A single blind, randomized prospective controlled clinical trial to study the effect of ibuprofen as a pre-emptive analgesic agent in impacted third molar post extraction pain

Background: Surgical removal of impacted third molar involves manipulation of both hard and soft tissues,(1) and is associated with postoperative complications like pain, swelling and trismus. Analgesics are routinely given after surgical removal of third molar for three to five days.(2) Aim of the study was to know whether analgesics given preoperatively will reduce the post-operative pain and the amount of analgesic requirement. Materials and Methods: This study was conducted in Department of Oral Maxillofacial Surgery of Mathikere Sampangi Ramaiah Dental College and Hospital Bangalore, India. 30 Patients requiring surgical extraction of impacted mandibular third molar were enrolled in the study. Patients were divided into group 1 (pre-emptive group) and group 2 (postoperative group) comprising of fifteen patients each. To group1 oral Ibuprofen-400mg tablet was administered 1 hour prior to the procedure and for group 2 oral Ibuprofen-400 mg tablets was administered 1 hour after the procedure. The first effective dosing time was obtained and the time taken for the first onset of postoperative pain and the influence of these analgesic administration times on post-operative pain, and clinical recovery was evaluated. Results: Pre-emptive use of Ibuprofen 400mg was effective in reducing postoperative pain, discomfort and number of analgesics required and also delayed the usual early in setting of post-operative pain. Conclusion: Pre-emptive Ibuprofen tablets of 400mg dosage can be used to reduce the severity of the post-operative squeal of the impacted mandibular third molar surgery.