Analgesic efficacy and safety of transdermal and oral diclofenac in postoperative pain management following dental implant placement.

The aim of this study was to compare the efficacy and safety of transdermal and oral routes of diclofenac for postoperative pain management in patients undergoing dental implant placement. Twenty systemically healthy, partially edentulous patients who required dental implants bilaterally in the mandibular first molar region were included. While the patient was under local anesthesia, an implant was placed in the mandibular first molar region of one quadrant. After a minimum of 4 weeks, an implant was placed in the contralateral quadrant under local anesthesia. Patients were prescribed 50 mg of oral diclofenac, taken twice daily for 3 days, following implant placement on the first side and a 100-mg diclofenac transdermal patch, placed once daily for 3 days, after surgery on the contralateral side. Postoperative pain was documented using the Numeric Rating Scale, Verbal Rating Scale, and Pain Relief Scale. Demographic, intraoperative, and postoperative characteristics were comparable in all the patients. The data obtained with the 3 subjective scales were analyzed by the Mann-Whitney test. No statistically significant differences in scores were discerned between the oral and transdermal routes of diclofenac delivery. None of the patients developed any adverse effects when using the transdermal patch, whereas 3 patients reported gastric irritation and a mild burning sensation when taking oral diclofenac. Thus, while the efficacy of transdermal and oral diclofenac for postoperative pain management was similar, the safety of the transdermal diclofenac patches was evidently superior. Further research with larger patient samples is necessary, but delivery of diclofenac through a transdermal route is a promising approach to the management of postoperative pain.