PDF herunterladen
CC BY 4.0 · Eur J Dent 2022; 16(02): 396-402
DOI: 10.1055/s-0041-1735910
Original Article

Single-Dose Ibuprofen-Arginine as a Preventive for Pain, Edema, and Trismus After Impacted Lower Third Molar Surgery: A Randomized Split-Mouth Clinical Trial

Edith Umasi Ramos
1   Department of Surgery and Integrated Clinic, Division of Oral and Maxillofacial Surgery, São Paulo State University, Araçatuba Dental School, Araçatuba, São Paulo, Brazil
,
Luan Pier Benetti
1   Department of Surgery and Integrated Clinic, Division of Oral and Maxillofacial Surgery, São Paulo State University, Araçatuba Dental School, Araçatuba, São Paulo, Brazil
,
Júlio César Silva Oliveira
1   Department of Surgery and Integrated Clinic, Division of Oral and Maxillofacial Surgery, São Paulo State University, Araçatuba Dental School, Araçatuba, São Paulo, Brazil
,
Ana Paula Farnezi Bassi 
1   Department of Surgery and Integrated Clinic, Division of Oral and Maxillofacial Surgery, São Paulo State University, Araçatuba Dental School, Araçatuba, São Paulo, Brazil
› Institutsangaben Funding None.
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Objective We examined if the association of ibuprofen with arginine has a better anti-inflammatory effect on pain, edema, and trismus after surgery of the impacted mandibular third molar than ibuprofen alone.

Materials and Methods The study included 21 patients, 18 to 30 years of age, each with an impacted, and bilateral and symmetric third molar (total n = 21) that required transalveolar extraction. Patients were randomly assigned numbers from 1 to 21. Group A received ibuprofen-arginine as preoperative medication, while Group B received only ibuprofen. Both groups received the same postoperative medications: amoxicillin + acetaminophen. All patients were evaluated for pain at 6, 12, and 24 hours. They were evaluated for edema and trismus before surgery; immediately after surgery; and at 24, 48, and 72 hours postoperatively. Postoperative pain scores used the visual analog scale (BS-11). For facial edema and trismus, linear measurements used the method modified by Gabka and Matsumura.

Statistical Analysis For the evaluation of data between Group A and Group B, we used the statistical software SPSS version 22. The Shapiro-Wilk, analysis of variance, the Bonferroni comparisons, and the Wilcoxon test were used. All tests were based on a significance level of 0.05.

Results The study results reveal that the facial edema scores of Group A and Group B presented statistically significant differences (p < 0.05), while for postoperative trismus, there was no statistically significant difference (p > 0.05) between the scores of Group A and Group B.

Conclusion As a conclusion, we can state that the use of ibuprofen-arginine allows for significantly better control of pain and edema, and shows a tendency toward better recovery from trismus, although without statistical significance. Based on this, we can assert that arginine improves the anti-inflammatory power of ibuprofen, thus generating better tissue healing after surgery of the impacted third molar.

