Upon joining the study, the patient must provide written informed consent, confirming the ability and willingness to comply with all scheduled study visits and procedures.

The patient must be at least 18 years old and have a body mass index (BMI) between 18.5 and 35 kg/m².

The patient is scheduled for the surgical extraction of at least two third molars, with at least one being a lower molar that requires bone removal.

The patient agrees not to take any pain relief medication other than those defined by the study protocol, starting 24 hours before the surgery and continuing until 48 hours after the study medication ends.

Within the first three hours after surgery, the patient’s pain level is assessed using the Visual Analogue Scale (VAS). A score of 55 mm or higher is required to continue in the study.

The patient receives a combination of ibuprofen (arginine) and tramadol hydrochloride in the form of granules for oral solution, with a dosage of 400 mg/37.5 mg.

This medication is administered orally every six hours to manage moderate to severe pain following dental surgery.

The primary goal is to measure the sum of pain intensity differences over 12 hours using the VAS.

Secondary assessments include pain intensity and differences at scheduled times up to 48 hours, the area under the curve of pain intensity differences during the first 12 hours, and the time to first pain relief.

The use of rescue medication is monitored, including the time to first use and the total amount used within 12 and 48 hours after starting the study medication.

Vital signs such as body temperature, heart rate, and blood pressure are regularly checked.

General physical examinations and laboratory tests are conducted to identify any abnormalities or adverse events.