Comparison of Oral Diclofenac & Transdermal Diclofenac Patch as a Post-Operative Analgesia in Orthodontic Patients Having Multiple Premolar Extractions: A Clinical Trial

Abstract

Background: Aims: This study was conducted to evaluate and compare the analgesic efficacy of transdermal Diclofenac patches and oral Diclofenac tablets following orthodontic premolar extractions, and to assess any associated adverse effects.

Methods: A total of fifty young pre-orthodontic patients requiring bilateral extraction of maxillary and mandibular first premolars were enrolled in the study. Extractions were performed in two separate appointments. During the first visit, the right maxillary and mandibular first premolars were extracted, and patients were prescribed 50 mg oral Diclofenac sodium tablets to be taken three times daily for three consecutive days. At the second appointment, the contralateral (left side) premolars were extracted, and a 100 mg transdermal Diclofenac patch was applied once daily for the following three days. Pain intensity and pain relief were assessed on each of the three postoperative days using standardized 5-point Verbal Pain Intensity, Pain Relief Score Charts, Visual analogue scale (VAS) and Verbal response scale (VRS) three times in three consecutive days after 2 hours, 6 hours and 12 hours.

Results: Statistical analysis demonstrated a consistent increase in pain relief scores and a corresponding decrease in pain intensity scores, VAS scores and VRS over the three-day postoperative period for both oral Diclofenac tablets and the transdermal Diclofenac patch. Although both formulations provided effective analgesia, a greater number of patients expressed a preference for the transdermal patch, citing the convenience of once-daily application, better analgesia and a lower frequency of systemic side effects.

Conclusion: These findings suggest that the transdermal Diclofenac patch offers analgesic efficacy better than that of oral Diclofenac tablets. Additionally, the improved patient compliance associated with the patch indicates its potential utility as a routine option for managing postoperative pain following dental extractions.