Efficacy of Ketoprofen With or Without Omeprazole for Pain And Inflammation Control After Third Molar Removal

Abstract

In view of the gastrointestinal problems generated by the ketoprofen use, the ketoprofen association with omeprazole is available on the market. However, this association efficacy in acute pain control has not been established. Bilateral extraction of lower third molars in similar positions is currently the most used model for the evaluation and investigation of the efficacy and pharmacological effects of new compounds for the treatment of acute postoperative pain. The randomized and crossover study consisted in evaluating the clinical efficacy of therapy performed by ketoprofen 100 mg (twice daily-b.i.d.) versus ketoprofen 200 mg + omeprazole 20 mg (once daily-q.d.) to pain, swelling and trismus control in the bilateral extraction model of lower third molars in similar positions in two different appointments, in 50 volunteers. Volunteers reported significantly less postoperative pain at various post-operative periods and consumed less rescue analgesic medication (acetaminophen 750 mg) throughout the study when they took the combination of ketoprofen 200 mg + omeprazole 20 mg (q.d.). Following administration of both study drugs, no gastrointestinal adverse reactions were reported by volunteers. Furthermore, the evaluations of the drugs in pain control by the volunteers were significantly favorable to ketoprofen 200 mg + omeprazole 20 mg (q.d.). For swelling and trismus control, the treatments presented similar results. In conclusion, when volunteers took ketoprofen 200 mg + omeprazole 20 mg (q.d.), they reported significantly less postoperative pain at various post-surgical periods and consumed less rescue analgesic medication throughout the study compared with ketoprofen 100 mg (b.i.d).

Multifocal Analysis of Acute Pain After Third Molar Removal

“…Briefly, 210 adults (≥18 years old) out of 300 were selected to participate in this study of unilateral lower third molar extraction after analysis of their panoramic radiograph (Weckwerth et al, 2016;Simoneti et al, 2018;Weckwerth et al, 2020), according to dental indications, such as orthodontic, endodontic and periodontal problems. All volunteers should have similar lower third molar position and similar degree of impaction according to Pell and Gregory's classification in order to provide similar tissue trauma during surgery (Simoneti et al, 2018); this information can be assessed on Table 1. Additionally, per the inclusion criteria, volunteers could not have systemic diseases, which could interfere in the study, and the extraction sites could not have inflammation or infection.…”

“…An additional 0.9 ml of local anesthetic (half of a cartridge) was administered around the soft tissue of lower third molar to reduce bleeding and ensure mucosal anesthesia (Zupelari-Goncalves et al, 2017). After anesthesia block, the surgical procedure was started (Calvo et al, 2012;Weckwerth et al, 2016;Zupelari-Goncalves et al, 2017;Simoneti et al, 2018) and surgeries that were very traumatic due the quantity of osteotomies and tooth sectioning, with duration of more than 40 min and additional complementation of anesthesia were excluded of the study since these patients could present more pain, swelling and trismus than the other patients. Hence, these were excluded from the study and received different dosage of medication.…”

“…Rescue medication (750 mg acetaminophen tablets) was also provided; volunteers could consume this medication to supplement the ibuprofen effect every 8 h, if they fell the necessity. Visual analog scale (VAS, 0-100 mm) Overall experience of surgery reported by volunteer in the 7th postoperative day 5-Point scale: 1) "poor"; 2) "fair"; 3) "good"; 4) "very good"; 5) "excellent" Evaluation of postoperative pain was determined using a visual analogue scale (VAS, 0-100 mm) with 0 mm indicating no pain and 100 mm indicating the worst possible pain, as previously described (Trindade et al, 2012;Simoneti et al, 2018). Volunteers recorded their postoperative pain using the VAS at the following time points after the surgical procedure: 0, 0.25, 0.5, 0.75, 1, 1.…”

Efficacy of Pre-Operative Submucosal Injection of Dexamethasone in Mandibular Third Molar Surgery: A Randomized Control Trial

“…5 There are various measures to alleviate the pain, swelling and trismus which includes application of cold or heat, oral or intravenous non-steroidal anti inflammatory agents (NSAIDs), corticosteroids. 6 Many researchers suggested use of local injection of steroid to overcome post-operative inflammation of surrounding tissue. [7][8][9] However, use of local or systemic steroid have some side-effects such as risk of infection, hyperglycemia and suppression of immune system.…”

“…NAIEM AHMED 1 , OMPRAKASH YADAV* 2 , SWATI JOSHI ASOPA 3 , MANJU PANWAR 4 , AARIF KHAN 5 , MAHENDRA BURI6 …”