Determination of Anti-Inflammatory and Analgesic Efficacy of Ascorbic Acid after Impacted Third Molar Surgery

Authors

  • Maryam Fatima Department of Pharmacology, Army Medical College/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Chaudhary Muhammad Usman Department of Pharmacology, Army Medical College/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Mudassar Noor Department of Pharmacology, Army Medical College/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Shabana Ali Department of Pharmacology, Army Medical College/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Mahjabeen Sharif Department of Pharmacology, Army Medical College/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i1.10240

Keywords:

Ascorbic acid, Molar, Analgesics, Inflammation, Anti-inflammatory agents

Abstract

Objective: To evaluate the clinical efficacy of Ascorbic acid in relieving pain and inflammation following surgical removal of
the third molar.

Study Design: Quasi-experimental study.

Place and Duration of Study: Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Jan to Mar 2023.

Methodology: Sixty participants who required surgical extraction of the impacted third molar were included and segregated equally into two groups. Group-A received Amoxicillin with Clavulanic acid (625 mg) thrice a day and Metronidazole (400 mg) twice daily, while Group-B received Amoxicillin with Clavulanic acid (625 mg) thrice daily, Ascorbic acid (500 mg) twice daily and Metronidazole (400 mg) twice daily. Both the groups received Naproxen Sodium as per requirement (550 mg). Pain, trismus, facial swelling, and requirement of analgesic consumption were evaluated on the seventh post-operative day.

Results: There was a statistically significant difference in reducing the intensity of pain (p<0.01), severity of facial swelling and trismus (p<0.01) and requirement of analgesic consumption between Group A and B (p<0.001).

Conclusion: Our study concluded that Ascorbic acid after surgery effectively reduces pain intensity, the severity of facial
swelling and trismus, and the requirement for analgesic consumption so that ascorbic acid may be used as an adjuvant
therapy with other conventional drugs.

Downloads

Download data is not yet available.

References

Mojsa IM, Stypulkowska J, Novak P, Lipczynski K, Szczeklik K,

Zaleska M, et al. Pre-emptive analgesic effect of lornoxicam in

mandibular third molar surgery: a prospective, randomized,

double-blind clinical trial. International journal of oral and

maxillofacial surgery. Int J Oral Maxillofac Surg 2017; 46(5): 614-

https://doi.org/10.1016/j.ijom.2016.11.008.

Shah A, Halli R, Merchant Y, Kshirsagar R, Khurana J. Efficacy of

ketamine as an adjunct to local anesthesia in the surgical removal

of impacted mandibular third molars–a split mouth prospective

controlled clinical study. J Clin Diagn Res 2016; 10(10): ZC29.

https://doi.org/10.7860/JCDR/2016/19677.8638.

Stojanović S, Burić N, Tijanić M, Todorović K, Burić K, Burić N,

et al. The Assessment of Prolonged Inferior Alveolar Nerve

Blockade for Postoperative Analgesia in Mandibular Third Molar

Surgery by a Perineural Addition of Dexamethasone to 0.5%

Ropivacaine: A Randomized Comparison Study. Int J Environ

Res Public Health 2022; 19(3): 1324.

https://doi.org/10.3390/ijerph19031324.

Sreesha S, Ummar M, Sooraj S, Aslam S, Roshni A, Jabir K.

Postoperative pain, edema and trismus following third molar

surgery - A comparitive study between submucosal and

intravenous dexamethasone. J Family Med Prim Care 2020; 9(5):

-2459. https://doi.org/10.4103/jfmpc.jfmpc_188_20.

Demirbas AE, Karakaya M, Bilge S, Canpolat DG, Kütük N,

Alkan A, et al. Does Single-Dose Preemptive Intravenous

Ibuprofen Reduce Postoperative Pain After Third Molar

Surgery? A Prospective, Randomized, Double-Blind Clinical

Study. J Oral Maxillofac Surg 2019; 77(10): 1990-1997.

https://doi.org/10.1016/j.joms.2019.04.019.

Chaitanya NC, Muthukrishnan A, Krishnaprasad C,

Sanjuprasanna G, Pillay P, Mounika BJ, et al. An insight and

update on the analgesic properties of vitamin C. J Pharm

Bioallied Sci 2018; 10(3): 119.

https://doi.org/10.4103/jpbs.JPBS_12_18.

Chaitanya NC, Badam R, Siva Prasad Reddy G, Alwala A,

Srinivas P, Saawarn N, et al. Analgesic Effect of Intravenous

Ascorbic Acid Versus Acelcofenac Post-Transalveolar Extraction:

A Case-Control Study. J Popul Ther Clin Pharmacol 2019; 26(2):

e43-e52.

https://doi.org/10.15586/jptcp.v26i2.626.

