Comparison of Clinical Efficacies of Preoperatively Initiated Naproxen Sodium + Codeine Phosphate Combination, Diclofenac Potassium and Benzydamine Hydrochloride over Pain, Edema and Trismus after Extraction of Impacted Lower Third Molar: A Randomized Double-Blind Study

Publication date: Available online 8 September 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Levent Cigerim, Cennet Neslihan Eroglu
PurposeThe immediate aim of this study is to compare the clinical efficacies of naproxen sodium + codeine phosphate combination, benzydamine hydrochloride, and diclofenac potassium for pain, edema, and trismus following lower third molar extraction.Material and Methods90 healthy volunteers who applied for impacted wisdom tooth extraction were randomly distributed into three groups. 1 hour prior to the tooth extraction process, patients were administered with one of the following drugs: naproxen sodium 550 mg + codeine phosphate 30 mg tablet; diclofenac potassium 50 mg coated pill; or benzydamine hydrochloride 50 mg coated pill. Pain assessment was conducted via the Visual Analog Scale, edema assessment by measuring the distances between predetermined facial landmarks, and trismus assessment by measuring interincisal distance. The number and the time of utilization regarding rescue analgesics (paracetamol 500 mg) by patients were recorded.ResultsNaproxen sodium + codeine phosphate was found to be more effective for pain, edema, and trismus compared to diclofenac potassium and benzydamine hydrochloride (P < 0.05). Benzydamine hydrochloride yielded similar clinical responses to diclofenac potassium (P > 0.05). No drug-related side effects were observed.ConclusionsNaproxen sodium + codeine phosphate constitutes the drug of choice following the extraction of a patient's impacted lower third molar. Benzydamine hydrochloride has similar efficacy when compared to diclofenac potassium, and it can be used as a nonsteroidal anti-inflammatory analgesic drug.



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