Comparison of analgesic and anti-inflammatory efficacy of selective and non-selective cyclooxygenase-2 inhibitors in dental implant surgery.

Background: The analgesic and anti-inflammatory efficacy of tenoxicam and meloxicam were evaluated in this double-masked, randomized, prospective study by analyzing pain scores and the need for rescue-analgesic agents following dental implant surgery.

Methods: One hundred patients, in whom 241 dental implants were placed, were divided into two groups. For 4 days beginning the day before surgery, the first group received meloxicam, 15 mg daily, and the second group received tenoxicam, 20 mg daily, followed by 1 hour preoperatively and for 2 days thereafter. Pain intensity was rated by the subjects based on a visual analog scale on the operation day and on the following 6 days. The patients were recommended to use a rescue analgesic if the pain score was > or =4. Postoperative complications, such as edema, hematoma, infection, severe pain, paresthesia, or gastrointestinal complaints, were also noted.

Results: Statistical analysis revealed that 54% of patients in the tenoxicam group and 66% of patients in the meloxicam group used rescue analgesics on day 1. However, the difference between the groups was not significant (chi(2) = 1.05; P = 0.30). The relationship between the reduction of consumption and time was not significant in either group (Z = 0.84; P = 0.40). The relationship between the use of rescue analgesics and the number of implants placed was not significant. Among patients who reported postoperative complications, there was not a statistically significant difference between the groups (chi(2) = 0.04; P = 0.84).

Conclusion: Meloxicam and tenoxicam exhibited a similar analgesic and anti-inflammatory efficacy in the present investigation.