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

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

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

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.

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

2016 ◽  
Vol 7 (2) ◽  
pp. 120 ◽  
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

<p><strong>Background:</strong> 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. <strong>Objectives:</strong> To assess the discomforts after impacted mandibular third molar extraction in different aged patient. <strong>Methods:</strong> 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. <strong>Results:</strong> 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. <strong>Conclusion:</strong> As postoperative immediate tissue reactions are more in late aged patient than younger so impacted mandibular third molar should extract in early age.</p>

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

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.

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

2019 ◽  
Vol 8 (3) ◽  
pp. 325 ◽  
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.

Postoperative pain after bupivacaine supplementation in mandibular third molar surgery: splint-mouth randomized double blind controlled clinical trial

2014 ◽  
Vol 18 (4) ◽  
pp. 387-391 ◽  
Author(s):  
Ana Mara Morais de Souza ◽  
Anna Carolina Ratto Tempestini Horliana ◽  
José Leonardo Simone ◽  
Waldyr Antonio Jorge ◽  
Isabel Peixoto Tortamano
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Third Molar ◽  
Third Molar Surgery ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Mandibular Third Molar ◽  
Mandibular Third Molar Surgery

scholarly journals Low-intensity laser efficacy in postoperative extraction of third molars

2017 ◽  
Vol 65 (1) ◽  
pp. 13-19 ◽  
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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