Comparison of the effect of Naproxen, Etodolac and Diclofenac on postoperative sequelsfollowing third molar surgery: A randomised, double-blind, crossover study

Abstract

Objectives: To compare the three non-steroidal anti-inflammatory agents (NSAIDs) diclofenac potassium, etodolac and naproxen sodium in relation to pain, swelling and trismus following impacted third molar surgery. Study Design: The study was a randomized and a double-blinded study which included 42 healthy young individuals with impacted third molars and bone retention. Patients were randomly assigned to 3 groups (n: 14) to which diclofenac potassium, naproxen sodium and etodolac were administered orally an hour before the operation. Impacted third molars were surgically extracted with local anaesthesia. Visual analog scales (VAS) were used to assess the pain in the 6th, 12th hours and on the 1st, 2nd, 3rd, 5th, and 7th days postoperatively. Swelling was evaluated using ultrasound (US) and mouth opening (trismus) was measured with a composing stick pre and post operatively on the 2nd and 7th days respectively. Results: Regarding pain alleviation, diclofenac potassium was better than naproxen sodium and naproxen sodium was better than etodolac but these differences were not statistically significant. US measurements showed that the swelling on postoperative 2nd day was significantly lowest with diclofenac potassium as compared to others (p= 0.027) while naproxen sodium and etodolac acted similarly (p=0.747). No difference was noted regarding trismus in any of the groups. Conclusions: NSAIDs (diclofenac, naproxen and etodolac) are somehow similarly effective for controlling pain and trismus following extraction of mandibular third molars but diclofenac potassium surpasses others in reduction of swelling. Key words:Diclofenac potassium, naproxen sodium, etodolac, impacted third molar surgery, pain, swelling, trismus.

Efficacy of naproxen with or without esomeprazole for pain and inflammation in patients after bilateral third molar extractions: A double blinded crossover study

“…Third molar extraction is the most common surgical procedure in dentistry, and it is commonly used to investigate acute postoperative pain and inflammation (1). In particular, third molar surgery involves the manipulation of the molar and the surrounding soft tissue and bone.…”

Best Practices for Management of Pain, Swelling, Nausea, and Vomiting in Dentoalveolar Surgery

“…11 One study compared the preoperative administration of oral diclofenac potassium, etodolac, and naproxen sodium on postoperative pain, swelling, and trismus. 12 The study concluded that diclofenac potassium was best at reducing swelling and equal to naproxen sodium and etodolac in reduction of pain and trismus. In another study, dexketoprofen trometamol was used in an intravenous preparation preoperatively and was found to have an excellent preemptive decrease in pain and swelling caused by third molar surgery.…”

Analgesics Use in Dentistry

“…It is comparable with etodolac, but less effective in swelling when compared with diclofenac when they were used in oral surgical procedures, including postoperative third molar surgery or orthodontic pain [96][97][98]. Diclofenac is used in moderate to severe pain following third molar extraction and it could be used in an intravenous form in risk population groups such as the elderly and renal insufficiency, postoperative anticoagulation which uses ketorolac as the only choice for the moderate to severe acute pain.…”