PMID- 24678099
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20140328
LR  - 20211021
IS  - 0011-393X (Print)
IS  - 0011-393X (Linking)
VI  - 67
IP  - 4
DP  - 2006 Jul
TI  - Prospective, randomized, open-label, pilot clinical trial comparing the effects 
      of dexamethasone coadministered with diclofenac potassium or acetaminophen and 
      diclofenac potassium monotherapy after third-molar extraction in adults.
PG  - 229-40
LID - 10.1016/j.curtheres.2006.07.001 [doi]
AB  - BACKGROUND: Patients who experience pain, swelling, and trismus after third-molar 
      extraction are reported to experience a 3-fold higher rate of adverse effects 
      (AEs) on quality of life compared with those who are asymptomatic after this 
      surgery. Therefore, investigators emphasize the necessity for better control of 
      this triad of sequelae. Steroids can reduce the risk for physiologic processes of 
      inflammation, thereby suppressing the development of inflammation. OBJECTIVE: The 
      aim of this study was to compare the effects of dexamethasone 8 mg IM and 
      diclofenac potassium (K) 50 mg PO, dexamethasone 8 mg IM and acetaminophen 1000 
      mg PO, and monotherapy with diclofenac K 50 mg PO on postoperative pain, 
      swelling, and trismus after surgical removal of third molars. METHODS: This 
      prospective, randomized, open-label pilot study was conducted at the Department 
      of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos, 
      Nigeria. Patients were randomly allocated to 1 of 3 treatment groups: concomitant 
      treatment with dexamethasone 8 mg IM and diclofenac K 50 mg PO or acetaminophen 
      1000 mg PO, or monotherapy with diclofenac K 50 mg PO. Overall analgesic efficacy 
      of the drug combinations was assessed for 7 days postoperatively using a 4-point 
      categorical pain-intensity rating scale (0 = no pain; 1 = mild pain; 2 = moderate 
      pain; and 3 = severe pain). Facial swelling was measured in 1 dimension on days 
      1, 2, and 7 after surgery using a tape measure placed from the tip of the tragus, 
      to gonion, to the tip of the contralateral tragus, and trismus was assessed using 
      interincisal mouth-opening ability, measured using a vernier-calibrated caliper 
      on postoperative days 1, 2, and 7. Tolerability was assessed using direct 
      questioning of the patients at follow-up visits. RESULTS: A total of 150 patients 
      (50 per treatment group) were included in the analysis (76 women, 74 men; mean 
      [SD] age, 26.8 [5.04] years [range, 18-45 years]; 100% Nigerian). The proportion 
      of patients reporting no pain on the pain-intensity rating scale was 
      significantly higher in the group receiving dexamethasone and diclofenac K 
      compared with that in the groups receiving dexamethasone and acetaminophen or 
      diclofenac K monotherapy (44% vs 22% and 24%, respectively; both, P < 0.05). 
      Facial swelling was significantly less with dexamethasone and diclofenac K or 
      dexamethasone and acetaminophen compared with diclofenac K alone (day 1: P = 
      0.013 and P = 0.011, respectively; day 2: P = 0.002 and P = 0.004, respectively). 
      However, trismus relief was statistically similar between the 3 treatment groups 
      on postoperative days 1 and 2. No AEs or complications were recorded. CONCLUSION: 
      In this open-label pilot study, concomitant treatment with dexamethasone and 
      diclofenac K provided significant relief of postsurgical pain and swelling 
      compared with dexamethasone and acetaminophen or monotherapy with diclofenac K 
      after third-molar extraction in these patients.
FAU - Bamgbose, Babatunde Olamide
AU  - Bamgbose BO
AD  - Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, 
      Lagos, Nigeria.
FAU - Akinwande, Jelili Adisa
AU  - Akinwande JA
AD  - Department of Oral and Maxillofacial Surgery, College of Medicine, University of 
      Lagos, Lagos, Nigeria.
FAU - Adeyemo, Wasiu Lanre
AU  - Adeyemo WL
AD  - Department of Oral and Maxillofacial Surgery, College of Medicine, University of 
      Lagos, Lagos, Nigeria.
FAU - Ladeinde, Akinola Ladipo
AU  - Ladeinde AL
AD  - Department of Oral and Maxillofacial Surgery, College of Medicine, University of 
      Lagos, Lagos, Nigeria.
FAU - Arotiba, Godwin Toyin
AU  - Arotiba GT
AD  - Department of Oral and Maxillofacial Surgery, College of Medicine, University of 
      Lagos, Lagos, Nigeria.
FAU - Ogunlewe, Mobolanle Olugbemiga
AU  - Ogunlewe MO
AD  - Department of Oral and Maxillofacial Surgery, College of Medicine, University of 
      Lagos, Lagos, Nigeria.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Curr Ther Res Clin Exp
JT  - Current therapeutic research, clinical and experimental
JID - 0372621
PMC - PMC3965982
OTO - NOTNLM
OT  - acetaminophen
OT  - dexamethasone
OT  - diclofenac potassium
OT  - third-molar extraction
EDAT- 2006/07/01 00:00
MHDA- 2006/07/01 00:01
PMCR- 2006/07/01
CRDT- 2014/03/29 06:00
PHST- 2006/05/30 00:00 [accepted]
PHST- 2014/03/29 06:00 [entrez]
PHST- 2006/07/01 00:00 [pubmed]
PHST- 2006/07/01 00:01 [medline]
PHST- 2006/07/01 00:00 [pmc-release]
AID - S0011-393X(06)00055-5 [pii]
AID - 10.1016/j.curtheres.2006.07.001 [doi]
PST - ppublish
SO  - Curr Ther Res Clin Exp. 2006 Jul;67(4):229-40. doi: 
      10.1016/j.curtheres.2006.07.001.