The Effect of Oral Magnesium Supplement on Postoperative Pain Following Mandibular Third Molar Surgery: A Split-Mouth Randomized Placebo-Controlled Trial

Objective: This study aimed to evaluate the analgesic efficacy of oral magnesium supplements, administered as an analgesic adjuvant to ibuprofen, on acute postoperative pain within 72 h following mandibular third molar (MTM) surgery. Materials and Methods: This triple-blind, placebo-controlled, split-mouth randomized study was conducted among 25 patients (50 MTMs), who intended to remove both MTMs. All patients underwent two surgeries separated by an interval of at least 4 weeks. For each surgery period, patients were randomly assigned with either receiving NSAIDs plus oral magnesium supplement (25 MTMs) or NSAIDs plus placebo (25 MTMs) for three days after surgery. The postoperative pain intensity at rest and movement were primarily evaluated at 24 h, postoperatively. Participants were also asked to record pain intensity at 6, 48, and 72 h, postoperatively, rescue analgesic consumption, time to first rescue analgesic, and magnesium-related adverse events. Results: The combination of ibuprofen plus oral magnesium supplement significantly decreased pain intensity at rest 24 h, postoperatively, compared to placebo (estimated mean difference -15.08; 95%CI -29.01 to -1.14). However, the pain intensity at rest and movement were similar between groups at other time points. There was no significant difference among groups in terms of rescue analgesic consumption and time to first rescue analgesic. No magnesium-related adverse event was observed. Conclusion: The addition of oral magnesium supplement as an analgesic adjuvant to NSAIDs significantly decreased pain intensity at rest 24 h following MTM surgery. Nevertheless, this result might not provide clinically relevant benefits for pain control following MTM surgery. Trial Registration: ClinicalTrials.gov identifier: TCTR20221003004.