Single-Dose Ibuprofen-Arginine as a Preventive for Pain, Edema, and Trismus After Impacted Lower Third Molar Surgery: A Randomized Split-Mouth Clinical Trial

单剂量布洛芬-精氨酸预防下颌阻生第三磨牙拔除术后疼痛、水肿和张口受限:一项随机分口临床试验

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Abstract

OBJECTIVE:  We examined if the association of ibuprofen with arginine has a better anti-inflammatory effect on pain, edema, and trismus after surgery of the impacted mandibular third molar than ibuprofen alone. MATERIALS AND METHODS:  The study included 21 patients, 18 to 30 years of age, each with an impacted, and bilateral and symmetric third molar (total n = 21) that required transalveolar extraction. Patients were randomly assigned numbers from 1 to 21. Group A received ibuprofen-arginine as preoperative medication, while Group B received only ibuprofen. Both groups received the same postoperative medications: amoxicillin + acetaminophen. All patients were evaluated for pain at 6, 12, and 24 hours. They were evaluated for edema and trismus before surgery; immediately after surgery; and at 24, 48, and 72 hours postoperatively. Postoperative pain scores used the visual analog scale (BS-11). For facial edema and trismus, linear measurements used the method modified by Gabka and Matsumura. STATISTICAL ANALYSIS:  For the evaluation of data between Group A and Group B, we used the statistical software SPSS version 22. The Shapiro-Wilk, analysis of variance, the Bonferroni comparisons, and the Wilcoxon test were used. All tests were based on a significance level of 0.05. RESULTS:  The study results reveal that the facial edema scores of Group A and Group B presented statistically significant differences (p < 0.05), while for postoperative trismus, there was no statistically significant difference (p > 0.05) between the scores of Group A and Group B. CONCLUSION:  As a conclusion, we can state that the use of ibuprofen-arginine allows for significantly better control of pain and edema, and shows a tendency toward better recovery from trismus, although without statistical significance. Based on this, we can assert that arginine improves the anti-inflammatory power of ibuprofen, thus generating better tissue healing after surgery of the impacted third molar.

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