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Effect of NSAIDs, melatonin, vitamin D and vitamin B12 chronotherapy on postoperative recovery after third molar surgical extraction: A pilot randomized crossover placebo-controlled trial.

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NSAID chronotherapy after impacted third molar extraction: a randomized controlled trial.

Zaid Tamimi1, Mohammad Abusamak2, Haider Al-Waeli3

  • 1Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan. zztamimi@just.edu.jo.

Oral and Maxillofacial Surgery
|January 22, 2022
PubMed
Summary

Reducing nighttime ibuprofen doses after third molar surgery may be sufficient for pain management. This study found no significant difference in pain or healing with a reduced, daytime-only nocturnal dose regimen.

Keywords:
ChronotherapyDrug chronotherapyMolarNSAIDsPain managementThirdTooth extraction

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Pharmacology
  • Pain Management

Background:

  • Postoperative pain significantly impacts patient recovery and quality of life.
  • Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, are commonly prescribed post-surgery.
  • Circadian rhythms influence pain and inflammation, suggesting optimized drug timing.

Purpose of the Study:

  • To investigate if nighttime administration of ibuprofen is necessary after surgical third molar extraction.
  • To evaluate the efficacy of a reduced ibuprofen dosing schedule on postoperative pain and healing.

Main Methods:

  • A double-blind, placebo-controlled randomized clinical trial was conducted.
  • Seventy participants received either a standard ibuprofen regimen (8 AM, 1 PM, 8 PM) or a reduced regimen (8 AM, 1 PM, placebo at 8 PM) for three days.
  • Pain was assessed using Visual Analog Scale (VAS), alongside measurements of facial swelling, mouth opening, and C-reactive protein levels.

Main Results:

  • Postoperative pain demonstrated a circadian variation, peaking at night.
  • No statistically significant differences were found in pain scores between the standard and reduced ibuprofen groups.
  • Healing indicators, including facial swelling and mouth opening, also showed no significant differences between groups.

Conclusions:

  • Postoperative pain exhibits a circadian pattern, with increased intensity at night.
  • Nighttime ibuprofen administration does not appear to offer significant benefits for pain management or inflammation control after third molar surgery.
  • A reduced dosing schedule of two daily doses of ibuprofen may be sufficient for effective postoperative pain management.