Comparative Assessment of Preoperative versus Postoperative Dexamethasone on Postoperative Complications following Lower Third Molar Surgical Extraction

Aim. To evaluate the effect of preoperative versus postoperative administration of oral Dexamethasone on postoperative complications including pain, edema, and trismus following lower third molar surgery.Methods. 24 patients were divided into two equal groups receiving 8 mg Dexamethasone orally, one group one hour preoperatively and the other group immediately after surgery. Pain was measured using VAS, edema was measured using a graduated tape between 4 fixed points in the face, and the mouth opening was measured using a graduated sliding caliper.Results. In this study pain and trismus records were similar and statistically nonsignificant in both groups. The results had proven that preoperative administration was superior when compared to postoperative administration regarding edema (0.002).Conclusions. Preoperative oral administration of 8 mg Dexamethasone was superior to the postoperative administration of the same dose concerning edema after lower third molar surgery.

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Efficacy of platelet rich plasma (PRP) on mouth opening and pain after surgical extraction of mandibular third molars

Journal of Oral Medicine and Oral Surgery ◽

10.1051/mbcb/2020045 ◽

2020 ◽

Vol 27 (1) ◽

pp. 9

Author(s):

Maidah Hanif ◽

Muhammad Azhar Sheikh

Keyword(s):

Platelet Rich Plasma ◽

Maxillofacial Surgery ◽

Third Molar ◽

Mouth Opening ◽

Third Molar Surgery ◽

Oral And Maxillofacial Surgery ◽

Surgical Removal ◽

Mandibular Third Molar ◽

Surgical Extraction ◽

Molar Teeth

Introduction: Surgery of mandibular third molar teeth for removal is one of the most common procedures undertaken in oral and maxillofacial surgery departments. The complications created by the post extraction wound healing and physiological consecution of third molar surgery can affect patients' quality of life. Platelet rich plasma (PRP) is an autologous concentrate of platelets suspended in the Plasma that accelerates healing by concentration of growth factors which lessen the inflammation and as a result pain and trismus. Materials and methods: A Study was conducted on 130 patients at the department of Oral and Maxillofacial Surgery, FUCD Islamabad, for a period of 6 months after ethical approval. The patients with impacted mandibular wisdom teeth were selected and divided equally into two equal groups. The pain score was measured using the visual analogue scale (VAS) and trismus was measured using Vernier caliper before the surgery, immediately after surgery, on 3rd and 7th follow up visits. Results: The mean postoperative pain on 7th day was significantly lower in the PRP group with statistically significant P-value <0.0001. Trismus was also less reported in the PRP group with P-value <0.00065. Conclusion: Platelet Rich Plasma is effective to lessen trismus and pain after surgical removal of mandibular third molar teeth.

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Piezo-surgery technique and intramuscular dexamethasone injection to reduce postoperative pain after impacted mandibular third molar surgery: a randomized clinical trial

BMC Oral Health ◽

10.1186/s12903-021-01759-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wissam Nehme ◽

Youssef Fares ◽

Linda Abou-Abbas

Keyword(s):

Clinical Trial ◽

Postoperative Pain ◽

Third Molar ◽

Mouth Opening ◽

Mean Difference ◽

Third Molar Surgery ◽

Third Molars ◽

Dexamethasone Group ◽

Mandibular Third Molar ◽

Surgical Extraction

Abstract Background Surgical extraction of the impacted mandibular third molar is commonly associated with postoperative pain, swelling, and trismus. Usually, rotatory instruments like burs have been used for osteotomy, while Piezosurgery is an innovative technique introduced to overcome the weaknesses related to the conventional technique. In addition, Dexamethasone administration before the extraction of impacted third molars is an efficient way to reduce postoperative pain due to robust anti-inflammatory activity. The purpose of the study is to evaluate the effect of piezo-surgery and dexamethasone injection on postoperative sequelae after the surgical extraction of impacted mandibular third molars, and ultimately to compare their effect on reducing postoperative pain. Methods A randomized controlled clinical trial was conducted with a sample of 80 patients. Participants were divided into four groups: Group 1 (Conventional rotatory), Group 2 (Conventional rotatory with 8 mg dose of dexamethasone 30 min before surgery), Group 3 (Piezo-surgery), and Group 4 (Piezo-surgery with 8 mg dose of dexamethasone 30 min before surgery). The outcome variables were surgical working time calculated in minutes, maximal mouth opening measured in millimeters using Vernier Caliper at baseline and day 3 and postoperative pain assessed using a Visual Analog Scale (VAS) on days 1, 3, and 7. Results The surgical working time was longer in piezo-surgery groups compared with the conventional rotatory instruments groups (15.82 ± 3.47 vs 23.33 ± 2.54; p value < 0.0001). The lowest reduction in mouth opening between baseline and 3rd-day post-op was found in the Piezo-surgery with Dexamethasone group (mean difference = 5.0, SD = 3.9, p value < 0.0001) followed by the Piezosurgery without Dexamethasone group (mean difference = 5.8, SD = 4.5, p value < 0.0001) and the highest average was reported by the Conventional rotatory without Dexamethasone (mean difference = 9.7, SD = 4.5, p value < 0.0001. In the four groups, the mean pain score was highest on the 1st day and gradually decreased over the following days. Comparison of the 1st and 3rd postoperative pain between groups revealed a lowest mean pain score in the Piezo-surgery with Dexamethasone group, followed by Conventional rotatory with Dexamethasone group and a highest mean score in the Conventional rotatory without Dexamethasone group (p value < 0.0001). Conclusion The association of Piezosurgery osteotomy and Dexamethasone intramuscular injection could be an effective combination to reduce postoperative pain and trismus after impacted third molar surgery. Trial registration: NCT04889781 (https://clinicaltrials.gov/), Date of Registration: 17/05/2021 (retrospectively registered), https://clinicaltrials.gov/ct2/show/NCT04889781?term=NCT04889781&draw=2&rank=1

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Effect of age on immediate postoperative tissue reaction following surgical extraction of impacted mandibular third molar

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v7i2.29447 ◽

2016 ◽

Vol 7 (2) ◽

pp. 120 ◽

Cited By ~ 1

Author(s):

Chandan Kumar Paul ◽

Quazi Billur Rahman ◽

Shamiul Alam ◽

Gokul Chand Kundu ◽

Helal Uzzaman

Keyword(s):

Third Molar ◽

Mouth Opening ◽

Tissue Reaction ◽

Third Molar Surgery ◽

Aged Patient ◽

Impacted Mandibular Third Molar ◽

Mandibular Third Molar ◽

Surgical Extraction ◽

Tissue Reactions ◽

Effect Of Age

Background: Postoperative morbidity following third molar surgery is affected by a number of factors. The aim of this study was to determine the effect of age on immediate postoperative tissue reactions following mandibular impacted third molar surgery. Objectives: To assess the discomforts after impacted mandibular third molar extraction in different aged patient. Methods: 100 patients, 54 Female and 46 male, aged 18 to 42 years comprised the study materials. Tooth extraction was performed with buccal guttering technique after adequate elevation and reflection of full thickness mucoperiosteal flap. Pain, swelling and trismus were evaluated preoperatively and on 2nd POD and 7th POD. Data was processed and analyzed using SPSS and was compiled and test of significance was done using Chi square (x2) test and un-paired 't' test. Results: Statistical analysis of the data indicated that pain and swelling was significantly less and significant maximum mouth opening was achieved in early aged patient than late age when preoperative and postoperative results were compared. Conclusion: As postoperative immediate tissue reactions are more in late aged patient than younger so impacted mandibular third molar should extract in early age.

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Evaluation of efficacy of submucosal tramadol after mandibular third molar surgery: a prospective pilot study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195009 ◽

2019 ◽

Vol 7 (11) ◽

pp. 4320

Author(s):

Karan V. Panchal ◽

Navin S. Shah ◽

Pratik Agrawal ◽

Parshwa N. Shah

Keyword(s):

Pilot Study ◽

Maxillofacial Surgery ◽

Third Molar ◽

Mouth Opening ◽

Analgesic Efficacy ◽

Third Molar Surgery ◽

Oral And Maxillofacial Surgery ◽

Third Molar Extraction ◽

Mandibular Third Molar ◽

Surgical Extraction

Background: Surgical extraction of mandibular third molar is one of the most commonly performed procedure in oral and maxillofacial surgery. Its removal causes swelling, trismus, and moderate to severe pain which can be treated with various NSAID’s drugs, which have numerous side effects and gastric disturbances. In order to bypass such disturbances, Tramadol may be considered as an alternative for such patients. The aim of the study was to evaluate analgesic efficacy of submucosal tramadol and its implication over swelling and mouth opening after mandibular third molar surgery.Methods: This is a prospective study where in after post-surgical extraction of mandibular third molar, efficacy of submucosal injection of tramadol is evaluated in terms of pain and its implication over swelling and mouth opening.Results: The present study suggested there was statistically significant VAS score for pain after submucosally injecting tramadol post-surgical extraction of mandibular third molar in the following visits- 4hourly, 8hourly and 24hourly. In respect to swelling, statistically significant values was noted during 24hr and 72 h our post extraction. Also in case of mouth opening, statistically significant values were found 24 hourly.Conclusions: The present pilot study concluded that submucosal tramadol post mandibular third molar extraction has been effective in reducing pain, limiting post-extraction swelling and less impacting mouth opening by inducing less complications thereby bypassing gastric disturbances.

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Analysis of the Effectiveness of Lornoxicam and Flurbiprofen on Management of Pain and Sequelae Following Third Molar Surgery: A Randomized, Controlled, Clinical Trial

Journal of Clinical Medicine ◽

10.3390/jcm8030325 ◽

2019 ◽

Vol 8 (3) ◽

pp. 325 ◽

Cited By ~ 18

Author(s):

Gaetano Isola ◽

Angela Alibrandi ◽

Eugenio Pedullà ◽

Vincenzo Grassia ◽

Sebastiano Ferlito ◽

...

