Pain management after third molar extraction. Observations of the use of mefenamic acid and rofecoxib in the treatment of postoperative pain in the dental office

: Pain monitoring is often inadequate in the ambulant field to assure therapy results. Today NSAID take the centre in acute pain and inflammation control in dental interventions. Compared to conventional non-selective NSAID modern selective Cyclooxygenase-2 inhibitors (COX-2) provide the potential for improved compatibility and simplified medication with heightened effectiveness in acute postoperative toothaches. The aim of this study was to compare the effect of selective COX-2 inhibitors with NSAID after operative wisdom tooth extraction in 30 ambulant patients. The pain curve under mefenamine acid showed a significant increase during the first 48 hours after extraction. With rofecoxib a continuous pain decrease with the lowest stand 48 hours after intervention was registered. One week after extraction the patient's satisfaction was in favour of rofecoxib, which showed a clearly prolonged analgetic effect over 24 hours. Additionally rofecoxib as a COX-2 selective inhibitor doesn't bear the risk for severe non-anticipatable gastrointestinal side effects or prolonged bleeding after surgical intervention.