scholarly journals Efficacy of various administrative techniques of methylprednisolone on oedema, trismus and pain after lower third molar surgery

2017 ◽  
Vol 5 (2) ◽  
pp. 186 ◽  
Author(s):  
Vaibhav Mukund ◽  
Sukumar Singh ◽  
Sanjeev Kumar ◽  
Rishi Rath ◽  
Siddharth Tevatia

Due to their anatomical position, the surgical removal of impacted third molars results in oedema, pain, and trismus. The purpose of this study was to evaluate the efficacy of four different routes of administration of methylprednisolone on oedema, trismus and pain after lower third molar surgery. This randomized, perspective, and controlled study included 150 patients. The patients were randomly divided into five groups: Group A (control; no steroids), Group B (Submucosal injection), Group C (oral tablets), Group D (i.v. injection) and Group E (Intramuscular Injection). On days 2 and 7 following surgery, linear oedema was determined using facial landmarks, and maximal mouth opening was measured. Postoperative mouths opening and swelling were evaluated for each route of methylprednisolone administration and compared. The female (59%) to male (41%) ratio was 1.44; the mean age of the patients was 29.6 years. The level of significance was set at P < 0.01 for mouth opening and P < 0.05 for oedema. With regard to trismus, all four routes of administration demonstrated better efficacy in comparison to the control. While oral administration and i.v. injection of methylprednisolone achieved similar results, masseter injection provided better results in reducing oedema and trismus when compared with the control following lower third molar surgery.

2017 ◽  
Vol 2 (1) ◽  
pp. 8-17
Author(s):  
AM Adetayo ◽  
TA Oyedele ◽  
AO Ajomoko ◽  
MO Adetayo ◽  
MO Adeyemi ◽  
...  

Objective: This study aimed to compare the effects of administration of both preoperative and postoperative dexamethasone with that of only preoperative dexamethasone, and with that of a no dexamethasone (control) on reduction of pain, trismus and swelling following lower impacted 3rd molar surgery. Methods: A prospective randomized controlled double blinded study at the dental clinic of Babcock University Teaching Hospital on 84 subjects that were divided into 3 groups. Group A had both preoperative and postoperative dexamethasone, while group B had only preoperative dexamethasone and group C was a 'no dexamethasone' group. Differential mean facial swelling, mouth opening and pain scores were compared within the three groups. Results: The pattern of postoperative swelling, pain and trismus showed a general decrease from day 1 to 7, with group A showing the highest rate of decrease. On postoperative day 1, there was a difference between the swelling of groups A and C (p =0.01) and groups B and C (p = 0.02) and also between the pain scores of group A and group C (p = 0.01). On postoperative day 3, there was only a difference between the swelling of groups A and C (p = 0.02), but not in pain and trismus and no difference was seen in all the measured variables on postoperative day 7. Conclusion: Administration of a combination of both preoperative and post operative dexamethasone to reduce the postoperative inflammatory sequelae that follows lower third molar surgery gave better results than administration of only a single preoperative dose.


2019 ◽  
Vol 21 (3) ◽  
pp. 224-229
Author(s):  
Rashmi Shakya Gurung ◽  
K. Bimb ◽  
D. Shrestha

Amoxicillin is the commonly prescribed antimicrobial for prevention of post-operative complications following surgical extraction of mandibular third molar. However recently, the use of macrolideantibiotics had been encouraged in dentistry. The aim of this study was to compare the efficacy of Amoxicillin and Azithromycin in preventing post-operative sequelae following third molar surgery. An open- labeled randomized controlled study was carried out in Department of Oraland Maxillofacial surgery, college of Dental Sciences and Hospital, Nepal Medical College (CODSHNMC), Attarkhel, Kathmandu, Nepal from May 2018 to June 2019. One hundred and twenty patients undergoing surgical extraction of impacted mandibular third molar were randomized by lottery method into two groups: Group A received Amoxicillin and Group B received Azithromycin. Both the groups were assessed postoperatively on 1st, 3rd and 7th days for post-operative complications- pain, swelling, trismus and pus discharge. The present study revealed no significant differences between the efficacy of Amoxicillin and Azithromycin in preventing postoperative sequelae following surgical extraction of impacted third molar. Amoxicillin and Azithromycin were therefore found to be equally effective. Thus, Azithromycin can be used as an alternative drug to Amoxicillin in case of resistance and intolerance to Amoxicillin.


2020 ◽  
Vol 27 (1) ◽  
pp. 9
Author(s):  
Maidah Hanif ◽  
Muhammad Azhar Sheikh

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.


2021 ◽  
Vol 15 (12) ◽  
pp. 3530-3532
Author(s):  
Raj Kumar ◽  
Fida Hussain ◽  
Muhammad Ilyas ◽  
Lavina . ◽  
Ashfaque Ahmed ◽  
...  

Objective: To evaluate the effectiveness of Aloe Vera gel in management of dry socket after surgical removal of 3rd molar. Study Design & Setting: From December 2020 to November 2021, a descriptive research was conducted in the Section of Oral & Maxillofacial Surgery, Liaquat University of Medical & Health Sciences, Jamshoro, Hyderabad, Sindh. Methodology: Total 70 patients were included and divided equally in two groups i.e. Group-A (Alveora dressing) and Group-B (Controls). Dry socket, pre-operative assessment was carried out on the basis of pain Visual analog scale (VAS) and healing index. Socket was irrigated with sterile saline 0.9% in experimental group. In control group, patient were given tablet Panadol 1gm SOS. Patients were evaluated post operatively at 1st, 2nd, and 3rd day on the basis of pain (VAS) and healing index. Results: In group-A mean postoperative VAS at day-1, day-2 and day-3 was 6.69±2.59, 3.17±2.39 and 1.14±1.03 respectively. In group-B it was 7.77±2.03, 6.97±2.14 and 4.57±2.57. In group-A, mean postoperative healing scale at day-1, day-2 and day-3 was 2.83±0.56, 3.49±0.61 and 4.37±0.73 respectively and in group-B it was 2.31±0.58, 2.63±0.69 and 3.26±0.65 respectively. Significant association of pain intensity at day-2 and day-3 and healing index (at day-1, day-2 and day-3) was observed. Conclusion: Aloe Vera gel significantly reduced postoperative pain and improve healing index. Keywords: Effectiveness, Aloe Vera Gel, Dry Socket, Surgical Removal, Third Molar


2020 ◽  
Vol 27 (08) ◽  
pp. 1606-1611
Author(s):  
Shuja Hamid ◽  
Mahwish Memon ◽  
Raza Ali ◽  
Salman Shams

Objectives: To evaluate the efficacy of 0.2% chlorhexidine gel placed intra alveolar in the prevention of alveolar osteitis after the surgical extraction of mandibular third molar. Study Design: Randomized Control trial. Setting: Department of Oral and Maxillofacial Surgery, LUMHS, Jamshoro/Hyderabad. Period: January 2016 to July 2016. Material & Methods: This study consisted of 40 patients in control group A and 40 patients of Chlorohexidine gel group B used after surgical extraction. A single dose of 0.2% bio-adhesive gel was introduced in group B while the control group A was left alone. Postoperative complications like pain, swelling, limited mouth opening, and dry socket were seen. Frequency and percentages were calculated. Mean +/- SD were calculated for quantitative variables. Results: On 3rd day patients reported with pain in group A were 24 and in group B were 15. Pain was seen in 4 patients (10%) on 15th day in group A while in group B no patient came with pain. 19 patients reported with dry socket on day 3 in group A and 4 patients in group B, While none of the patient encountered with Dry socket on 15th day in group in both groups. Conclusion: The data presented indicates that the bio-adhesive gel containing 0.2% chlorohexidine, applied post-extraction produced a better patient recovery.


2013 ◽  
Vol 14 (3) ◽  
pp. 401-404 ◽  
Author(s):  
M Ummar ◽  
Rakesh B Nair ◽  
NM Mujeeb Rahman ◽  
KA Abdul Hafiz ◽  
Johnson K Issac ◽  
...  

ABSTRACT Aim To evaluate the relative ability of 4 mg dose of intraoperative dexamethasone, administered submucosally, to reduce the postoperative discomfort after third molar surgery. Materials and methods A total of 100 patients requiring surgical removal of a single mandibular third molar were included. The experimental group (50) received dexamethasone 4 mg as submucosal injection and control group (50) received no drugs. The maximum interincisal distance and facial contours were measured at baseline and at postsurgery days 2 and 7. The measurement of pain was done using visual analog scale (VAS). Results None of the patients developed wound infection or any serious postoperative complications. Postoperative edema tended to be less severe on the second postoperative day in the experimental group and the result was statistically significant. There were no significant differences in the reduction of pain and trismus between the two groups studied. Conclusion Submucosal administration of dexamethasone sodium phosphate (4 mg) results in reduction of postoperative edema, comparable with or greater than other routes of administration. Presumably, a higher effective drug concentration at the site of injury without loss due to distribution to other compartments may be achieved, and the submucosal route is convenient for both the surgeon and the patient. Clinical significance Submucosal route of administration of dexamethasone (4 mg) is effective in reducing postoperative discomfort after third molar surgeries. How to cite this article Nair RB, Rahman NMM, Ummar M, Hafiz KAA, Issac JK, Sameer KM. Effect of Submucosal Injection of Dexamethasone on Postoperative Discomfort after Third Molar Surgery: A Prospective Study. J Contemp Dent Pract 2013;14(3):401-404.


2020 ◽  
Vol 27 (07) ◽  
pp. 1408-1413
Author(s):  
Wajid Ali Rajper ◽  
Kashif Ali Channar ◽  
Munawar Din Larik ◽  
Sajid Ali Majeedano ◽  
Aftab Ahmed Soomro ◽  
...  

Objectives: To determine the effectiveness of tube drain compared with conventional suturing on postoperative complications after extraction of impacted mandibular third molars. Study Design: Cross Sectional study (Comparative). Setting: Department of Oral & Maxillofacial Surgery, Institute of Dentistry, LUMHS Jamshoro/Hyderabad. Period: Six months duration from 12-11-2015 to 13-05-2016. Material & Methods: All the patient age from 18 to 45 years irrespective of gender, having mesioangular impacted mandibular third molar were included in the study. Patients were divided into two groups, Group-A and group-B. The severity of pain was recorded by using Visual Analog Scale from 0 no pain to 10 worst pain, degree of swelling was measured by facial size through Amin and Laskin criteria and mouth opening was measured by interincisal distance through ruler. All data was recorded on the 3rd and 7th day by the clinician. Results: Mean age of group A was 31.22+7.21 years, and mean age of group B was 28.34+5.33 years. Male were found slightly more as compared to female. On 3rd day the post-operative pain assessment was almost equal in both groups p-value 0.06 and assessment of post-operative swelling on 3rd day was found with insignificant difference p-value 0.22. Assessment of pain on 7th post-operative day was that the severe pain was found significantly reduced in group B as compared to group A p-value 0.01, swelling was significantly reduced in group B p-value 0.04. While mouth opening was also found significantly more in group B as compared to group A p-value 0.022. Conclusion: After removal of impacted mandibular third molars, incorporating tube drain is very effective as compared to conventional suturing in reducing the facial swelling, trismus and postoperative pain.


