Topical Diclofenac Patches Versus Oral Diclofenac for Postoperative Dental Pain: A Systematic Review

Postoperative pain is common following dental procedures, and the route of administration may influence analgesic efficacy and tolerability. This review compared topical diclofenac patches with oral diclofenac tablets for postoperative dental pain. The patches evaluated in the included studies are local topical therapies that release diclofenac into and near the skin at the application site; they should not be interpreted as systemic transdermal delivery systems. Indexed databases, including PubMed, EMBASE, Ovid, Scopus, ISI Web of Knowledge, and the Cochrane Library, were searched through August 2024. Fourteen studies met the eligibility criteria for qualitative synthesis, and risk of bias was assessed using the Cochrane Risk of Bias tool for interventions. Some studies reported early postoperative pain relief and fewer gastrointestinal complaints with topical diclofenac patches than with oral tablets; however, findings were heterogeneous and not consistently significant, and the overall risk of bias was high. Accordingly, the available evidence does not establish superior efficacy of topical diclofenac patches over oral diclofenac. The apparent analgesic effects at dental sites distant from patch placement require mechanistic clarification and confirmation in standardized, high-quality trials.