Keyword(s):

Primary Outcome ◽

Third Molar ◽

Mouth Opening ◽

Placebo Treatment ◽

Third Molar Surgery ◽

Controlled Clinical Trial ◽

Postoperative Phase ◽

Impacted Mandibular Third Molar ◽

Mandibular Third Molar ◽

Surgical Extraction

The aim of this study was to analyze the effectiveness of Lornoxicam and Flurbiprofen in reducing perioperative sequelae after impacted mandibular third molar surgery. Ninety-one patients who needed surgical extraction of an impacted mandibular third molar were selected for the study. All subjects were randomly allocated to receive one of the following treatments twice a day for 5 days after surgery: placebo (n = 29), Flurbiprofen (n = 31), or Lornoxicam (n = 31). The primary outcome was postoperative pain, evaluated using the visual analogue scale (VAS) score at 30 min, 2, 6, 12, 24, 48 h, 7 and 10 days following surgery. The secondary outcomes chosen were changes in postoperative swelling and maximum mouth opening values compared to preoperative ones. Compared to placebo, treatment with Flurbiprofen and Lornoxicam was characterised by an improvement in the primary outcome. Moreover, the treatment with Lornoxicam presented significantly lower median pain scores at 2 h (p < 0.001) and at 6 h (p = 0.016) compared to Flurbiprofen and at 2 h (p < 0.001), 6 h (p = 0.01), and at 24 h (p = 0.018) after surgery compared with placebo. Swelling and maximum mouth opening values were not significantly different between the groups at each follow-up session. This trial demonstrated that treatment with Lornoxicam showed a decrease in the incidence and severity of pain in the first postoperative phase following third molar surgery compared to Flurbiprofen and placebo.

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Assessment of Pain, Swelling, Trismus Following Impacted Lower Third Molar Surgery, With Pre-Operative Single Dose Oral Dexamethasone: A Prospective, Randomized Double Blind Controlled Clinical Trial

Journal of Dental and Maxillofacial Surgery ◽

10.18314/jdms.v2i1.1730 ◽

2019 ◽

pp. 155-163

Author(s):

Rilna P ◽

Sathyanarayanan R ◽

Raghu K ◽

Nithin Joseph J ◽

Sankar K ◽

...

Keyword(s):

Single Dose ◽

Social Impact ◽

Third Molar ◽

Study Patient ◽

Third Molar Surgery ◽

Control Group ◽

Oral Dexamethasone ◽

Mandibular Molar ◽

Surgical Extraction ◽

Molar Teeth

Background: The removal of the lower impacted third molar teeth is always associated with varying degrees of inflammation that may have a social impact for the patients. To control these symptoms associated, it is necessary to provide an adequate anti-inflammatory therapy. The present study was undertaken to evaluate the therapeutic effect of pre-operative single dose of 8 mg oral Dexamethasone on pain, swelling, trismus following impacted lower third molar surgery. Materials and Methods: This study was conducted at MGPGI puducherry. Hundred patients with bilateral mandibular molar impaction were included in the study. Patient was allocated randomly as study and control group. Study group received 8 mg oral Dexamethasone one hour prior the surgical extraction. Patients with contraindication to the use of steroids were excluded from the study. Pain, facial contour and mouth opening were measured preoperatively and at 2nd and 5th days postoperatively.Results: On 2nd post-operative day, no statistically significant differences were noted in pain for both the groups. However, low pain scores were obtained with the use of Dexamethasone compare to placebo group. Dexamethasone group showed shows statistically significant reduction in swelling and trismus compared with the control group at all intervals.Conclusion: Dexamethasone 8 mg given orally one hour preoperatively is effective in minimizing pain, swelling, and trismus after removal of impacted lower third molar teeth.

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Low-intensity laser efficacy in postoperative extraction of third molars

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-863720170001000023084 ◽

2017 ◽

Vol 65 (1) ◽

pp. 13-19 ◽

Cited By ~ 1

Author(s):

Tiago Nascimento MILETO ◽

Fabiano Goulart AZAMBUJA

Keyword(s):

Laser Therapy ◽

Randomized Clinical Trials ◽

Third Molar ◽

Recovery Phase ◽

Low Level Laser Therapy ◽

Clinical State ◽

Third Molar Surgery ◽

Third Molars ◽

Level Laser ◽

Surgical Extraction

ABSTRACT The search for means that enable a better quality of life for postoperative patients should be incessant. The surgical extraction of third molars can result in potential complications such as pain, swelling and trismus, along with discomfort in the recovery phase. Therefore, this narrative review was to analyze, from systematic reviews and randomized clinical trials, the use of low level laser therapy as influencer the clinical state after third molar surgery. Scientific articles were searched through PubMed and Science Direct database. In spite of the evaluated studies have cited the effectiveness of laser therapy such as tissue repair, anti-inflammatory and analgesic, variety of analysis models and diversity of dosimetry leaves a gap on their true efficacy. Based on the research conducted, we suggest the adjuvant use of diode laser GaAlAs with 810 nm (λ), 100 mW constant power and 4 J/cm2 of energy, intra and extra oral form at least three sections to minimize possible occurrences of third molar surgery.

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