title: Efficacy of naproxen with or without esomeprazole for pain and inflammation in patients after bilateral third molar extractions: A double blinded crossover study.
abstract: BACKGROUND
  Using a double-blinded randomized crossover design, this study aimed to evaluate acute postoperative pain management, swelling and trismus in 46 volunteers undergoing extractions of the two lower third molars, in similar positions, at two different appointments who consumed a tablet of either NE (naproxen 500 mg + esomepraz ole 20 mg) or only naproxen (500 mg) every 12 hours for 4 days.
  
  
  METHODS
  Parameters were analyzed: self-reported pain intensity using a visual analog scale (VAS) pre- and postoperative mouth opening; incidence, type and severity of adverse reactions; total quantity consumed of rescue medication; and pre- and postoperative swelling.
  
  
  RESULTS
  Female volunteers reported significantly more postoperative pain at 1, 1.5, 2, 3 and 4hrs after surgery while also taking their first rescue medication at a time significantly earlier when consuming NE when compared to naproxen (3.7hrs and 6.7hrs). Conversely, no differences were found between each drug group in males.
  
  
  CONCLUSIONS
  In conclusion, throughout the entire study, pain was mild after using either drug in both men and women with pain scores on average well below 40mm (VAS), although in women naproxen improved acute postoperative pain management when compared to NE.
authors.affiliation: Discipline of Pharmacology, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, Brasil, cfsantos@fob.usp.br.
authors.forename: G-M
authors.initials: GM
authors.lastname: Weckwerth
authors.forename: L-F
authors.initials: LF
authors.lastname: Simoneti
authors.forename: P
authors.initials: P
authors.lastname: Zupelari-Gonçalves
authors.forename: A-M
authors.initials: AM
authors.lastname: Calvo
authors.forename: D-T
authors.initials: DT
authors.lastname: Brozoski
authors.forename: T-J
authors.initials: TJ
authors.lastname: Dionísio
authors.forename: E-A
authors.initials: EA
authors.lastname: Torres
authors.forename: J-R-P
authors.initials: JR
authors.lastname: Lauris
authors.forename: F-A-C
authors.initials: FA
authors.lastname: Faria
authors.forename: C-F
authors.initials: CF
authors.lastname: Santos
mesh_terms: D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D064098:Esomeprazole / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000188:drug therapy*; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D009288:Naproxen / Q000627:therapeutic use*; D059408:Pain Management; D010149:Postoperative Pain / Q000188:drug therapy*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D014081:Tooth Extraction; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors; D009288:Naproxen; D064098:Esomeprazole