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AuthorTamimi, Zaid
AuthorAbusamak, Mohammad
AuthorAl-Waeli, Haider
AuthorAl-Tamimi, Mohammad
AuthorAl Habashneh, Rola
AuthorGhanim, Mohammad
AuthorAl-Nusair, Mohammed
AuthorGao, Qiman
AuthorNicolau, Belinda
AuthorTamimi, Faleh
Available date2022-05-16T04:39:01Z
Publication Date2022-01-01
Publication NameOral and Maxillofacial Surgery
Identifierhttp://dx.doi.org/10.1007/s10006-021-01029-8
CitationTamimi, Z., Abusamak, M., Al-Waeli, H. et al. NSAID chronotherapy after impacted third molar extraction: a randomized controlled trial. Oral Maxillofac Surg (2022). https://doi.org/10.1007/s10006-021-01029-8
ISSN18651550
URIhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85123255222&origin=inward
URIhttp://hdl.handle.net/10576/30900
AbstractObjectives: Postoperative pain management impacts patients’ quality of life and morbidity. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are widely used for this following a 3-doses-per-day regime. However, pain and inflammation follow a circadian rhythm, and animal models assessing the scheduling of NSAID administration (e.g., chronotherapy) have shown that while their use during the active phase of the day enhances postoperative recovery, their administration during the resting phase could have detrimental effects. This observation has led us to hypothesize that night administration of NSAID might be unnecessary in post-surgical scenarios. Therefore, a randomized clinical trial was conducted to test this hypothesis in surgical third molar extractions. Materials and methods: Seventy (18–35 years) healthy participants requiring surgical removal of impacted lower third molars were recruited and randomized into a double-blind placebo-controlled study. For three days postoperatively, the treatment group (n = 33) received ibuprofen (400 mg) at 8 AM, 1 PM, and a placebo at 8 PM, while the control group (n = 37) received ibuprofen (400 mg) at 8 AM, 1 PM, and 8 PM. Pain severity was assessed by visual analog scale (VAS) and healing indicators including facial swelling, mouth opening, and C-reactive protein blood levels were also measured. Results: Pain VAS measures showed a circadian variation peaking at night. Also, no significant differences were observed between the two groups of the study in terms of postoperative pain scores (estimate: 0.50, 95% CI = [− 0.38, 1.39]) or any other healing indicator. Conclusions: Postoperative pain follows a circadian rhythm. Moreover, night administration of ibuprofen might not provide any significant benefits in terms of pain management and control of inflammation, and two doses during the day only could be sufficient for pain management after surgical interventions. Knowledge transfer statement: Even though this study cannot rule out the possibility that a reduced regime is different than a standard regime, nocturnal doses of ibuprofen seem to have no clinical significance in the short term, and the results of this study provide evidence in favor of reducing ibuprofen administration from three doses to two doses only after third molar surgery.
SponsorThis study was funded by Jordan University of Science and Technology in Irbid, Jordan (funding number: 20170307).
Languageen
PublisherSpringer
SubjectChronotherapy
Drug chronotherapy
Molar
NSAIDs
Pain management
Third
Tooth extraction
TitleNSAID chronotherapy after impacted third molar extraction: a randomized controlled trial
TypeArticle
ESSN1865-1569
dc.accessType Full Text


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