Bilateral surgical removal of impacted lower third molar teeth as a model for drug evaluation: A test with ibuprofen

Abstract

It was considered that double-blind crossover studies of therapeutic efficacy after acute injury could well be done in patients who required surgical removal of impacted wisdom teeth from both sides of the lower jaw. In the present trial 24 healthy patients received either placebo or ibuprofen (Brufen: 400 mg three times daily), a non-steroidal anti-inflammatory agent, for 5 days commencing the day before surgery. Treatments were given on the two occasions when impacted wisdom teeth were to be removed from one side or other of the lower jaw. A number of objective and subjective parameters were recorded for paired comparison of the post-operative courses, including swelling, trismus and pain. A mechanical device which allows simple and accurate measurement of cheek swelling is described. On the 1st, 3rd and 5th post-operative days in the ibuprofen group the measured swelling averaged 93, 89 and 82%, respectively, of that in the placebo group; the corresponding alpha-values were 0.35, 0.06 and 0.07. Patients with less swelling after ibuprofen were not always those with a high serum concentration of the drug. Ibuprofen significantly reduced pain on the day of the operation. This may at least partly account for less trismus and the preference of the patients for their post-operative courses with ibuprofen. Examination of various haematological parameters did not reveal any significant difference between the two operations. Subjective scores indicated that neither wound-healing nor bleeding was affected by ibuprofen, nor were any side effects detected.

Clinical trial evaluating the effectiveness of biocompound IMMUNEPOTENT CRP in the third-molar extraction

“…The presence of INF-g, IL-10, IL-4 and IL-6 could play a role in the process of tissue repair, chemotaxis and control of inflammation because the healing process was successful in the patients who participated in our study. Similar results have been reported in the control of cytokines and pro-inflammatory metabolites in other studies of the inflammatory model with ibuprofen [5,6]. In the present study, the inflammatory response caused by cytokines was evaluated in the saliva, which is a representative fluid of the local microenvironment next to the area of the surgery.…”

“…For control of postoperative pain and trismus resulting from lower third-molar surgery, some non-steroidal antiinflammatory drugs (NSAIDs) are generally used [3,4]. Among NSAIDs used in dentistry, ibuprofen, a non-selective COX inhibitor with a highly effective analgesic and anti-inflammatory action, has been largely studied [5][6][7]. However, many NSAIDs have side effects, such as gastrointestinal irritation, ulcers and bleeding, and can also aggravate some inflammatory responses [8,9].…”

Hemodynamic Behavior in Third Molar Surgeries Using Lidocaine or Articaine

“…The surgical technique and the surgeon should be the same for all procedures, and the patients should be carefully selected to ensure similar trauma during both surgical operations (Lökken et al, 1975). It is also important to highlight that the results of the present study were obtained with identical volumes of both of the anesthetic solutions used (5.4 ml), thereby minimizing any bias, as was the case in earlier studies (Colombini et al, 2006;Santos et al, 2007;Vasconcellos et al;de Morais et al, 2012a).…”

Prostaglandins and bone: potential risks and benefits related to the use of nonsteroidal anti-inflammatory drugs in clinical dentistry

“…Based on clinical postoperative assessment, some surgeons have reported no significant difference in the rate of bone healing following administration of ibuprofen (48), aspirin, diclofenac (49) and flurbiprofen (50). Regarding these clinical observations, Godden (51) contested a previous recommendation by Stone and Richards (52) that more clinical trials would be required to confirm or refute the alleged harmful effects of NSAIDs on bone healing.…”