Comparative Evaluation of Diclofenac Tablet, Gel, and Transdermal Patch for Postoperative Pain Management Following Third Molar Extraction: A Randomized Clinical Trial

Abstract

Background: Effective postoperative pain management is essential following third molar extractions. Diclofenac, a commonly used NSAID, is available in various formulations with differing pharmacokinetics and tolerability. This study compares the efficacy of oral tablets, soft gelatin capsules, and transdermal patches of diclofenac in managing postoperative pain.

Materials and Methods: A prospective, randomized clinical trial was conducted with 75 patients undergoing mandibular third molar extraction. Patients were divided into three groups: Group A (diclofenac transdermal patch 100 mg), Group B (oral diclofenac tablet 50 mg), and Group C (diclofenac soft gel capsule 50 mg). Pain intensity was evaluated using the Visual Analog Scale (VAS) and Verbal Rating Scale (VRS) on days 1, 2, 3, 5, and 7 postoperatively. The number of paracetamol tablets used as rescue analgesia was recorded.

Results: The diclofenac transdermal patch group demonstrated significantly lower VAS and VRS scores at 3 hours (p < 0.001) and on day 3 (p < 0.001), compared to other groups. By day 7, all groups showed similar pain relief. The patch group required fewer rescue analgesics and exhibited an earlier and more sustained reduction in pain intensity.

Conclusion: Diclofenac transdermal patches provide superior early postoperative pain control compared to tablets and soft gel capsules. Their non-invasive nature, better compliance, and steady drug release make them a preferable alternative in postoperative dental pain management.