Does minimal-invasive envelope flap reduce side effects compared to conventional envelope flap following impacted third molar surgery? A split-mouth randomized clinical trial

2021 ◽  
Author(s):  
Kazem Khiabani ◽  
Mohammad Hosein Amirzade-Iranaq ◽  
Arman Babadi
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Randomized Clinical Trial ◽  
Third Molar ◽  
Minimal Invasive ◽  
Third Molar Surgery ◽  
Impacted Third Molar

scholarly journals Effect of submucosal injection of ketorolac versus dexamethasone on postoperative pain after third molar surgery: a randomized clinical trial

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Dariush Hasheminia ◽  
Reyhaneh Faghihian ◽  
Farhad Mardani
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Third Molar ◽  
Study Groups ◽  
Third Molar Surgery ◽  
Control Group ◽  
Impacted Third Molar ◽  
Significant Difference ◽  
The Mean ◽  
The Difference

Abstract Background One of the most common dentoalveolar surgeries is the removal of impacted third molars. Moderate to severe pain is predictable after these surgeries, usually leaving the patient in need of an effective analgesic for at least 24 h. Corticosteroids and NSAIDs are well-known medications used to reduce pain. This prospective, randomized clinical trial aimed to assess the effectiveness of two types of analgesics, ketorolac and dexamethasone, on pain experienced after unilateral impacted third molar surgery. The analgesics were injected sublingually after profound anesthesia was confirmed in 60 healthy adult patients. During this study, the patients were divided into three groups. The patients in group K received 1 mL of ketorolac (30 mg), while the patients in group D received 1 mL of dexamethasone (4 mg) sublingually. The patients in group C (the control group) received 1 mL of normal saline solution as a placebo. Results The mean pain scores reported by the patients in groups K and D were significantly lower than group C (P = 0.002 and P < 0.001, respectively). However, the difference between groups D and K was not significant (P = 0.158). The mean number of analgesics taken by patients in groups K and D 24 h after surgery was significantly lower than the control group (P < 0.05). At 48 and 72 h postoperatively, however, the difference was not significant between the study groups (P > 0.05). The mean time of the first analgesic taken by the patients in groups K and D was 200.94 and 214.74 min after surgery, respectively. Exhibiting a significant difference, it was 132.65 min for the patients in group C (P = 0.003). Conclusions Under this study’s limitations, preoperative sublingual injection of ketorolac and dexamethasone were similarly effective in pain control after impacted third molar surgery.

scholarly journals The efficacy of antibiotic prophylaxis for impacted and semi-impacted third molar surgery: A prospective randomized double-blind clinical trial

2021 ◽  
Vol 10 (9) ◽  
pp. e58610918398
Author(s):  
Ana Paula Silva Gangá ◽  
Henrique Augusto Pautz Tarantino ◽  
Natália Bermond Arpini ◽  
Tatiany Pimentel Ferreira ◽  
Paula Sampaio de Mello ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Antibiotic Prophylaxis ◽  
Third Molar ◽  
Dental Students ◽  
Third Molar Surgery ◽  
Resistant Bacteria ◽  
Double Blind ◽  
Impacted Third Molar ◽  
Double Blind Clinical Trial

Impacted and semi-impacted third molar surgery is a frequent dental procedure. Due to potentially major tissue manipulation during surgery, antibiotic prophylaxis may be indicated to prevent infection of the surgical wound. This study evaluated the surgical conditions of patients following extraction of impacted and semi-impacted third molars with or without prior antibiotic prophylaxis. Signs of infection and inflammation, postoperative pain level and efficacy of the prescribed drugs were recorded. This was a prospective, randomized, double blind clinical trial with split-mouth design. A total of 23 healthy (ASA I) volunteers with indication for bilateral mandibular third molar extraction were recruited, totaling 46 surgical procedures. One hour prior to the procedure, volunteers received 1g of amoxicillin or placebo and a drug for pain prevention and control. The surgical acts were performed by last-year dental students. Postoperative pain was assessed using a visual analogue scale and an 11-point box scale at selected postoperative intervals of 4 h, 12 h, and 24 h. After seven postoperative days, study volunteers were examined for clinical signs of infection and/or inflammation, such as pus, intra and extraoral swelling, trismus, heat, flushing and temperature change. There were only two cases of postoperative complications, one of intraoral edema (placebo group) and one of trismus (antibiotic prophylaxis group). There were no statistically significant differences for any of the indicative signs of infection. The pain scales revealed no differences between pain levels in both groups at all times evaluated, regardless of the pain scale used (P > 0.05). To conclude, the low infection rate observed in our study does not reflect any need for antibiotic prescription in systemically healthy patients. The adverse effects of antibiotics in addition to selection for resistant bacteria outweigh the benefits of antibiotic prophylaxis in healthy (ASA I) patients.

Sign in / Sign up

Export Citation Format

Share Document