Effects of 15 mg meloxicam administered before odontectomy on pain, facial edema, trismus, and expressions of TNF following odontectomy of impacted mandibular third molar
Abstract
Objective:To evaluate the effects of 15 mg meloxicam administered 60 minutes before odontectomy on pain, facial edema, trismus and expressions of TNF-α after odontectomy of impacted mandibular third molar.Material and Methods: A total of 24 patients were randomized into treatment groups, each with 12 patients: Group A was administered with 15 mg of meloxicam; and Group B with placebo. Drugs were administered orally 60 minutes prior to surgery. Observation of pain (seen from VAS scores), facial edema (seen from swollen cheeks), trismus (seen from mouth opening) and expressions of TNF-α (measured from saliva by ELISA method), performed before odontectomy, H+1 (24 hours after odontectomy) and H+3 (72 hours after odontectomy).Results: Patients who received 15 mg meloxicam 60 minutes before odontectomy showed less postoperative pain (p=0.000), less facial edema (p=0.000) and lower expressions of TNF-α (p=0.000). No differences were found in mouth opening between the meloxicam group and placebo group (p=0.522). The higher level of TNF-α level will lead to higher level of pain, greater facial edema and causes smaller mouth opening.Conclusion: Oral administration of 15 mg meloxicam 60 minutes prior to odontectomy was found more effective in reducing pain, facial edema and expressions of TNF-α after odontectomy of impacted mandibular third molar compared with placebo.
Section
References
- Fragiskos FD. Oral Surgery, Berlin: Springer Verlag; 2007.
- p. 31-41, 95-200.
- Muhajir I, Yusuf HY, Riawan L. Correlation between
- swelling post odontectomy in lower third molar with the
- increase of concentration alpha amylase saliva. Int J Sci Res
- ;9: 870-873.
- Gutiérrez-Corrales A, Campano-Cuevas E, Castillo-Dalà G,
- et al. Relationship between salivary biomarkers and postoperative swelling after the extraction of impacted lower third
- molars. Int J Oral Maxillofac Surg 2017;46: 243-249.
- Orozco-SolÃs M, GarcÃa-Ãvalos Y, Pichardo-RamÃrez C,
- et al. Single dose of diclofenac or meloxicam for control of
- pain, facial swelling, and trismus in oral surgery. Med Oral
- Patol Oral Cir Bucal 2016;21: e127-34.
- Aznar-Arasa L, Harutunin K, Figueiredo R, et al. Effect of
- preoperative ibuprofen on pain and swelling after lower
- third molar removal: a randomized controlled trial. Int J
- Oral Maxillofac Surg 2012;41: 1005-1009.
- Albuquerque AFM, Fonteles CSR, do-Val DR, et al. Effect
- of pre-emptive analgesia on clinical parameters and tissue
- levels Of TNF-α And IL-1β in third molar surgery: a
- triple-blind, randomized, placebo controlled study. Int J
- Oral Maxillofac Surg 2017;46: 1615-1625.
- Veleska-Stevkovska D. Cytokines (IL-1, TNF-α, IL-6)
- and oral surgery interventions. Balk J Stom 2010;14:
- -132.
- Dhingra AK, Chopra B, Dua JS, et al. New insight on
- inflammation and its management: a review. J Innov
- Pharm Biol Sci 2017;4: 117-126.
- Gunaydin C, Bilge SS. Effects of nonsteroidal antiinflammatory drugs at the molecular level. Eurasian J Med
- ;50: 116-21.
- Euller-Ziegler L, Velicitat P, Bluhmki E, et al. Meloxicam:
- a review of its pharmacokinetics, efficacy and tolerability
- following intramuscular administration, inflamm. Res
- ;50: S5-S9.
- Calvo AM, Sakai VT, Giglio FPM, et al. Analgesic and
- anti-inflammatory dose–response relationship of 7.5
- and 15 mg meloxicam after lower third molar removal:
- a double-blind, randomized, crossover study. Int J Oral
- Maxillofac Surg 2007;36: 26-31.
- Del-Tacca MD, Colucci R, Fornai M, et al. Efficacy and
- tolerability of meloxicam, a cox-2 preferential nonsteroidal anti-inflammatory drug, a review. Clin Drug Invest
- ;22: 799-818.
- De Menezes SA, Cury PR. Effcacy of nimesulide versus
- meloxicam in the control of pain, swelling and trismus
- following extraction of impacted lower third molar. Int J
- Oral Maxillofac Surg 2010;39: 580-584.
- Sudarshan RSG, Venkataraghavan K. Management of
- postoperative pain and swelling following mandibular
- third molar surgery with newer drugs-a comparative study.
- Int J Contemp Dent 2011;2: 92-97.
- Sener M, Ozgur PZ, Yilmaz I, et al. Comparison of preemptive analgesic effects of a single dose of nonopioid
- analgesics for pain management after ambulatory surgery:
- a prospective, randomized, single-blind study in turkish
- patients. Curr Ther Res Clin Exp 2005;66: 541-551.
- Aoki T, Yamaguchi H, Naito H, et al. Premedication with
- cyclooxygenase-2 inhibitor meloxicam reduced postoperative
- pain in patients after oral surgery. Int J Oral Maxillofac Surg
- ;35: 613-617.
- Tiigimae-Saar J, Leibur E, Tamme T. The effect of prednisolone on reduction of complaints after impacted third
- molar removal. SBDMJ 2010;12: 17-22.
