Efficacy of Benzydamine Hydrochloride Mouthwash Versus Diclofenac Tablet in Postoperative Pain After Periodontal Surgery: A Comparative Study.

Abstract

Introduction: Benzydamine hydrochloride is an NSAID most often used in radiation induced oral mucositis. The indazole analogue benzydamine has physical,chemical, and pharmacological properties which differ from those of the aspirin-like NSAIDs. Benzydamine specifically act on the local mechanisms of inflammation, granuloma, and exudate.
 Methodology: The study was a double-blinded, randomized, controlled clinical trial. A total of 30 chronic periodontitis patients reported to the dental hospital were selected for the study using a purposive sampling technique. Thirty chronic periodontitis patients scheduled for periodontal surgeries were randomized to receive either Benzydamine hydrochloride Mouthwash (MW) or Diclofenac Tablets (TB), post-surgery. The MW group patients were advised to rinse with undiluted 15 ml solution for 60 secs, 2-5 times daily for three days. TB group were asked to take 50 mg tablet twice daily for three days. A 10-point Visual Analog Scale (VAS) and Wong-Baker Facial Rating Scale (FRS) were recorded to measure the pain perception by the patients.Gingival status was assessed by the Modified Gingival Index (MGI) at baseline and seventh day.
 Results: Intra-group comparison of pain values at day 1 and day 2 in both VAS and WONGBAKER scales demonstrated significance for the mouthwash group, suggesting more efficacy than the tablet group. Inter-group results showed statistical significance in both groups in relief of pain (p<0.05). Intra-group comparison results for both groups signified the superior efficacy of the mouthwash with p-values 0.010 and 0.005 at day 1 and day 2 for the Wong-Baker scale and with p-values 0.020 and 0.017 for VAS scale.
 Conclusion: Inter-group comparison at baseline, day 1, day 2 showed significant results on day 1 and day 2, suggesting both the products were effective. Intra-group comparison of pain values in both VAS and WONG BAKER scales showed the significance of the mouthwash group, suggesting more efficacy than the tablet.
 Keywords: Pain, Benzydamine hydrochloride mouthwash, Post-periodontal surgery.

Benzydamine hydrochloride: an overview on a well-established drug with news in mechanisms of action

“…42 Another double-blind RCT involving patients affected by periodontitis demonstrated the superiority of 0.15% benzydamine HCl vs. 50 mg diclofenac sodium tablets in reduction of pain perceived by patients submitted to periodontal surgery. 43 The potential role of benzydamine hydrochloride in nociceptor excitability: insights from novel preclinical data In addition to the anti-inflammatory, analgesic and antimicrobial effects described above (Figure 1), some studies are revealing the ability of benzydamine HCl to block the neuronal excitability as well. A first indication came from a study investigating the effect of four different NSAIDs, including benzydamine HCl, on neuronally evoked contractile responses to a submaximal dose of prostaglandin E1 (PGE1) or cholecystokinin-octapeptide (CCK-8) in isolated guinea-pig ileum.…”