Rizqiawan A, Lesmaya YD, Rasyida AZ, Amir MS, Ono S,

Kamadjaja DB, et al. Postoperative complications of impacted

mandibular third molar extraction related to patient's age and

surgical difficulty level: A Cross-Sectional Retrospective Study.

Int J Dent 2022; 2022: 7239339.

https://doi.org/10.1155/2022/7239339.

Katz MS, Peters F, Elvers D, Winterhalder P, Kniha K,

Möhlhenrich SC, et al. Effect of drain application on

postoperative complaints after surgical removal of impacted

wisdom teeth—a randomized observer-blinded split-mouth

clinical trial. Clin Oral Investig. 2021; 25(1): 345-353.

https://doi.org/10.1007/s00784-020-03464-5.

Rasotra RJ. Effectiveness of physiotherapy Intervention on

trismus (lock-jaw): a case report. Int J Health Sci 2022; 6: 912-920.

https://doi.org/10.53730/ijhs.v6nS3.5337.

Al-Samman AA, Othman HA. Facial expression drawings and

the full cup test: valid tools for the measurement of swelling after

dental surgery. Br J Oral Maxillofac Surg 2017; 55(1): 22-25.

https://doi.org/10.1016/j.bjoms.2016.08.015.

Cigerim L, Eroglu CN. Comparison of clinical efficacies of

preoperatively initiated naproxen sodium-codeine phosphate

in combination, diclofenac potassium, and benzydamine

hydrochloride for pain, edema, and trismus after extraction of

impacted lower third molar: A Randomized Double-Blind Study.

J Oral Maxillofac Surg 2018; 76(3): 495-502.

https://doi.org/10.1016/j.joms.2017.08.041.

Pisalsitsakul N, Pinnoi C, Sutanthavibul N, Kamolratanakul PJ.

Taking 200 mg Vitamin C Three Times per Day Improved

Extraction Socket Wound Healing Parameters: A Randomized

Clinical Trial. Int J Dent 2022; 2022: 6437200.

https://doi.org/10.1155/2022/6437200.

Chaudhary DS, Parwani SR, Barkhade S, Gajbhiye M, Parwani R,

Sikka G, et al. Physiological gingival melanin hyperpigmentation

treatment with injectable vitamin C and scalpel technique: A

Randomised Controlled Clinical Trial. Int J Dent 2023; 2023:

https://doi.org/10.1155/2023/4586923.

Gadge H, Fernandes B, Priyadarshini H, Grover S, Kumar J,

Khiraiya NJ, et al. impact of vitamin c on wound healing

following dental implantation. Ann Romanian Soc Cell Biol 2021;

(5): 2356-2360.

Mukherjee S, Gowda VS. The Role of Vitamin C in Wound

Healing in Periodontal Flap Surgery in Patients with Chronic

Periodontitis: A Randomized Controlled Trial. J Dent Res 2022;

(4): 01-11.

https://doi.org/10.4172/jdrp. 22.4 (3).017.

Yussif NM, Abdul Aziz MA, Abdel Rahman AR. Evaluation of

the anti-inflammatory effect of locally delivered vitamin C in the

treatment of persistent gingival inflammation: clinical and

histopathological study. J Nutr Metab 2016; 2016: 2978741.

https://doi.org/10.1155/2016/2978741.

Li X, Tang L, Lin YF, Xie GFJCID, Research R. Role of vitamin C

in wound healing after dental implant surgery in patients treated

with bone grafts and patients with chronic periodontitis. Clin

Implant Dent Relat Res 2018; 20(5): 793-798.

https://doi.org/10.1111/cid.12647.

Mahajani M, Ghani B, Ahmed M, Haseeb M, Billaiya P, Gadewar

KJ. Role of vitamin c in patients with chronic periodontitis and

its influence on salivary total antioxidant capacity levels. Ann

Romanian Soc Cell Biol 2021: 12126-12133.

González-Serrano J, López-Pintor RM, Cecilia-Murga R, Torres J,

Hernández G, López-Quiles J, et al. Application of propolis

extract, nanovitamin C and nanovitamin E to prevent alveolar

osteitis after impacted lower third molar surgery. A randomized,

double-blind, split-mouth, pilot study. Med Oral Patol Oral Cir

Bucal 2021; 26(2): e118-e25.

https://doi.org/10.4317/medoral.23915

Downloads

Published

28-02-2024

Issue

Section

Original Articles

How to Cite

1.
Fatima M, Usman CM, Noor M, Ali S, Sharif M. Determination of Anti-Inflammatory and Analgesic Efficacy of Ascorbic Acid after Impacted Third Molar Surgery. Pak Armed Forces Med J [Internet]. 2024 Feb. 28 [cited 2024 Jul. 27];74(1):99-103. Available from: https://pafmj.org/PAFMJ/article/view/10240