Diclofenac sodium vs. dexketoprofen trometamol: selecting NSAIDs for managing postoperative inflammatory complications after third molar surgery-a randomized clinical trial.

BACKGROUND

After surgical procedures involving bone and soft tissue, such as impacted tooth extraction, profen and diclofenac derivatives are commonly prescribed. Diclofenac sodium (DS) and dexketoprofen trometamol (DT), derivatives of diclofenac and profen, exhibit clinical differences from their parent compounds. Despite their widespread use, comparative studies of their effects on postoperative complications remain limited. This randomized controlled trial was performed to compare the analgesic and anti-inflammatory effects of DS and DT following impacted tooth extraction.

METHODS

This split-mouth, randomized clinical study included healthy individuals aged 18 to 40 years with bilaterally impacted third molars. Left and right teeth were randomly assigned to either the DT or DS group. Participants took 25 mg of DS or 36.9 mg of DT twice daily for 7 days, beginning 1 h before extraction. Postoperative pain was assessed using a visual analogue scale at 4, 8, 12, and 24 h postoperatively, as well as on days 2 through 7. Trismus was evaluated by the interincisal distance, and edema was anatomically measured preoperatively and on postoperative days 2 and 7. The surgical duration and rescue analgesic use were also recorded.

RESULTS

In total, 35 patients (28 women, 7 men) aged 18 to 31 years (mean, 21.31 ± 3.19 years) participated. The mean operation duration was 12.94 ± 2.26 min for the DT group and 13.26 ± 2.19 min for the DS group (p > 0.05). No statistically significant difference was observed between the groups regarding pain, edema, or trismus development (p > 0.05). However, from days 2 to 7, the DS group exhibited a greater reduction in edema than did the DT group (p < 0.05). Additionally, the DS group required 10% more frequent use of rescue analgesics than the DT group.

CONCLUSION

Following impacted tooth extraction, administering DT during the initial days-when pain is more intense and the inflammatory response is developing-followed by DS in the later recovery phase may enhance postoperative comfort.

TRIAL REGISTRATION

This clinical trial was retrospectively registered on 03.10.2023 with the number TCTR20231003006.