Periodontal Postoperative Pain
The Effect of Diclofenac Mouthwash on Periodontal Postoperative Pain
Jaber Yaghini,1 Ahmad Moghareh Abed,2 Seyed Abolfazl Mostafavi,3 and Najmeh Roshanzamir4
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Abstract
Background:
The need to relieve pain and inflammation after periodontal surgery and the side effects of systemic drugs and advantages of topical drugs, made us to evaluate the effect of Diclofenac mouthwash on periodontal postoperative pain.
Methods:
In this double-blind, randomized clinical trial study 20 quadrants of 10 patients(n = 20) aged between 22-54 who also acted as their own controls, were treated using Modified Widman Flap procedure in two quadrants of the same jaw with one …show more content…
Use of non steroidal anti-inflammatory drugs (NSAIDs), to control the pain, is more effective than narcotics, due to blocking the source of pain which in fact, is inflammation.3
One of the NSAIDs is Diclofenac, which reduces duration of pain.4 Like other NSAIDs,Diclofenac inhibits the production of cyclooxygenase enzyme and prevents the arachidonic acid converting to other compounds such as prostaglandins. Analgesic effect of the drug is related to its peripheral anti-inflammatory effect and probably by weakening the pain threshold under the thalamus cortex,then the pain is decreased or interrupted.5 At high drug concentrationsin tissues, it seems that Diclofenac can act as sodium channel blocker which is mediated by topical analgesic.6
According to systemic complications associated with the use of NSAIDs, it is preferred to relief pain and inflammation by using topical medications.7 The main benefit of topical application of a drug is the access to more concentration compared to the systemic use and minimizing side-effects. In addition, mucosal surface has usually rich source of blood that causes quick drug transfer in to systemic blood circulation and in most cases prevents the primary metabolism by …show more content…
In high tissue concentration, it seems that diclofenac could act as sodium channel blockers which mediates the topical analgesia. Behavioural studies on rats suggest that similar concentration of diclofenac may open the sensitive potassium channels to ATP; however, the importance of this mechanism on the skin receptors is more than muscle receptors. Topical application of diclofenac makes the concentration of drug in tissue essentially higher than the concentration needed to inhibit the cyclooxygenase enzyme. Therefore, it is suggested that other mechanisms could also accompany the performance of topical medication.6 It appears following the use of topical diclofenac, a collection of topical and environmental-systemic effects, causes more reduction in
Jaber Yaghini,1 Ahmad Moghareh Abed,2 Seyed Abolfazl Mostafavi,3 and Najmeh Roshanzamir4
Author information ► Article notes ► Copyright and License information ►
Go to:
Abstract
Background:
The need to relieve pain and inflammation after periodontal surgery and the side effects of systemic drugs and advantages of topical drugs, made us to evaluate the effect of Diclofenac mouthwash on periodontal postoperative pain.
Methods:
In this double-blind, randomized clinical trial study 20 quadrants of 10 patients(n = 20) aged between 22-54 who also acted as their own controls, were treated using Modified Widman Flap procedure in two quadrants of the same jaw with one …show more content…
Use of non steroidal anti-inflammatory drugs (NSAIDs), to control the pain, is more effective than narcotics, due to blocking the source of pain which in fact, is inflammation.3
One of the NSAIDs is Diclofenac, which reduces duration of pain.4 Like other NSAIDs,Diclofenac inhibits the production of cyclooxygenase enzyme and prevents the arachidonic acid converting to other compounds such as prostaglandins. Analgesic effect of the drug is related to its peripheral anti-inflammatory effect and probably by weakening the pain threshold under the thalamus cortex,then the pain is decreased or interrupted.5 At high drug concentrationsin tissues, it seems that Diclofenac can act as sodium channel blocker which is mediated by topical analgesic.6
According to systemic complications associated with the use of NSAIDs, it is preferred to relief pain and inflammation by using topical medications.7 The main benefit of topical application of a drug is the access to more concentration compared to the systemic use and minimizing side-effects. In addition, mucosal surface has usually rich source of blood that causes quick drug transfer in to systemic blood circulation and in most cases prevents the primary metabolism by …show more content…
In high tissue concentration, it seems that diclofenac could act as sodium channel blockers which mediates the topical analgesia. Behavioural studies on rats suggest that similar concentration of diclofenac may open the sensitive potassium channels to ATP; however, the importance of this mechanism on the skin receptors is more than muscle receptors. Topical application of diclofenac makes the concentration of drug in tissue essentially higher than the concentration needed to inhibit the cyclooxygenase enzyme. Therefore, it is suggested that other mechanisms could also accompany the performance of topical medication.6 It appears following the use of topical diclofenac, a collection of topical and environmental-systemic effects, causes more reduction in