Efficacy of ibuprofen gargle for postoperative pain after mandibular third molar extraction: a phase II, placebo-controlled, double-blind, randomized crossover trial (Preprint)

2021 ◽  
Author(s):  
Yasumasa Kakei ◽  
Takeshi Ioroi ◽  
Takahiro Ito ◽  
Yutaro Okazaki ◽  
Takumi Hasegawa ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Crossover Trial ◽  
Third Molar ◽  
Third Molars ◽  
Double Blind ◽  
Third Molar Extraction ◽  
Randomized Crossover Trial ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars ◽  
Subject Difference

BACKGROUND Extraction of mandibular third molars is one of the most commonly performed oral surgical procedures, and non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for pain management. Oral administration of NSAIDs can produce various adverse events such as gastrointestinal disorders, renal and hepatic dysfunction, and platelet dysfunction. Topical use of analgesics has been proposed as an alternative to oral and injectable medications to safely improve postoperative pain relief. We will conduct a single-center, placebo-controlled, double-blind, randomized crossover trial to assess the pain-relieving effect of an ibuprofen-containing gargle in patients undergoing extraction of mandibular third molars in comparison with a placebo gargle. OBJECTIVE This will be the first clinical study to evaluate the efficacy of ibuprofen gargle for relieving postoperative pain after extraction of mandibular third molars. METHODS This study will be performed at Kobe University Hospital. Participants (n = 40) will be randomized equally to one of two groups. The IP group will receive ibuprofen gargle on postoperative day (POD) 1 and placebo gargle on POD 2. The PI group will receive placebo gargle on POD 1 and ibuprofen gargle on POD 2. Both groups will receive ibuprofen gargle on PODs 3 to 5 at least once daily. The primary objective is to estimate the within-subject difference in a visual analogue scale (VAS) before and 5 minutes after use of ibuprofen or placebo gargle on PODs 1 and 2. The secondary objectives are to estimate the within-subject difference in ΔVAS before and 15 minutes after use of ibuprofen or placebo gargle on PODs 1 and 2, the ΔVAS before and after 5 or 15 minutes of use of ibuprofen gargle on PODs 3 to 5, the overall effectiveness (self-completion, five scales) on PODs 1 to 5, the daily frequency of use (ibuprofen or placebo gargle and analgesics) on PODs 1 to 7, and the occurrence of adverse events. RESULTS The Kobe university Certified Review Board approved the study. The intervention was implemented in May 2021. CONCLUSIONS This trial will provide exploratory evidence of the efficacy and safety of ibuprofen gargle for pain reduction after mandibular third molar extraction. CLINICALTRIAL Japan Registry of Clinical Trials (jRCT) identifier: jRCTs051210022. Registered on 10 May 2021.

scholarly journals Efficacy of Ibuprofen Gargle for Postoperative Pain After Mandibular Third Molar Extraction: A Phase II, Placebo-Controlled, Double-Blind, Randomized Crossover Trial

2021 ◽  
Author(s):  
Yasumasa Kakei ◽  
Takeshi Ioroi ◽  
Takahiro Ito ◽  
Yutaro Okazaki ◽  
Takumi Hasegawa ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Crossover Trial ◽  
Third Molar ◽  
University Hospital ◽  
Third Molars ◽  
Double Blind ◽  
Randomized Crossover Trial ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars ◽  
Subject Difference

Abstract BackgroundExtraction of mandibular third molars is one of the most commonly performed oral surgical procedures, and non-steroidal anti-inflammatory drugs (NSAIDs) are widely used for pain management. Oral administration of NSAIDs produces various adverse events such as gastrointestinal disorders, renal and hepatic dysfunction, and platelet dysfunction. Topical use of analgesics has been proposed as an alternative to oral and injectable medications to safely improve postoperative pain relief. We will conduct a single-center, placebo-controlled, double-blind, randomized crossover trial to assess the pain-relieving effect of an ibuprofen-containing gargle in patients undergoing extraction of mandibular third molars in comparison with a placebo gargle.MethodsThis study will be performed at Kobe University Hospital. Participants (n = 40) will be randomized equally to one of two groups. The IP group will receive ibuprofen gargle on postoperative day (POD) 1 and placebo gargle on POD 2. The PI group will receive placebo gargle on POD 1 and ibuprofen gargle on POD 2. Both groups will receive ibuprofen gargle on PODs 3 to 5 at least once daily. The primary objective is to estimate the within-subject difference in a visual analogue scale (VAS) before and 5 minutes after use of ibuprofen or placebo gargle on PODs 1 and 2. The secondary objectives are to estimate the within-subject difference in ΔVAS before and 15 minutes after use of ibuprofen or placebo gargle on PODs 1 and 2, the ΔVAS before and after 5 or 15 minutes of use of ibuprofen gargle on PODs 3 to 5, the overall effectiveness (self-completion, five scales) on PODs 1 to 5, the daily frequency of use (ibuprofen or placebo gargle and analgesics) on PODs 1 to 7, and the occurrence of adverse events.DiscussionThis will be the first well-designed clinical study to evaluate the efficacy of ibuprofen gargle for relieving postoperative pain after extraction of mandibular third molars. This trial will provide exploratory evidence of the efficacy and safety of ibuprofen gargle for pain reduction after mandibular third molar extraction.Trial registrationJapan Registry of Clinical Trials (jRCT) identifier: jRCTs051210022. Registered on 10 May 2021.

scholarly journals Effect of Intraoral Drainage after Impacted Mandibular Third Molar Extraction on Non-Infectious Postoperative Complications

2021 ◽  
Vol 10 (20) ◽  
pp. 4705
Author(s):  
Grzegorz Trybek ◽  
Joanna Jarzęcka ◽  
Olga Preuss ◽  
Aleksandra Jaroń
Keyword(s):  
Postoperative Complications ◽  
Sodium Alginate ◽  
Third Molar ◽  
Surgical Removal ◽  
Third Molars ◽  
Third Molar Extraction ◽  
Mandibular Third Molar ◽  
Wisdom Teeth ◽  
Group B ◽  
Mandibular Third Molars

Surgical removal of mandibular third molars is associated with non-infectious postoperative complications, including pain, swelling, trismus. Intraoral drains are noteworthy because of their ease of application, availability, and effectiveness. This study aimed to evaluate the use of latex and calcium–sodium alginate mouth flat drains on the severity of postoperative complications such as pain, trismus, and edema after surgical removal of mandibular third molars. Ninety patients who underwent surgical removal of wisdom teeth were studied. The patients were divided into three groups. Group A—with a latex flat drain, group B—with a sodium–calcium alginate (Kaltostat) flat drain, and group C—with a wound closed with knotted sutures. Patients were assessed for pain on a VAS scale every day from surgery to postoperative day 7. Before the procedure and on postoperative days 1, 2, and 7, the pain level, edema, and trismus were measured, respectively. Intraoral drainage with a flat drain after mandibular third molar removal does not significantly reduce pain, as measured by the VAS scale, or postoperative swelling, as measured by lines between craniometric points. Intraoral drainage with a latex drain after mandibular third molar removal does not significantly reduce trismus, while intraoral drainage with a calcium–sodium alginate drainage bag significantly increases trismus.

scholarly journals Evaluasi Ekstraksi Molar Ketiga Rahang Bawah Berdasarkan Angulasi Mesial pada Radiografi Panoramik

e-GIGI ