Comparison of Efficacy of Aceclofenac and Ibuprofen After Surgical Removal of Impacted Third Molar

Abstract

BACKGROUND The removal of impacted mandibular third molar is one of the most frequently performed oral surgical procedure, which leads to severe pain and swelling owing to trauma and inflammation of soft tissue and bone. The quality of life after lower third molar surgery is affected three times more in patients with pain, swelling and trismus alone or in combinations. Postoperative pain after third molar surgery is often used as a model to test the efficacy of analgesics. Despite existence of several studies, no analgesics has won the certificate of excellence and the quest is still on to find out a better agent in this aspect. MATERIALS AND METHODS The present study was aimed at evaluating ibuprofen and aceclofenac, among 100 patients regarding the individual efficacies and to compare between the two drugs in reducing postoperative facial swelling, pain and trismus after removal of mandibular third molars. The patients were randomly divided into two groups to receive either ibuprofen 400 mg (Group A, n = 50) or aceclofenac 100 mg (Group B, n = 50), each drug 8 th hourly for three days postoperatively. Facial swelling, pain and mouth opening scores were recorded on the first, second, fifth and seventh postoperative days. RESULTS Both the drugs were found to be effective in controlling postoperative facial swelling, pain and mouth opening compared with their own baseline measurements. Relief of pain and trismus were found better in patients receiving ibuprofen (400 mg) compared with aceclofenac (100 mg), while control of facial swelling was found comparable between the groups. CONCLUSION The study concludes that both ibuprofen (400 mg) and aceclofenac (100 mg) are effective in controlling postoperative swelling, pain and trismus after surgical removal of impacted lower-third molars. Ibuprofen is better than aceclofenac in alleviation of pain and trismus. Control of facial swelling is comparable with the use of both drugs. A dose-response study and evaluation of different drug formulations of these molecules are warranted in such surgical setting in future.

Effect of preemptive intravenous ibuprofen on postoperative edema and trismus in third molar tooth extraction: A randomized controlled study

“…Osunde et al [ 14 ] observed that age, sex, and surgical difficulty level had no effect on the limitation of mouth opening, which was in agreement with the findings of the present study. Agarwal et al [ 12 ] reported that the use of ibuprofen 400 mg resulted in better relief of trismus compared to aceclofenac. Similarly, Jain et al [ 9 ] stated that the general recovery was better in patients treated with ibuprofen.…”

“…Over the years, various techniques have used in an attempt to measure the edema objectively. The measurement tools mentioned in the literature include standardized stereo radiography or photography measurements, computed tomography, linear measurement, use of Vernier calipers for measuring the cheek circumference, modified face-holding devices, ultrasonography, facial plethysmographs, or various direct face-taking methods [ 12 ]. The comparative superiority or accuracy of any techniques used in edema analysis have not been proven.…”

“…However, while this is valid for oral ibuprofen, the effect of preemptive intravenous ibuprofen on trismus and edema has not been investigated. In the study by Agarwal et al [ 12 ], ibuprofen and aceclofenac were effective in controlling edema on the face. Similarly, Troullos et al [ 15 ] reported that ibuprofen improved the patients' recovery by limiting the edema when administered in both preoperative and postoperative periods.…”

“…The power of the study was calculated by considering 10 mm as a reference based on previous study [ 12 ]. In this study, the difference between the face edema measured in the preoperative period and postoperative day 2 was 16 mm.…”