ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Oxaprozin and Naproxen Sodium Post-operatively Reduce Pain After Removal of Impacted Third Molars
Clinical Question In adult patients having extraction of impacted third molars, do oxaprozin or naproxen prevent or reduce pain better than does placebo?
Clinical Bottom Line 1,200 mg oxaprozin or 550 mg naproxen sodium daily for one week reduce postoperative pain after extraction of impacted third molars better than does placebo, but do not exceed placebo for swelling. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20206429Kara 201036 healthy adults 18-25 yrsRCT, double-blind, crossover
Key resultsBoth oxaprozin and naproxen sodium provided better pain relief than placebo, measured by patients on a visual analog scale, at 5, 6, and 8 hours and at 3 days post-operatively. There was no difference in pain relief between the two medications. Swelling, assessed at 2 days and 7 days postoperatively, did not differ between the medications nor placebo. Naproxen sodium was more effective than placebo at preventing trismus at postoperative day 2. Mild to moderate nausea or vomiting were reported by 2 patients on oxaprozin, 1 patient on naproxen sodium, and 3 patients on placebo. Both medication groups required less rescue medication than did the placebo group.
Evidence Search ("Molar, Third"[Mesh] OR "Tooth, Impacted"[Mesh]) AND "oxaprozin" [Supplementary Concept] AND "Naproxen"[Mesh] ...view in PubMed
Comments on
The Evidence
Of 36 patients recruited, 6 dropped out, four of these due to refusal of the second contralateral surgery, one for failure to use the outcome measurement tool, and one for inconsistency in measurement of preoperative and postoperative swelling. Only 30 patients (60 teeth, 60 procedures) were analyzed. The three groups did not differ in mean age nor in duration of the surgical procedure.
Applicability Both naproxen sodium and oxaprozin may be considered as options for post-third molar extraction analgesia.
Specialty/Discipline (Oral Surgery)
Keywords third molar extraction, pain
ID# 873
Date of submission: 05/05/2011spacer
E-mail bechara@uthscsa.edu
Author Boulos Bechara, DDS
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author S. Thomas Deahl, II, DMD, PhD
Faculty mentor/Co-author e-mail DEAHL@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Lorena Ray and Kelly Ramey (San Antonio, Texas) on 10/09/2014
A PubMed search conducted on September 2014 found no recent publications on this topic. The study by Kara IM (PMID: 20206429) listed above seems to be the latest evidence regarding this topic.
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