scholarly journals 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

Author(s):  
Rilna P ◽  
Sathyanarayanan R ◽  
Raghu K ◽  
Nithin Joseph J ◽  
Sankar K ◽  
...  

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.

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Hashem M. Al-Shamiri ◽  
Maha Shawky ◽  
Nermin Hassanein

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.


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.


2012 ◽  
Vol 59 (3) ◽  
pp. 107-117 ◽  
Author(s):  
Kyle J. Kramer ◽  
Steven Ganzberg ◽  
Simon Prior ◽  
Robert G. Rashid

This study aimed to compare continuous intravenous infusion combinations of propofol-remifentanil and propofol-ketamine for deep sedation for surgical extraction of all 4 third molars. In a prospective, randomized, double-blinded controlled study, participants received 1 of 2 sedative combinations for deep sedation for the surgery. Both groups initially received midazolam 0.03 mg/kg for baseline sedation. The control group then received a combination of propofol-remifentanil in a ratio of 10 mg propofol to 5 μg of remifentanil per milliliter, and the experimental group received a combination of propofol-ketamine in a ratio of 10 mg of propofol to 2.5 mg of ketamine per milliliter; both were given at an initial propofol infusion rate of 100 μg/kg/min. Each group received an induction loading bolus of 500 μg/kg of the assigned propofol combination along with the appropriate continuous infusion combination . Measured outcomes included emergence and recovery times, various sedation parameters, hemodynamic and respiratory stability, patient and surgeon satisfaction, postoperative course, and associated drug costs. Thirty-seven participants were enrolled in the study. Both groups demonstrated similar sedation parameters and hemodynamic and respiratory stability; however, the ketamine group had prolonged emergence (13.6 ± 6.6 versus 7.1 ± 3.7 minutes, P = .0009) and recovery (42.9 ± 18.7 versus 24.7 ± 7.6 minutes, P = .0004) times. The prolonged recovery profile of continuously infused propofol-ketamine may limit its effectiveness as an alternative to propofol-remifentanil for deep sedation for third molar extraction and perhaps other short oral surgical procedures, especially in the ambulatory dental setting.


2017 ◽  
Vol 65 (1) ◽  
pp. 13-19 ◽  
Author(s):  
Tiago Nascimento MILETO ◽  
Fabiano Goulart AZAMBUJA

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.


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.


2016 ◽  
Vol 10 (03) ◽  
pp. 381-385 ◽  
Author(s):  
Jehona Ahmedi ◽  
Enis Ahmedi ◽  
Osman Sejfija ◽  
Zana Agani ◽  
Vjosa Hamiti

ABSTRACT Objective: The objective of this study was to assess the efficacy of ozone gas (O3) on the reduction of dry socket (DS) occurrence following surgical extraction of lower jaw third molars, influence of the indication for the extraction, and the difficulty of extraction on the incidence of DS. Materials and Methods: This study included thirty patients with bilaterally impacted third molars of mandible requiring surgical procedure for extraction. Following extraction, in the control group, saline solution was used for irrigation of extraction sockets and in the experimental group, intra-alveolar O3 was applied for 12 s (Prozone, W and H, UK, Ltd.). The surgeries were performed by the same oral surgeon. The follow-up visits were performed at 48 h and on day seven, postsurgery where the symptoms of DS were evaluated and intensity of pain has been recorded using visual analog scale 0–100. Results: In this pilot study, DS was present in 16.67% and 3.33% of cases in the control and experimental groups, respectively (P = 0.20). Conclusion: The application of O3 may reduce the incidence of DS and accelerates the recovery period after the surgery. Prophylactic use of O3 may be suggested in all patients, especially in the patients at a risk of development of DS.


2015 ◽  
Vol 22 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Mohammad H. Jarrah ◽  
Hytham F. Al-Rabadi ◽  
Mohammad Imrayan ◽  
Ahmad A. Al-Share

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Christian Bacci ◽  
Giulia Cassetta ◽  
Bruno Emanuele ◽  
Mario Berengo

The aim of this study was to assess the efficacy of Normast 300 mg in reducing swelling and pain after the surgical extraction of impacted lower third molars. Materials and Methods. A randomized, split-mouth, single-blind study was conducted on 30 patients between 18 and 30 years of age requiring lower third molar extraction. Patients underwent bilateral extractions in a randomized sequence, one extraction being performed under Normast treatment. The Normast treatment involved 2 tablets a day for 15 days. The parameters assessed at each procedure were trismus, swelling, pain, NSAID consumption, postoperative complications, drug tolerability, and safety. The results obtained were processed using repeated measures analysis of variance. Results. Perceived postoperative pain was reportedly significantly milder on Normast treatment than control. The trend of the means differed over time (P<.0001) and between the two extraction groups (P<.0221). On the other hand, for edema and trismus, the trend differed over time for both groups but did not differ between the two groups. Discussion. Our analyses indicate that patients experienced significantly less postoperative pain when they were treated with Normast. Conclusions. Administering Normast improves the postoperative course—in terms of pain—after lower third molar extraction.


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