Comparison of oral and sublingual piroxicam for management of postoperative pain after mandibular third molar surgery: A prospective, randomized study

Abstract

Background and Objectives: Surgical extraction of the third molars has been one of the widely performed procedures of all the minor oral surgical procedures in oral and maxillofacial surgery. Inflammation is a critical part of the normal sequence of healing as well as is an important cause for postoperative sequelae. They include pain, restriction of mouth opening, and swelling which are a few reasons for discomfort to the patient. There are various measures for the management of these complications including administration of nonsteroidal anti-inflammatory drugs. This study was done to compare the clinical efficacy of oral and sublingual piroxicam in the management of postoperative pain after surgical removal of the lower third molars. Methodology: The study comprised thirty selected patients with bilaterally impacted mandibular third molars. Split-mouth study design was implicated such that the patients served as their own control. Group 1 consisted of patients who were given piroxicam orally, and Group 2 consisted of patients who were given sublingual preparation postoperatively. Subjective evaluation (visual analog scale) and objective evaluation (validated landmarks) were carried out for pain, swelling, and trismus for the postoperative days 1 st , 3 rd , and 7 th . Results: The results showed no significant differences with respect to postoperative pain, trismus, and swelling when the two routes of drug delivery, namely, oral and sublingual were compared. Furthermore, the amount of rescue analgesics taken was slightly higher in the oral group but not statistically significant. Conclusion: Within the limitations of the study, it can be concluded both oral and sublingual formulations of piroxicam show comparable results and that both are equally effective in the postoperative management of pain, trismus, and swelling after surgical removal of the third molar.

Keywords

• Impaction
• nonsteroidal anti-inflammatory drug
• sublingual and oral piroxicam