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

Abstract

BackgroundThis study aimed to evaluate the anti-inflammatory efficacy of preemptive intravenous ibuprofen on inflammatory complications such as edema and trismus in patients undergoing impacted mandibular third molar surgery.MethodsSixty patients were included and divided into three groups (800 mg IV ibuprofen + 50 mg dexketoprofen, 800 mg IV ibuprofen, and control). In all patients, preoperative hemodynamic values were recorded before the infusions. The operation was started at 15-min post-infusion. Evaluation of edema size on the face and mouth opening (trismus) was conducted in the preoperative period, and at postoperative 48 h and 1 week.ResultsNo difference was determined among the groups in trismus and edema size in postoperative measurements (P > 0.05). There was a difference between group 2 and group 3 only in measurement value of tragus-corner of the mouth on the postoperative day 2 (P < 0.05). A difference was found between the measurement values of trismus preoperatively and at preoperative day 2, and between postoperative day 2 and 1 week in group 3 based on time (P < 0.05). In group 3, edema on the face on postoperative day 2 increased significantly compared to that in the preoperative period (P < 0.001); in addition, edema increased significantly in groups 1 and 2 in the postoperative period but was less than that in group 3 (P < 0.001).ConclusionsIn this study, intravenous ibuprofen was determined to be more effective alone or in combination in alleviating trismus and to better limit the postoperative edema.

Pre-emptive analgesic efficacy of injected ketorolac in comparison to other agents for third molar surgical removal: a systematic review

“…Propionic acid derivatives Ibuprofen [9,[12][13][14]39,47,48], ketoprofen [27], Dexketoprofen [26,28].…”

“…Intravenous Ibuprofen [9,[12][13][14], acetaminophen [13], dipyrone [16], tramadol [23,32,37,38], dexamethasone [24], dexketoprofen [28], tenoxicam [29], methylprednisolone [29], lornaxicam [31], ketotolac [32,49], diclofenac [37]. 4.…”

Mandibular Third Molar Postoperative Complications – A Brief Review

“…Pain and swelling are the most common features in third molar surgery or any dental extraction, and these factors frequently discourage patients from undergoing dental procedures. [5][6][7] The mechanism is due to the release of pain mediators related to the injured tissues; where these mediators are released as a part of inflammatory process, causing pain and tenderness. The mediators are categorized as vascular and neural.…”

“…Other uncommon injuries include the injury of the lingual nerve. 6,7 The learning outcome of the study is to understand the possible complications when extracting mandibular third molars.…”

Persistent trismus following mandibular third molar extraction and its management: A case report and literature review

“…The primary causes include elevation of flap beyond the external oblique ridge, low-grade infection following local anesthesia and repeated stimulation of the medial pterygoid muscle (inferior alveolar nerve block), as well as other causes (2). The symptom of trismus is alleviated by the post-operative local injection of dexamethasone (3,4). Generally, trismus is gradually alleviated or disappears within approximately 1 to 2 weeks post-operatively; however, in very rare cases, trismus persists for >1 month.…”