Analgesic and anti-inflammatory dose–response relationship of 7.5 and 15mg meloxicam after lower third molar removal: a double-blind, randomized, crossover study

The selective and non-selective cyclooxygenase inhibitors valdecoxib and piroxicam induce the same postoperative analgesia and control of trismus and swelling after lower third molar removal

“…The patients received a regional anesthetic blockade of buccal, lingual and inferior alveolar nerves with 1.8 mL 4% articaine with 1:100,000 adrenaline (5,6). When anesthesia of the lower lip was achieved, an additional 0.9 mL of the same anesthetic was infiltrated into the mucosa in order to guarantee hemostasis and anesthesia at the site (5,6). The removal of third molars followed a standard surgical technique.…”

“…Rescue analgesic medication was available to any patient as needed throughout the study; for this purpose, 750 mg paracetamol was provided to all patients (5,6). Patients recorded the date and time when rescue medication was taken.…”

“…The following parameters were assessed: duration of the surgery after anesthetic administration (in minutes), which corresponded to the period between the first incision and the last suture (2,5,6); subjective postoperative pain evaluation with the aid of a 100-mm length visual analogue scale, with 0 corresponding to "no pain" and 100 corresponding to "worst pain imaginable" (5,6,13); subjects recorded the intensity of postoperative pain at 15-min intervals for the first 60 postoperative minutes, and 1.5, 2, 3, 4, 5, 6, 7, 8, 10, 12, 16, 24 (6,13,25), 48, 72, and 96 h (6) after the end of surgery; mouth opening (distance, in mm, between the mesial-incisal corners of the upper and lower right central incisors at maximum opening of the jaws) before surgery and at the time of suture removal (7 days postoperatively); the postoperative ability to open the mouth was expressed as a percentage of the preoperative measure (2,5,6); incidence, type and severity of adverse reactions (gastrointestinal irritation, nausea, vomiting, bleeding, allergy, headache, dizziness, sleepiness, and any other kinds of reaction) (5,6,13); total amount of rescue analgesic medication (paracetamol, in mg) needed during the postoperative period, and facial swelling determined by a tape-measuring method on the 2nd and 7th postoperative days (2). This method takes V. Benetello et al…”

“…Several non-steroidal anti-inflammatory drugs (NSAIDS) have been used for pain, trismus and swelling control after lower third molar surgeries (2)(3)(4)(5)(6). The therapeutic effect of these medications is based on the inhibition of cyclooxygenases (COX), which determines an inhibition of prostaglandin production (7).…”

Effect of preoperative prednisolone on clinical postoperative symptoms after surgical extractions of mandibular third molars

“…Postoperative pain, swelling, and trismus can be reduced via the membrane-stabilizing anti-exudative effect of corticosteroids and by inhibiting cyclooxygenase with an NSAID. [9][10][11][12][13][14][15][16][17][18][19][20] Steroids can be prescribed in conjunction with NSAIDs, and the combination of corticosteroids and NSAIDs has proved to be well suited to the treatment of postoperative pain, trismus, and swelling after dental surgical procedures. 21,22 Nevertheless, there are potential complications associated with perioperative corticosteroid use, 23 and standardized dosage and administration methods for steroids during third molar surgery have yet to be established.…”