The Comparison of the Analgesic and Anti-Inflammatory Effect of Two NSAIDs in Patients Undergoing Third Molar Surgery Using C - Reactive Protein Estimation

Abstract

BACKGROUND Surgical removal of the lower impacted third molar is the most classic procedure performed in oral surgery. This procedure is often linked with hard and soft tissue manipulation leading to activation of acute-phase inflammatory response. This has led to the development of serum inflammatory biomarkers which has given the advantage of reducing the prolonged use of prophylactic antibiotics and an analgesic. The purpose of this study was to determine the analgesic and antiinflammatory effects of two NSAIDs in patients undergoing third molar surgery and assess the serum CRP levels preoperatively and postoperatively. METHODS Our study was carried out on twenty (20) healthy volunteering young adults who reported to the Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College & Hospital, Chennai, for the surgical removal of impacted mandibular third molars. Patients were enrolled in two groups. Each group was subjected to the withdrawal of a venous blood sample of 2 ml preoperatively, immediately 1 hr after the surgery and on the third postoperative day. A turbidimetric test was done for CRP level on all these samples and the results were analyzed. RESULTS An investigation was performed to find the association of gender, age, difficulty index, duration of surgery and pain scores by using a biochemical marker – C - reactive protein. The ibuprofen group showed increased postoperative 72 hr CRP levels and diclofenac group showed decreased postoperative 72 hr CRP levels in comparison to initially measured preoperative CRP levels regardless of an increase or decrease in the duration of the surgery. CONCLUSIONS Thus, it can be concluded that a non-steroidal anti-inflammatory drug like diclofenac is a better analgesic and anti-inflammatory drug than ibuprofen in controlling the pain perception and inflammation responses based on inflammatory biomarker–C-reactive protein levels. An inflammatory biomarker like CRP is a reliable and potent indicator of various inflammatory responses. KEY WORDS NSAIDS, CRP, Molar, Analgesics.