Dexketoprofen Time-Dependent Administration After Third Molar Extraction - Pilot Randomized Cross-Over Controlled Trial

Sep 30, 2026

Objective: Assess how chronotherapy affects recovery after bilateral third molar extraction when Dexketoprofen is used as an anti-inflammatory. Material and methods: Ten patients underwent a randomized cross-over controlled trial. For 7 days, the chronotherapy group received a 25 mg daytime dose, while the control group received two doses daily (every 12 h). Pain was measured at baseline, 24, 48, and 72 h; swelling parameters at baseline, 24, 72, and 168 h; inflammatory biomarkers were analyzed at baseline, 72, and Day 7. Results showed reduced overall complications and faster pain recovery with chronotherapy; VAS pain, swelling, and trismus did not differ significantly, and inflammatory markers were similar. Conclusions: Daytime NSAID administration may be sufficient for postoperative pain management after third molar extraction, with comparable complications between groups.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Introduction

Pain and postoperative complications after third molar extraction

Analgesics and limitations

Circadian rhythm and chronotherapy rationale

Abstract

Objective

Materials and methods

Results

Conclusions

Clinical and Experimental Dental Research | ORIGINAL ARTICLE
Dexketoprofen Time‐Dependent Administration After Third Molar Extraction: A Pilot Randomized Cross‐Over Controlled Trial
Fabián Pérez‐González1 | Mohammad Abusamak2 | Leire Virto Ruiz1,3 | Luis Miguel Sáez‐Alcaide1 | Haider Al‐Waeli2 | Faleh Tamimi4 | Jesus Torres García‐Denche1
1Faculty of Dentistry, Department of Dental Clinical Specialties, University Complutense of Madrid, Madrid, Spain | 2Faculty of Dentistry, Dalhousie, Halifax, Nova Scotia, Canada | 3Department of Anatomy and Embriology, Faculty of Optics and Optometry, University Complutense of Madrid, Madrid,
Spain | 4College of Dental Medicine, Qatar University, Doha, Qatar Correspondence: Faleh Tamimi ([fmarino@qu.edu.qa](fmarino@qu.edu.qa))
Received: 1 April 2025 | Revised: 2 June 2025 | Accepted: 10 June 2025
Funding: The authors received no specific funding for this work.
Keywords: chronotherapy | cytokines | NSAIDs, postoperative complications, third molar extraction | | | | | --- | --- | --- | --- | | ABSTRACT
Objective: To assess how chronotherapy influences recovery after bilateral third molar extraction when Dexketoprofen is administered as an anti‐inflammatory agent.
Material and Methods: A randomized cross‐over controlled trial with 10 patients with bilateral impacted third molar extraction was enrolled. For 7 days after the surgery, the chronotherapy group was prescribed one dose of Dexketoprofen (25 mg) limited to daytime, while the control group were given two doses per day (every 12 h) . Pain intensity was recorded at baseline, 24, 48, and 72 h, while facial swelling parameters were evaluated at baseline, 24, 72, and 168 h (Day 7) postoperatively. Also, the inflammatory profile was analyzed for each patient by blood samples at baseline, 72 and 168 h. The concentrations of IL‐1β, IL‐1a, IL‐2, IL‐4, IL‐6, IL‐7, IL‐10, and IL‐13 were measured using high‐sensitivity multiplex map human immunoassays. Results: No significant differences in postoperative VAS pain, swelling, and mouth opening (trismus) measures were observed between the two groups. However, the chronotherapy group had reduced overall postoperative complications compared to the control group. Regarding postoperative recovery, pain intensity scores in the chronotherapy group at 24, 48, and 72 h indicated a faster recovery than the control group. Blood samples analysis showed no statistical differences between the different inflammatory markers studied at 72 h or Day 7 in both groups.
Conclusions: Daytime administration of NSAIDs might be sufficient to manage postoperative pain after third molar extraction, and complications were similar between both groups.
Clinical Trial Registration: [clinicaltrials. gov](clinicaltrials. gov), Identifier database: NCT05176158. | | | | | 1 | Introduction | | | surgeries in dentistry. In the United States alone, over 10 million wisdom teeth are extracted from around 5 million in- | | The surgical removal wisdom teeth, is one | of
of | third molars, commonly known asthe most frequently performed oral | dividuals each year, costing approximately 3 billion dollars (Friedman 2007) . This procedure can lead to various | | Fabián Pérez‐González and Mohammad Abusamak contributed equally and share the first authorship. | | | | | This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2026 The Author(s) . Clinical and Experimental Dental Research published by John Wiley & Sons Ltd. | | | | Clinical and Experimental Dental Research, 2026; 12:e70163 1 of 14 [https://doi.org/10.1002/cre2.70163](https://doi.org/10.1002/cre2.70163) postoperative complications, including pain, swelling, trismus, and bleeding (Chen et al. 2021) . Additionally, these surgeries are often accompanied with significant anxiety, inc

FAQs

How does the study evaluate chronotherapy after third molar extraction?

It uses a randomized cross-over controlled trial comparing daytime Dexketoprofen dosing against a twice-daily control regimen after bilateral impacted third molar extraction.

What outcomes are measured during postoperative recovery?

Pain intensity is recorded at baseline, 24, 48, and 72 h; facial swelling parameters at baseline, 24, 72, and 168 h; and inflammatory profiles via blood samples at baseline, 72, and 168 h (Day 7).

What are the main findings regarding pain, swelling, trismus, and complications?

No significant differences were observed between groups for postoperative VAS pain, swelling, and mouth opening (trismus), but the chronotherapy group showed reduced overall postoperative complications and faster pain recovery at 24, 48, and 72 h.

Sep 30, 2026

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