Preemptive vs. Preventive Coadministration of Ibuprofen L-Arginine and Dexamethasone in Lower Third Molar Surgeries: A Randomized Controlled Trial

Objective To compare the effect of different preemptive and preventive analgesia strategies involving oral coadministration of ibuprofen-arginine (770mg)–Ib-Ar and dexamethasone (8mg)-DX, and their respective placebos (P-Ib-Ar and P-DX), four evaluation groups on inflammatory and laboratory parameters, impact on quality of life, pain catastrophizing perception and sleep quality related after lower third molar surgery. Study Design A randomized split-mouth, triple-blind, controlled clinical trial was conducted with 48 volunteers. They were allocated depending on the use of Ib-Ar or DX, 1 hour before surgery or immediately postoperatively, discriminating the groups: G1 (Ib-Ar + DX), G2 (Ib-Ar + P-DX), G3 (P-Ib-Ar + DX), and G4 (P-Ib-Ar + P-DX). Results Pain peaks occurred after 2h (P-Ib-Ar groups) (p=0.003), while the other groups showed peak pain after 4h (p<0.05). Regarding the edema: groups treated with placebos measurements significantly reduced without returning to baseline (p<0.001). Regarding laboratory parameters: MPO and MDA levels, the G1 group (p<0.001) was the only one showing significant reduction. Conclusions The use of preemptive and preventive analgesia strategies of Ib-Ar and DX showed that the combined use delayed peak pain, with no difference in edema and trismus. The benefit of coadministration of both strategies was superior to isolated use of drugs.