Keywords

arginine - ibuprofen - third molar - pain - edema


Publikationsverlauf

Artikel online veröffentlicht:
22. Dezember 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Mahmoud Hashemi H, Mohammadi F, Hasheminasab M, Mahmoud Hashemi A, Zahraei S, Mahmoud Hashemi T. Effect of low-concentration povidone iodine on postoperative complications after third molar surgery: a pilot split-mouth study. J Oral Maxillofac Surg 2015; 73 (01) 18-21
    CrossrefPubMedGoogle Scholar
  • 2 Kim K, Brar P, Jakubowski J, Kaltman S, Lopez E. The use of corticosteroids and nonsteroidal antiinflammatory medication for the management of pain and inflammation after third molar surgery: a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107 (05) 630-640
    CrossrefPubMedGoogle Scholar
  • 3 Koray M, Ofluoglu D, Onal EA. et al. Efficacy of hyaluronic acid spray on swelling, pain, and trismus after surgical extraction of impacted mandibular third molars. Int J Oral Maxillofac Surg 2014; 43 (11) 1399-1403
    CrossrefPubMedGoogle Scholar
  • 4 Jaroń A, Preuss O, Konkol B, Trybek G. Quality of life of patients after kinesio tape applications following impacted mandibular third molar surgeries. J Clin Med 2021; 10 (10) 2197
    CrossrefPubMedGoogle Scholar
  • 5 Jaroń A, Preuss O, Grzywacz E, Trybek G. The impact of using kinesio tape on non-infectious complications after impacted mandibular third molar surgery. Int J Environ Res Public Health 2021; 18 (02) 1-13
    CrossrefPubMedGoogle Scholar
  • 6 Chukwuneke F, Onyejiaka N. Management of postoperative morbidity after third molar surgery: a review of the literature. Niger J Med 2007; 16 (02) 107-112
    CrossrefPubMedGoogle Scholar
  • 7 Isiordia-Espinoza MA, Bologna-Molina RE, Hernández-Miramontes YA. et al. Pharmacological control of complications following to third molar removal: evidence based on a meta-analysis. Drug Res (Stuttg) 2019; 69 (01) 5-11
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 8 Maulina T, Diana H, Cahyanto A, Amaliya A. The efficacy of curcumin in managing acute inflammation pain on the post-surgical removal of impacted third molars patients: a randomised controlled trial. J Oral Rehabil 2018; 45 (09) 677-683
    CrossrefPubMedGoogle Scholar
  • 9 Mehra P, Reebye U, Nadershah M, Cottrell D. Efficacy of anti-inflammatory drugs in third molar surgery: a randomized clinical trial. Int J Oral Maxillofac Surg 2013; 42 (07) 835-842
    CrossrefPubMedGoogle Scholar
  • 10 Weiser T, Richter E, Hegewisch A, Muse DD, Lange R. Efficacy and safety of a fixed-dose combination of ibuprofen and caffeine in the management of moderate to severe dental pain after third molar extraction. Eur J Pain 2018; 22 (01) 28-38
    CrossrefPubMedGoogle Scholar
  • 11 Black P, Max MB, Desjardins P, Norwood T, Ardia A, Pallotta T. A randomized, double-blind, placebo-controlled comparison of the analgesic efficacy, onset of action, and tolerability of ibuprofen arginate and ibuprofen in postoperative dental pain. Clin Ther 2002; 24 (07) 1072-1089
    CrossrefPubMedGoogle Scholar
  • 12 Cattaneo D, Clementi E. Clinical pharmacokinetics of ibuprofen arginine. Curr Clin Pharmacol 2010; 5 (04) 239-245
    CrossrefPubMedGoogle Scholar
  • 13 Benites BD, Olalla-Saad ST. An update on arginine in sickle cell disease. Expert Rev Hematol 2019; 12 (04) 235-244
    CrossrefPubMedGoogle Scholar
  • 14 Wang L, Li J, Wang C. et al. Effect of N-carbamoylglutamate supplementation on the growth performance, antioxidant status and immune response of mirror carp (Cyprinus carpio) fed an arginine-deficient diet. Fish Shellfish Immunol 2019; 84: 280-289
    CrossrefPubMedGoogle Scholar
  • 15 Qi C, Wang X, Han F. et al. Arginine supplementation improves growth, antioxidant capacity, immunity and disease resistance of juvenile Chinese mitten crab, Eriocheir sinensis. Fish Shellfish Immunol 2019; 93 (May): 463-473
    CrossrefPubMedGoogle Scholar
  • 16 Jaroń A, Trybek G. The pattern of mandibular third molar impaction and assessment of surgery difficulty: a retrospective study of radiographs in east baltic population. Int J Environ Res Public Health 2021; 18 (11) 6016
    CrossrefPubMedGoogle Scholar
  • 17 Ali AS, Benton JA, Yates JM. Risk of inferior alveolar nerve injury with coronectomy vs surgical extraction of mandibular third molars-A comparison of two techniques and review of the literature. J Oral Rehabil 2018; 45 (03) 250-257
    CrossrefPubMedGoogle Scholar
  • 18 Aznar-Arasa L, Harutunian K, Figueiredo R, Valmaseda-Castellón E, Gay-Escoda C. Effect of preoperative ibuprofen on pain and swelling after lower third molar removal: a randomized controlled trial. Int J Oral Maxillofac Surg 2012; 41 (08) 1005-1009
