Avaliação do efeito da analgesia preemptiva sobre os eventos inflamatórios e níveis de citocinas pró-inflamatórias (TNF-α E IL-1β) em cirurgias de terceiros molares inferiores

Abstract

The surgery for removal of third molars constitutes a com monly performed procedure in dentistry, and is associated with varying degrees of postoperative pain, which can significantly affect the quality of life of patients. Considering the maximum benefit to the patient undergoing an operation, the preemptive ana lgesia has been the pharmacological strategy widely researched in recent decades. This study aimed to evaluate the pre - emptive analgesia effect on the levels of proinflammatory cytokines ( TNF - α e IL - 1 β ) following mandibular third molar surgery. A unicentric, triple - blind, randomized, placebo - controlled study was conducted with 36 patients undergoing surgical removal of mandibular third molars. All volunteers were allocated randomly to recei ve either etoricoxib 120 mg, ibuprofen 400 mg or placebo 1 hour preoperatively, and inflammatory events were evaluated. There was significant difference between groups with respect to pain scores (p <0.001). Both etoricoxib and ibuprofen reduced pain score s compared to placebo (p <0.05). The TNF - α dose consumed by the placebo group showed no statistically significant difference (p = 0.127) from time 0 ' to time 30' minutes , whereas both ibuprofen and etoricoxib showed significant reduction between times. The IL - 1 β dosage consumed by the placebo gr oups and etoricoxib showed no significant variation; however, the ibuprofen group showed a significant reduction (p = 0.038) of IL - 1 β levels from time 0 ’ to time 30 ’ . As a conclusion, both TNF - α and IL - 1 β levels and the inflammatory events in surgeries for removal of third molars showed to be inversely proportional to the NSAID's COX - 2 selectivity used preemptively. Moreover, TNF - α and IL - 1 β showed a significant reduction in clinical parameters related to inflammatory events compared to the placebo group.