Abstract
This study focused on the clinical evaluation of naproxen and ibuprofen efficacy on pain, swelling and trismus after surgical removal of impacted mand-ibular third molar, whether they used only pre–operatively or pre– and post–opera-tively. The number of patients included in the present study was 40, divided into four groups: Each group is 10 patients, the first group received naproxen as sodium 1hour pre-operatively followed by three times daily for five days post–operatively. Whereas the second group received naproxen as sodium three times daily for five days begins 1hour post–operatively. However, the third group had been given ibuprofen 1hour pre–operatively followed by three times daily for five days post–operatively. The fourth group administered ibuprofen three times daily for five days begins 1hour post–operatively.The pain was evaluated by the number of paracetamol tablets taken by the patients recorded on the pocket chart, whereas the swelling was measured subjectively. The trismus was evaluated by measuring the maximum mouth opening between the incisal edges of the maxillary and mandi-bular central incisors using the graduated vernier.The results showed that the use of naproxen as sodium 1hour pre–operatively minimized the pain, swelling and trismus significantly compared to ibuprofen.
Highlights
Removal of either partially or completely impacted third molars involve trauma to soft tissue and bone, which results in post–operative inflammation, significant pain, swelling and trismus
The cause of trismus is due to inf-luence on the muscle by post–operative edema developed in adjacent tissue[2] and surgical trauma to masticatory mus-cles mainly the masseter one.[3]. Many approaches have been made to overcome or at least to reduce the severity of post-operative problems and localize the extend of inflammatory process
Prostaglandin E2 plays an important role in the inflammatory process and immune response causing long lasting vasodilatation accompanied by increased vascular permeability.[12]. Prostaglandin are not stored in large amount in the body in contrast to other biologically active compounds but rather are synthesized immediately before they release
Summary
Removal of either partially or completely impacted third molars involve trauma to soft tissue and bone, which results in post–operative inflammation, significant pain, swelling and trismus. The cause of trismus is due to inf-luence on the muscle by post–operative edema developed in adjacent tissue[2] and surgical trauma to masticatory mus-cles mainly the masseter one.[3] Many approaches have been made to overcome or at least to reduce the severity of post-operative problems and localize the extend of inflammatory process. That trials were made to achieve such goals either by using medicaments as antibiotics[4] or glucocorticosteroids which found to exert universal effect on inflammatory process,(5) antihistamine was showed to reduce the extend of inflammatory process,(6) non–steroidal anti–inflammatory drugs (NSAIDs) were used.[7,8] Vogel et al[9] reported that the NSAIDs, are becoming part of preoperative analgesic regimens to reduce post surgical pain and swelling, in that giving single dose immediately before an invasive procedure rather than prescribing the NSAIDs only after the pain become significant. When ibuprofen is given following surgery, their blood level will be reached before peak prostaglandin level.[13]
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