Comparative Effects of Naproxen, Diclofenac, and Piroxicam on Temporomandibular Disorders: A Clinical Trial.

Objectives: The prevalence of temporomandibular disorders (TMDs) is increasing in adults, and they are associated with symptoms such as pain and dysfunction. Non-surgical treatment, which may include pharmacotherapy, laser therapy, and physiotherapy, is the first step in treatment of TMDs. This study aimed to compare the effects of naproxen, diclofenac, and piroxicam on TMDs. Materials and Methods: This clinical trial was conducted on 104 patients who were randomly assigned to four groups (n=26) to receive either 500mg naproxen tablets, 50mg diclofenac tablets, 10mg piroxicam capsules, or the placebo. The patients were evaluated for pain, clicking, tenderness, and maximum mouth opening (MMO) in five stages, i.e., before starting the treatment and 1 week, 3 weeks, 5 weeks, and 6 weeks after starting the treatment. Data were analyzed by one-way repeated measures ANOVA with one repeated and one between-subject factor, Fisher's exact test, and Chi-square test (alpha=0.05). Results: Tenderness and clicking decreased with time in all groups (P≤0.05). The mean pain intensity and tenderness were significantly lower in the naproxen group than the other groups (P<0.05). Conclusion: Naproxen tablets can reduce pain and tenderness in TMD patients more than diclofenac tablets, piroxicam capsules, and the placebo.