Efficacy and safety of combined piroxicam, dexamethasone, orphenadrine, and cyanocobalamin treatment in mandibular molar surgery

Abstract

Third molar extraction is a common procedure frequently accompanied by moderate or severe pain, and involves sufficient numbers of patients to make studies relatively easy to perform. The aim of the present study was to determine the efficacy and safety of the therapeutic combination of 10 mg piroxicam, 1 mg dexamethasone, 35 mg orphenadrine citrate, and 2.5 mg cyanocobalamin (Rheumazin ® ) when compared with 20 mg piroxicam alone (Feldene ® ) in mandibular third molar surgery. Eighty patients scheduled for removal of the third molar were included in this randomized and double-blind study. They received (vo) Rheumazin or Feldene 30 min after tooth extraction and once daily for 4 consecutive days. Pain was determined by a visual analogue scale and by the need for escape analgesia (paracetamol). Facial swelling was evaluated with a measuring tape and adverse effects and patient satisfaction were recorded. There was no statistically significant difference in facial swelling between Rheumazin and Feldene (control group). Both drugs were equally effective in the control of pain, with Rheumazin displaying less adverse effects than Feldene. Therefore, Rheumazin appears to provide a better risk/ benefit ratio in the mandibular molar surgery. Since the side effects resulting from nonsteroidal anti-inflammatory drug administration are a severe limitation to the routine use of these drugs in clinical practice, our results suggest that Rheumazin can be a good choice for third molar removal treatment.

Use of Dietary Supplements in Patients Seeking Treatment at a Periodontal Clinic

“…These few studies have shown that micronutrients (vitamin D and the B vitamins) [23,24,25] and macronutrients (DHA and eicosapentaenoic acid (EPA)) [26,27] can improve patient recovery following periodontal therapy. Being vitamin D sufficient (serum 25(OH)D > 50 nmol/L) before open flap debridement surgery resulted in greater clinical attachment levels and reductions in probing depths post-surgery than patients with lower levels of serum 25(OH)D [23].…”

“…Likewise, patients receiving access flap surgery experienced better clinical attachment levels when treated post-operatively with a vitamin-B complex (50 mg thiamine HCl, riboflavin, niacinamide, d -calcium pantothenate, pyridoxine HCl; 50 μg d -biotin, cyanocobalamin; 400 μg folate) [24]. Vitamin B12 as a component of post-surgical medication also resulted in less patient pain at 6 and 120 h post third molar extraction than in control patients [25]. In patients requiring sanative therapy, a combination of acetylsalicylic acid (81 mg) and fish oil (containing 900 mg DHA and EPA) decreased probing depths while increasing clinical attachment and reducing levels of salivary RANKL and MMP-8, markers of inflammation [26].…”

Use of diffusion‐ordered NMR spectroscopy and HPLC–UV–SPE–NMR to identify undeclared synthetic drugs in medicines illegally sold as phytotherapies

“…When used in dentistry, this drug was found to have similar pain relief properties as Feldene, which consists of piroxicam alone. [37] However, Rheumazin is an unregistered drug in Brazil, [38] because of insufficient studies of its therapeutic efficacy, safety, and quality. [39] Its sale is therefore prohibited, although it continues to be sold illegally.…”

Dietary Strategies to Optimize Wound Healing after Periodontal and Dental Implant Surgery: An Evidence-Based Review

“…Few intervention studies have investigated if and how specific dietary components modulate oral wound healing [2-5] (Table 1 ). One study showed that vitamin B12 supplementation resulted in lower pain scores at 6 and 120 hours post-extraction with no effect on facial swelling [2].…”

“…One study showed that vitamin B12 supplementation resulted in lower pain scores at 6 and 120 hours post-extraction with no effect on facial swelling [2]. Among patients undergoing surgical removal of an oral tumor, a selenium supplement was associated with a reduction in associated-lymphedema [3].…”