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Analgesics effect of local diclofenac in third molar surgery: a randomized, controlled trial

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Abstract

Objectives

This study aimed to evaluate the effect of locally diclofenac application on postoperative pain, sequalae, and adverse effects following mandibular third molar (MTM) surgery.

Methods

A randomized, crossover, double-blind, controlled trial was conducted in 20 patients who required surgical removal of bilateral symmetrical impacted MTM at two separate appointments. The 40 MTMs were randomly allocated to two groups. One side was assigned 0.1% w/v diclofenac sodium as the diclofenac group. The contralateral side was assigned phosphate-buffered saline (PBS) as the control group. Postoperative pain intensity was measured by visual analogue scale (VAS), where the time when the first pain emerged, the time to first rescue medication, pain at 6 and 24 h after surgery, and the total number of analgesics consumed were recorded. Postoperative swelling and trismus were assessed on postoperative days 2 and 7. The differences of continuous outcomes between two groups were analyzed by paired t-test or Wilcoxon signed-rank test.

Results

VAS scores were significantly lower when the first pain emerged and 6 h after surgery in diclofenac group (p < 0.05). The onset of pain in the diclofenac group was significantly longer than in the control group (p < 0.05). Two patients reported mild nausea and dizziness in the diclofenac group.

Conclusion

This study demonstrates the analgesic effectiveness of 0.1% local application of diclofenac within 6 h postoperative with few side effects.

Clinical relevance

Locally diclofenac application is an alternative of postoperative analgesic in MTM surgery which provides pain-free periods within 6 h.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank R. L. Wilson for his assistance in the preparation of the English manuscript. We also thank T. Sastraruji for statistical consultation.

Funding

This study was funded and sponsored by Intramural Endowment Fund, Faculty of Dentistry, Chiang Mai University and Fundamental Fund 2023, Chiang Mai University, Thailand.

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand

    Anya Siritham, Warit Powcharoen & Chayarop Supanchart

  2. Department of Family and Community Dentistry, Faculty of Dentistry, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand

    Pinpinut Wanichsaithong

  3. Center of Excellence in Materials Science and Technology, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand

    Chayarop Supanchart

Authors
  1. Anya Siritham
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  2. Warit Powcharoen
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  4. Chayarop Supanchart
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Contributions

A. Siritham, contributed to data conception, design, acquisition, analysis, and interpretation, and drafted and critically revised the manuscript. W. Powcharoen contributed to conception, performed all statistical analyses, and drafted and critically revised the manuscript. P. Wanichsaithong contributed to conception, acquisition, and drafted and critically revised the manuscript. C. Supanchart contributed to conception, design, data acquisition and interpretation, performed all statistical analyses, and drafted and critically revised the manuscript. All authors gave their final approval and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Chayarop Supanchart.

Ethics declarations

Ethical approval

All procedures were performed in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and later amendments or comparable ethical standards. This study was approved by the Human Experimentation Committee, Office of Research Ethics, Faculty of Dentistry, Chiang Mai University (no. 17/2021). This prospective study was also registered on Thai Clinical Trials Registry (TCTR20210915002).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

Competing interests

The authors declare no competing interests.

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Siritham, A., Powcharoen, W., Wanichsaithong, P. et al. Analgesics effect of local diclofenac in third molar surgery: a randomized, controlled trial. Clin Oral Invest 27, 6073–6080 (2023). https://doi.org/10.1007/s00784-023-05221-w

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  • DOI: https://doi.org/10.1007/s00784-023-05221-w

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