Aim: To manage postoperative discomfort following the avulsion of the mandibular third molar, many strategies have been developed for minimizing clinical manifestations after surgery through a pharmacological approach. The objective of this study was to compare the efficacy of celecoxib and ibuprofen in reducing postoperative sequelae following the surgical removal of impacted mandibular third molars. Materials: Ninety-eight patients requiring the surgical removal of a mandibular third molar were randomly assigned to receive a placebo (group 1, 32 patients), ibuprofen (group 2, 33 patients), and celecoxib (group 3, 33 patients). Drugs were administered after tooth extraction twice a day for 5 days. The primary outcome, pain, was evaluated using a visual analogue scale at 30 min, 2 h, 6 h, 12 h, 24 h, 48 h, and 7 and 10 days after surgery. Postoperative pain intensity was measured using a 10-cm visual analogue scale (VAS), which consisted of an interval scale ranging from 0 (absence of pain or discomfort) to 10 (maximum pain or discomfort). The secondary outcomes were the changes in maximum mouth opening and facial contours (mm) between baseline and at 24 h, 72 h, and 5, 7, and 10 days after surgery. The maximum mouth opening was measured in millimeters between the upper and lower central incisors using a calibrated sliding caliper (Therabite Range of Motion Scales), preoperatively (baseline) and at 24 and 72 h and 7 days after surgery. Results: Compared to the baseline, all treatments demonstrated an improvement in the primary and secondary outcomes. Compared to placebo, treatment with celecoxib and ibuprofen resulted in improvements in the primary outcome. Furthermore, when compared to the other groups, patients in the celecoxib group showed a significant reduction in postoperative pain scores at 6 h (P < 0.001), 12 h (P = 0.011), and 24 h (P = 0.041) after surgery. Measurements of the facial distances, recorded pre- and postoperatively to determine the degree of swelling in the study groups, did not differ between the three groups at any of the observation time points (P > 0.05). Moreover, the maximum mouth opening values did not differ significantly between the treatment groups at any of the observation time points (P > 0.05). Conclusions: This study suggests that celecoxib used as postoperative therapy after third molar surgery shows favorable effects in the management of perioperative pain compared to ibuprofen and placebo. Celecoxib was found to be safe and simple to use in the postsurgical management of discomfort following third molar surgery.

Effectiveness of ibuprofen and celecoxib on the management of pain and postsurgical inflammatory sequelae following third molar surgery: a randomized, controlled clinical trial

Leonardi R;Ferlito S;Isola G
Ultimo
2020-01-01

Abstract

Aim: To manage postoperative discomfort following the avulsion of the mandibular third molar, many strategies have been developed for minimizing clinical manifestations after surgery through a pharmacological approach. The objective of this study was to compare the efficacy of celecoxib and ibuprofen in reducing postoperative sequelae following the surgical removal of impacted mandibular third molars. Materials: Ninety-eight patients requiring the surgical removal of a mandibular third molar were randomly assigned to receive a placebo (group 1, 32 patients), ibuprofen (group 2, 33 patients), and celecoxib (group 3, 33 patients). Drugs were administered after tooth extraction twice a day for 5 days. The primary outcome, pain, was evaluated using a visual analogue scale at 30 min, 2 h, 6 h, 12 h, 24 h, 48 h, and 7 and 10 days after surgery. Postoperative pain intensity was measured using a 10-cm visual analogue scale (VAS), which consisted of an interval scale ranging from 0 (absence of pain or discomfort) to 10 (maximum pain or discomfort). The secondary outcomes were the changes in maximum mouth opening and facial contours (mm) between baseline and at 24 h, 72 h, and 5, 7, and 10 days after surgery. The maximum mouth opening was measured in millimeters between the upper and lower central incisors using a calibrated sliding caliper (Therabite Range of Motion Scales), preoperatively (baseline) and at 24 and 72 h and 7 days after surgery. Results: Compared to the baseline, all treatments demonstrated an improvement in the primary and secondary outcomes. Compared to placebo, treatment with celecoxib and ibuprofen resulted in improvements in the primary outcome. Furthermore, when compared to the other groups, patients in the celecoxib group showed a significant reduction in postoperative pain scores at 6 h (P < 0.001), 12 h (P = 0.011), and 24 h (P = 0.041) after surgery. Measurements of the facial distances, recorded pre- and postoperatively to determine the degree of swelling in the study groups, did not differ between the three groups at any of the observation time points (P > 0.05). Moreover, the maximum mouth opening values did not differ significantly between the treatment groups at any of the observation time points (P > 0.05). Conclusions: This study suggests that celecoxib used as postoperative therapy after third molar surgery shows favorable effects in the management of perioperative pain compared to ibuprofen and placebo. Celecoxib was found to be safe and simple to use in the postsurgical management of discomfort following third molar surgery.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11769/486879
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