In people undergoing lower third molar surgery, the association of ibuprofen with arginine is considerably better to control postoperative pain and edema and exhibits better healing from trismus when compared to only ibuprofen.

A randomized split-mouth clinical trial was carried out to determine the efficiency of ibuprofen-arginine in comparison to ibuprofen alone to prevent trismus, edema and pain after third molar surgery.

Overall 21 subjects (age 18-30 years) with an impacted, bilateral and symmetric third molar that needed trans alveolar extraction were recruited. Participants were randomly allocated numbers from 1-21 and segregated into two groups. The test group (Group1) was given a single dose of ibuprofen-arginine and the control group (Group 2) was administered only ibuprofen as a preoperative medication. Both groups were given amoxicillin + acetaminophen as a postoperative medication.

Evaluation of pain on the visual analog scale (VAS) was done at 6, 12 and 24 hrs. The subjects were investigated for trismus and edema before surgery, quickly after surgery and at 24, 48 and 72 hrs postsurgery. Postoperative pain was investigated using the VAS. The facial edema and trismus scores were also assessed.

There was no statistically considerable difference in the scores of Group 1 and Group 2 for postoperative trismus while the facial edema scores displayed statistically significant differences. Group 1 experienced less pain when compared to Group 2, as shown in Table 1:

Arginine enhances the anti-inflammatory effect of ibuprofen on pain, edema and trismus after impacted mandibular third molar surgery.