- Simone JL, Jorge WA, Horliana ACRT, et al. Comparative
- analysis of preemptive analgesic effect of dexamethasone
- and diclofenac following third molar surgery. Braz Oral
- Res 2013;27: 266-271.
- Nazar MN, Puthiriraj V. Analgesics following mandibular
- third molar surgery. Int Journal Pharm Clin Res 2014;6:
- -19.
- Li LC, Hou Q, Guo Y, et al. Inhibitory effect of meloxicam on human polymorphonuclear leukocyte adhesion to
- human synovial cell. Yao Xue Xue Bao 2002;37: 103-107.
- Davies NM, Skjodt NM. Clinical pharmacokinetics of
- meloxicam: a cyclooxygenase-2 preferential nonsteroidal
- anti-inflammatory drug. Clin Pharmacokinet 1999;36:
- -126.
- Auvinet B, Ziller R, Appelboom T, et al Comparison of the
- onset and intensity of action of intramuscular meloxicam
- and oral meloxicam in patients with acute sciatica. Clin
- Therap 1995;17: 1078-1090.
- Engelhardt G. Pharmacology of meloxicam, a new
- non-steroidal anti-inflammatory drug with an improved
- safety profile through preferential inhibition of COX-2.
- British J Rheumatol 1996;35: 4-12.
- Bekker A, Kloepping C, Collingwood S. Meloxicam in the
- management of post-operative pain: Narrative review. J
- Anaesthesiol Clin Pharmacol 2018;34: 450-457.
- Sirintawat N, Sawang K, Chaiyasamut T, Wongsirichat N.
- Pain measurement in oral and maxillofacial surgery. J Dent
- Anesth Pain Med 2017;17: 253-263.
- Costa FWG, Esses DFS, de-Barros SPG, et al. Does the
- preemptive use of oral nonsteroidal anti-inflammatory
- drugs reduce postoperative pain in surgical removal of
- third molars? a meta-analysis of randomized. Clin Trials
- Anesth Prog 2015;62: 57-63.
- Yamaguchi A, Sano K. Effectiveness of preemptive
- analgesia on postoperative pain following third molar
- surgery: review of literatures. Japanese Dent Sci Rev
- ;49: 131-138.
- Villafuerte-Nuñez AE, Téllez-Anguiano AC, HernándezDÃaz O, et al. Facial edema evaluation using digital image
- processing. Discrete Dynamics Nature Soc 2013: 1-13.
- Bekker A, Kloepping C, Collingwood S. Meloxicam in the
- management of post-operative pain: narrative review. J
- Anaesthesiol Clin Pharmacol 2018;34: 450-457.
- Pochapski MT, Santos FA, de-Andrade ED, et al. Effect
- of pretreatment dexamethasone on postendodontic pain.
- Oral Surg Oral Med Oral Pathol Oral Radiol Endod
- ;108: 790-795.
- Deliverska EG, Petkova M. Complications after extraction
- of impacted third molars- Literature review. J IMAB
- ;22: 1202-1211.
- Shugars DA, Gentile MA, Ahmad N, et al. Assessment
- of oral health-related quality of life before and after third
- molar surgery. J Oral Maxillofac Surg 2006;64: 1721-1730.
- Selimović E, Ibrahimagić-Šeper L, Šišić I, et al. Prevention
- of trismus with different pharmacological therapies after
- surgical extraction of impacted mandibular third molar.
- Med Glas (Zenica) 2017;14: 145-151.
- Franco-Molina MA, Mendoza-Gamboa E, CoronadoCerda EE, et al. Clinical trial evaluating the effectiveness
- of biocompound immunepotent crp in the third-molar
- extraction. Biotechnol Biotechnol Equipment 2017;31:
- -186.
- Mittal S, Bansal V, Garg S, et al. The diagnostic role of
- saliva-a review. J Clin Exp Dent 2011;3: e314-320.
- Bradley JR. TNF-α mediated inflammatory disease. J
- Pathol 2008;214: 149-160.
- Fahs F, Bi X, Yu F, et al. Critical review: new insights into
- microRNAs in skin wound healing. Int Union Biochem
- Molec Biol 2015;67: 889-896.
- Xu F, Zhang C, Graves DT. Review article, abnormal cell
- responses and role of TNF-α. BioMed Res Int 2013;2013:
- -802.
- Ritsu M, Kawakami K, Kanno E, et al. Critical role of
- tumor necrosis factor-a in the early process of wound healing
- in skin. J Dermatol Dermatol Surg 2017;21: 14-19.
- Veleska-Stevkovska D. Cytokines (IL-1, TNF-α, IL-6) and
- oral surgery interventions. Balk J Stom 2010;14: 124-132.
- Verri Jr WA, Cunha TM, Poole S, et al. Cytokine inhibitors
- and pain control. Rev Bras Reumatol 2007;47: 341-353.
- Pfaffe T, Cooper-White J, Beyerlein P, et al. Diagnostic
- Potential of Saliva: Current State And Future Applications.
- Clin Chem 2011;57: 675-687.
How to Cite
Ruth, M., Hasan, C. Y., Rahardjo, & Rustamadji, R. (2020). Effects of 15 mg meloxicam administered before odontectomy on pain, facial edema, trismus, and expressions of TNF following odontectomy of impacted mandibular third molar. Journal of Dentomaxillofacial Science, 5(2), 103–109. https://doi.org/10.15562/jdmfs.v5i2.1031