIC REVIEW AND META-ANALYSIS</subject></subj-group></article-categories><title-group><article-title>Анальгетики в современной стоматологической практике: эволюция обезболивания</article-title><trans-title-group xml:lang="en"><trans-title>Analgesics in modern dental practice: the evolution of pain relief</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0002-9947-6457</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мкртичян</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Mkrtichyan</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Мкртичян Артём Альбертович — аспирант, кафедра фармакологии и доказательной медицины</p><p>Санкт-Петербург</p></bio><bio xml:lang="en"><p>Artem A. Mkrtichyan — postgraduate student, Department of Pharmacology and Evidence-Based Medicine</p><p>Saint Petersburg</p></bio><email xlink:type="simple">aa@berlinstoma.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет имени академика И. П. Павлова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>First Saint Petersburg State Medical University named after Academician I. P. Pavlov</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>25</day><month>12</month><year>2025</year></pub-date><volume>5</volume><issue>4</issue><fpage>48</fpage><lpage>59</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Мкртичян А.А., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Мкртичян А.А.</copyright-holder><copyright-holder xml:lang="en">Mkrtichyan A.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.myrwd.ru/jour/article/view/120">https://www.myrwd.ru/jour/article/view/120</self-uri><abstract><p>Цель исследования заключалась в проведении систематического обзора современных подходов к анальгетической терапии в стоматологической практике на основе научных публикаций последнего десятилетия. В работе рассмотрены основные группы анальгетических препаратов, применяемых в стоматологии, включая нестероидные противовоспалительные средства, опиоидные анальгетики, местные анестетики и их комбинации. Особое внимание уделено механизмам действия различных классов препаратов, их эффективности и профилю безопасности при использовании у различных категорий пациентов. Проанализированы современные тенденции в области мультимодальной анальгезии, персонализированных подходов к обезболиванию с учётом индивидуальных особенностей пациентов, возрастных групп и сопутствующей патологии. Рассмотрены инновационные технологии доставки лекарственных средств, включая наносомальные формы, пролонгированные системы высвобождения и трансдермальные системы. Представлены данные о применении искусственного интеллекта и цифровых технологий для оптимизации анальгетической терапии. Систематический обзор выполнен с использованием методологии PRISMA на основе анализа 42 источников, отобранных из 1247 первично идентифицированных публикаций в международных базах данных. Результаты исследования демонстрируют эволюцию подходов к обезболиванию в стоматологии от универсальных протоколов к персонализированной медицине. Показана важность комбинированного применения различных групп анальгетиков для достижения оптимального соотношения эффективности и безопасности. Выявлены перспективные направления развития анальгетической терапии, связанные с интеграцией достижений молекулярной биологии, нанотехнологий и цифровых технологий в клиническую практику стоматологов.</p></abstract><trans-abstract xml:lang="en"><p>This study systematically analyzed the current approaches to analgesic therapy in dental practice based on scientific publications of the last decade. This study examined the main groups of analgesic medications used in dentistry, including nonsteroidal anti-inflammatory drugs, opioid analgesics, local anesthetics, and their combinations. Particular attention is paid to the mechanisms of action of various classes of medications, their efficacy, and safety profiles when used in various patient categories. The current trends in multimodal analgesia and personalized pain relief approaches tailored to individual patient characteristics, age groups, and comorbidities are analyzed. Innovative drug delivery technologies, including nanosomal formulations, extended-release systems, and transdermal systems, are considered. Data on the use of artificial intelligence and digital technologies to optimize analgesic therapy are presented. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, and 42 sources selected from 1,247 initially identified publications in international databases were analyzed. The results of this study demonstrate the evolution of approaches to dental pain relief from universal protocols to personalized medicine. This study demonstrated the importance of combining different analgesic groups to achieve an optimal balance of efficacy and safety. Promising areas for developing analgesic therapy related to the integration of advances in molecular biology, nanotechnology, and digital technologies into dental clinical practice are identified.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>анальгетики</kwd><kwd>стоматологическая практика</kwd><kwd>обезболивание</kwd><kwd>нестероидные противовоспалительные средства</kwd><kwd>местная анестезия</kwd><kwd>опиоидные анальгетики</kwd><kwd>мультимодальная анальгезия</kwd><kwd>персонализированная медицина</kwd><kwd>болевой синдром</kwd><kwd>стоматологические вмешательства</kwd><kwd>безопасность лекарств</kwd><kwd>инновационные технологии доставки препаратов</kwd></kwd-group><kwd-group xml:lang="en"><kwd>analgesics</kwd><kwd>dental practice</kwd><kwd>pain relief</kwd><kwd>nonsteroidal anti-inflammatory drugs</kwd><kwd>local anesthesia</kwd><kwd>opioid analgesics</kwd><kwd>multimodal analgesia</kwd><kwd>personalized medicine</kwd><kwd>pain syndrome</kwd><kwd>dental interventions</kwd><kwd>drug safety</kwd><kwd>innovative drug delivery technologies</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Лильеберг Р.Э. 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