Efficacy of Celecoxib and Diclofenac Sodium in the Management of Postoperative Pain, Swelling and Mouth Opening after Surgical Removal of Impacted Third Molars: A Split-mouth Randomised Clinical Study
Introduction: The surgical removal of mandibular third molars is generally followed by complaints of pain, trismus, and swelling. The duration of surgery and the reflection of a mucoperiosteal flap have been shown to affect the intensity and frequency of postoperative complaints. Pain from t...
Main Authors: | , , , , , , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2023-08-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://jcdr.net/articles/PDF/18307/63808_CE[Ra1]_F(IS)_PF1(HB_KM_OM)_QC(SHK_SS)_PFA_NC(KM)_PN(KM).pdf |
Summary: | Introduction: The surgical removal of mandibular third molars is
generally followed by complaints of pain, trismus, and swelling.
The duration of surgery and the reflection of a mucoperiosteal
flap have been shown to affect the intensity and frequency of
postoperative complaints. Pain from third molar surgery typically
begins within one to three hours after surgery and ranges in
intensity from moderate to severe. Numerous analgesics have
been used to minimise pain and discomfort following the
surgical removal of impacted third molars. Commonly used
agents include ibuprofen, diclofenac sodium, paracetamol,
or their combinations. Newer drugs, such as selective COX
inhibitors, have not been extensively used for minor oral surgical
procedures.
Aim: To compare the clinical efficacy of celecoxib and diclofenac
sodium on pain, swelling, and mouth opening after the surgical
removal of impacted mandibular third molars.
Materials and Methods: A split-mouth randomised controlled
clinical trial was conducted in the Department of Oral and
Maxillofacial Surgery at BharatiVidyapeeth DU Dental College and
Hospital, Pune, Maharashtra, India. The study duration was six
months, from August 2022 to January 2023. A total of 21 subjects
(11 males and 10 females) who required surgical extraction of an
impacted mandibular third molar were selected. All subjects were
randomly allocated to receive one of the following treatments
twice a day for five days after surgery: celecoxib 200 mg (n=11)
or diclofenac sodium 75 mg (n=10). Pain scores were evaluated
using the Visual Analogue Scale (VAS) on postoperative day one,
two, and three. Swelling and mouth opening were evaluated on
Postoperative Day (POD) two and seven. Intergroup comparison
was done using Student’s t-test.
Results: The mean age of the study participants was 28±1.5
years, and the mean VAS score for pain evaluation with celecoxib
was 6.61, 5.38, and 5.00 on day 1 (p=0.027), 2 (p=0.972), and 3
(p=0.809), respectively. The difference in swelling values for the
celecoxib group was significant, while there were no significant
differences in the values of mouth opening.
Conclusion: It was concluded that celecoxib 200 mg is a better
analgesic and anti-inflammatory compared to diclofenac sodium
75 mg. Celecoxib was easily tolerable and comfortable for the
patients. There was no significant difference in the values of
mouth opening.
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ISSN: | 2249-782X 0973-709X |