Author(s):  
Ramvihari Thota ◽  
Senthilnathan Periasamy ◽  
N. Mahathi

Aim: The aim of this study is to evaluate the effect of tenoxicam compared to diclofenac sodium in controlling postoperative pain after third molar surgery. Materials and Methods: 36 patients with mean age 30 were selected randomly and placed them in two groups A and B, under group A there are 18 patients and in group B 18 patients were placed, group a is given with tenoxicam 30 mg and for  group b diclofenac sodium 50 mg. Results: Group A experienced significantly less pain than those patients in group b. at 24 hr on the day of surgery, average pain scores of patients in both treatment groups did not differ significantly. On the evening of the third day postoperatively, the group a (tenoxicam) patients experienced significantly less pain than those in group b (diclofenac sodium). Discussion: It is generally accepted that pain following third molar surgery reaches moderate to severe intensity within the first 5 hr after surgery. Pain control in this period is thus of vital importance to the oral surgeon. NSAIDs have shown considerable analgesic activity for the relief of pain after surgery. Prostaglandin concentrations do not peak until 4 hr after surgical trauma. tenoxicam has been shown in our study to produce significant analgesia when compared to diclofenac sodium, especially at 3 to 4 hr postoperatively, the period when there is maximum prostaglandin formation in the tissue. Conclusion: Tenoxicam as administered in the present study was significantly more efficacious than diclofenac sodium and useful for pain control in these cases.


2021 ◽  
Vol 9 (1) ◽  
pp. 13-18
Author(s):  
Tejashree Rajanna ◽  
Hemalatha B R

The postoperative sequelae after third molar surgery include pain, swelling and trismus, Zinc acts as anti-inflammatory agent, can promote wound healing, immune system modulation, tissue repair, and significant reduction in the use of analgesics for oral pain. This study was aimed to evaluate the efficacy of oral zinc lozenge given 30 min before surgery on reducing postoperative sequelae.s: We recruited 70 patients, randomly assigned to two groups: Zinc and Control group, groups received 40mg Zinc lozenge, placebo lozenge 30 min before surgery respectively and every 6h till 72h after surgery. Third molar extraction was performed under local anesthesia. After extraction, pain, swelling, and mouth opening in both groups observed till 72h.Preoperative and postoperative measurement of visual analog scale scores for pain, edema, interincisal opening, was analyzed using Student t test or ANOVA, Chi-square or Mann-Whit­ney U test was performed for non-parametric samples. P &#60; 0.05 was considered as statistically significant: The overall incidence of Pain in the Zinc group was 18% compared to 43% in the Control group (P = .003) Incidence of Pain, swelling, and mouth opening at different time intervals 6h, 24h, 48h and 72h were significantly (P &#62;0.05) better in Zinc group oral zinc lozenge administered 30 minutes preoperatively can significantly reduce complications like pain, swelling, and limited mouth opening after third molar extraction.


2016 ◽  
Vol 3 (4) ◽  
pp. 775
Author(s):  
R Chethan ◽  
T K Ramamuthy ◽  
Shilpa Patil ◽  
Satheesha Reddy

AIM: Assessing the efficacy of drug in controlling pain intensity after surgical removal of impacted  mandibular third molar teeth and to compare the effects. MATERIAL AND METHODS: A double-blind, randomized, controlled clinical trial was conducted. 40 patients were randomly selected and divided into two equal groups. Group A received 50 mg of tramadol orally and Group B received 10 mg of ketorolac orally. In both groups dose was repeated for next 24 hrs. Visual analogue scale was used for the collection of pain intensity from the patients. RESULTS: The results revealed, in Group A, the analgesia started within 1 hour and reached the maximum analgesic effect in 4 hours, pain intensity was 1.8 out of 10, on visual analog scale. In Group B, analgesia started within 1hour and showed it’s maximum analgesic effect. The pain intensity was 2.5 on visual analog scale. The analgesic effect of 50 mg tramadol lasted up to 6 hours and that of ketorolac lasted for 5 hour. CONCLUSION: The study shows that 50mg tramadol is a suitable and safe analgesic for the relief of post-extraction pain and is more effective than 10mg ketorolac with prolonged analgesia and minimal side effects, we recommend studies with randomized clinical trials with larger sample size are needed it in clinical practice.


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