The Efficacy of Ketorolac Buccal Infiltration Following Surgical Removal of The Impacted Mandibular Third Molar on Postoperative Pain and Trismus

Abstract

Surgical extraction of the mandibular third molars are widely carried out in dental practice. The procedure is associated with postoperative complications such as pain and trismus. Objective: The study aimed to assess ketorolac's analgesic and anti-inflammatory efficacy after surgical extraction of the mandibular third molar. Methods: The study was designed as a double-blinded, randomized prospective clinical study in which 44 patients who required surgical removal of an impacted mandibular third molar were included. They were randomly distributed into two groups (the study and the control/placebo groups), with 22 patients in each group. Immediately after the last stitch, the study group received 30mg/1 ml of ketorolac, while the control group received 1 ml of normal saline at the buccal mucosa near the extraction site of both groups. The mouth openings of the patients were recorded preoperatively, and on the 2nd and 7th postoperative days, a comparison between the two groups was made. The pain level was assessed postoperatively using the numeric rating scale. Results: The comparison between the two groups by pain score showed that there was a statistically significant difference (P = 0.001) in postoperative pain between the study and control groups at all times after the operation. Regarding the trismus, there was no significant difference (p>0.05) between both groups on the 2nd and 7th postoperative days. Conclusion: Ketorolac buccal infiltration is effective for postoperative pain following third molar surgery but has no significant effect on trismus.