Kara Isa M, Polat Serkan, Inci M Fatih, Gümüş Cesur
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gaziantep University, Gaziantep, Turkey.
J Oral Maxillofac Surg. 2010 May;68(5):1018-24. doi: 10.1016/j.joms.2009.09.094. Epub 2010 Mar 5.
In this study, oxaprozin, a long-acting nonsteroidal anti-inflammatory drug, and naproxen sodium were compared in terms of their effects on edema, pain, and trismus after surgery for impacted mandibular third molars.
Thirty healthy patients with bilaterally impacted mandibular third molars were included in this randomized, cross-over, double-blind, placebo-controlled study. Patients were assigned randomly to 1 of 3 surgery groups and received postoperatively 1,200 mg oxaprozin, 550 mg naproxen sodium, or a placebo. Postoperative edema was measured with ultrasonography performed before and after surgery. Trismus was measured by comparison of preoperative and postoperative maximum interincisal mouth opening measurements by caliper. Pain was assessed by a visual analog scale (VAS) and by recording the number of rescue analgesic pills taken.
After removal of impacted third molars, the patients administered oxaprozin and naproxen showed superior results over those given placebo in terms of pain parameters (P < .05), but these treatments had no statistically significant effect on facial swelling. Comparing the oxaprozin and naproxen groups, there were no differences in the mouth opening measurements, but naproxen showed a statistically superior effect over the placebo (P < .05). Although not statistically significant, oxaprozin showed a more pronounced effect in reducing trismus than did the placebo (P = .07).
Administration of either oxaprozin or naproxen sodium during the postoperative period is effective and has similar effects in reducing pain but questionable benefit for the management of trismus. However, neither agent has clinical benefit in terms of reducing edema.
在本研究中,对长效非甾体抗炎药奥沙普秦和萘普生钠在下颌阻生第三磨牙手术后对水肿、疼痛和牙关紧闭的影响进行了比较。
本随机、交叉、双盲、安慰剂对照研究纳入了30例双侧下颌阻生第三磨牙的健康患者。患者被随机分配到3个手术组中的1组,术后接受1200mg奥沙普秦、550mg萘普生钠或安慰剂。术前和术后通过超声测量术后水肿。通过用卡尺比较术前和术后最大切牙间开口测量值来测量牙关紧闭。通过视觉模拟量表(VAS)和记录服用的急救止痛片数量来评估疼痛。
拔除阻生第三磨牙后,服用奥沙普秦和萘普生的患者在疼痛参数方面比服用安慰剂的患者效果更好(P <.05),但这些治疗对面部肿胀没有统计学上的显著影响。比较奥沙普秦组和萘普生组,开口测量值没有差异,但萘普生对安慰剂显示出统计学上的显著效果(P <.05)。虽然没有统计学意义,但奥沙普秦在减轻牙关紧闭方面比安慰剂显示出更明显的效果(P =.07)。
术后服用奥沙普秦或萘普生钠是有效的,在减轻疼痛方面有相似的效果,但对牙关紧闭的治疗益处存疑。然而,两种药物在减轻水肿方面均无临床益处。