    CrossrefPubMedGoogle Scholar
  • 19 Daniels SE, Goulder MA, Aspley S, Reader S. A randomised, five-parallel-group, placebo-controlled trial comparing the efficacy and tolerability of analgesic combinations including a novel single-tablet combination of ibuprofen/paracetamol for postoperative dental pain. Pain 2011; 152 (03) 632-642
    CrossrefPubMedGoogle Scholar
  • 20 Antunes AA, Avelar RL, Martins Neto EC, Frota R, Dias E. Effect of two routes of administration of dexamethasone on pain, edema, and trismus in impacted lower third molar surgery. Oral Maxillofac Surg 2011; 15 (04) 217-223
    CrossrefPubMedGoogle Scholar
  • 21 Silva de Oliveira JC, Grossi de Oliveira GA, Bassi APF. Comparative assessment of the effect of ibuprofen and etodolac on edema, trismus, and pain in lower third molar surgery: a randomized clinical trial. J Oral Maxillofac Surg 2016; 74 (08) 1524-1530
    CrossrefPubMedGoogle Scholar
  • 22 Kapse S, Surana S, Satish M, Hussain SE, Vyas S, Thakur D. Autologous platelet-rich fibrin: can it secure a better healing?. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127 (01) 8-18
    CrossrefPubMedGoogle Scholar
  • 23 Ong KS, Seymour RA, Chen FG, Ho VCL. Preoperative ketorolac has a preemptive effect for postoperative third molar surgical pain. Int J Oral Maxillofac Surg 2004; 33 (08) 771-776
    CrossrefPubMedGoogle Scholar
  • 24 Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain 1986; 27 (01) 117-126
    Google Scholar
  • 25 Ustun Y, Erdogan O, Esen E, Karsli ED. Comparison of the effects of 2 doses of methylprednisolone on pain, swelling, and trismus after third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003; 96 (05) 535-539 doi:10.1016/S1079210403004645
    CrossrefPubMedGoogle Scholar
  • 26 Landim FS, Laureano Filho JR, Nascimento J, do Egito Vasconcelos BC. Effectiveness of nicotine patch for the control of pain, oedema, and trismus following third molar surgery: a randomized clinical trial. Int J Oral Maxillofac Surg 2020; 49 (11) 1508-1517
    CrossrefPubMedGoogle Scholar
  • 27 Bouloux GF, Steed MB, Perciaccante VJ. Complications of third molar surgery. Oral Maxillofac Surg Clin North Am 2007; 19 (01) 117-128 , vii
    CrossrefPubMedGoogle Scholar
  • 28 Freudlsperger C, Deiss T, Bodem J, Engel M, Hoffmann J. Influence of lower third molar anatomic position on postoperative inflammatory complications. J Oral Maxillofac Surg 2012; 70 (06) 1280-1285
    CrossrefPubMedGoogle Scholar
  • 29 Zhou J-B, Wu Y-H, Zhang S-C, Wang M, Han Y. [Clinical evaluation of mandibular impacted third molar removed without surgical flaps]. Shanghai Kou Qiang Yi Xue 2020; 29 (02) 221-224
    PubMedGoogle Scholar
  • 30 Glera-Suárez P, Soto-Peñaloza D, Peñarrocha-Oltra D, Peñarrocha-Diago M. Patient morbidity after impacted third molar extraction with different flap designs. A systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal 2020; 25 (02) e233-e239
    PubMedGoogle Scholar
  • 31 Torre LF, Patricia N, Laura D, Alonso-castro ÁJ, Rivera-luna F, Isiordia-espinoza MA. A meta-analysis of the analgesic efficacy of single-doses of ibuprofen compared to traditional non-opioid analgesics following third molar surgery. 2021; DOI: 10.3390/ph14040360.
    CrossrefPubMedGoogle Scholar
  • 32 Weckwerth GM, Dionísio TJ, Costa YM. et al. CYP450 polymorphisms and clinical pharmacogenetics of ibuprofen after lower third molar extraction. Eur J Clin Pharmacol 2021; 77 (05) 697-707
    CrossrefPubMedGoogle Scholar
  • 33 Shin D, Lee SJ, Ha YM. et al. Pharmacokinetic and pharmacodynamic evaluation according to absorption differences in three formulations of ibuprofen. Drug Des Devel Ther 2017; 11: 135-141
    CrossrefPubMedGoogle Scholar
  • 34 Lau SL, Chow RLK, Yeung RWK, Samman N. Pre-emptive ibuprofen arginate in third molar surgery: a double-blind randomized controlled crossover clinical trial. Aust Dent J 2009; 54 (04) 355-360
    CrossrefPubMedGoogle Scholar
  • 35 Desjardins P, Black P, Papageorge M. et al. Ibuprofen arginate provides effective relief from postoperative dental pain with a more rapid onset of action than ibuprofen. Eur J Clin Pharmacol 2002; 58 (06) 387-394
    CrossrefPubMedGoogle Scholar
  • 36 Bjørnsson GA, Haanaes HR, Skoglund LA. A randomized, double-blind crossover trial of paracetamol 1000 mg four times daily vs ibuprofen 600 mg: effect on swelling and other postoperative events after third molar surgery. Br J Clin Pharmacol 2003; 55 (04) 405-412
    CrossrefPubMedGoogle Scholar