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The low 3rd molar and anti phlogistics effects of betamethasone ibuprofen indomethacin naproxen niflumic acid oxyphen butazone tranexamic acid and glafenine on the patients condition after surgical removal of a lower 3rd molar

, : The low 3rd molar and anti phlogistics effects of betamethasone ibuprofen indomethacin naproxen niflumic acid oxyphen butazone tranexamic acid and glafenine on the patients condition after surgical removal of a lower 3rd molar. International Journal of Oral Surgery 11(6): 340-350

A multidisciplinary, double-blind, parallel placebo controlled investigation was made to find an effective antiinflammatory drug which prevents postoperative swelling, trimus and a general feeling of malaise. The antiinflammatory properties of antirheumatics were also objectively evaluated. In 126 healthy patients, who were without complaints, the lower 3rd molar was surgically removed. A drug was taken orally according to a fixed scheme for 4 days. Glafenine had to be taken in case of pain. The number of tablets taken was used to quantify pain. Swelling of the cheek was measured photographically and trismus was deducible from the maximal mouth-opening. The drugs investigated were: betamethasone 14.5 mg decreasing over 4 days, ibuprofen 1200 mg/day, indomethacin 150 mg/day, naproxen 750 mg/day, niflumic acid 1000 mg/day, oxyphenylbutazone 600 mg/day and tranexamic acid 2000 mg/day. Oxyphenylbutazone and tranexamic acid were not significantly different from placebo in their pain-killing effects. Betamethasone prevents swelling and trismus significantly more than the placebo. Betamethasone is significantly better than the other drugs in the prevention of swelling. Reduction of the swelling by antirheumatics may be 10-15% and a 20% reduction of trismus to be expected. The strongest analgesic niflumic acid. Tranexamic acid may reduce the swelling by 28%. The questionnaire and the blood- and urine-test showed that antirheumatics have to be considered to be acetylsalicylic acid-like drugs. Serious side effects have been reported previously for antirheumatics. When taken for a short time, corticosteroids are very safe drugs with a few mild side effects. Many patients experience a slight euphoria. Betamethasone, in a dosage of 14.5 mg decreasingly divided over 4 days prevents pain by 80%, swelling by 65% and trismus by 40% compared with the placebo group. This safe drug is recommended in elective surgery.

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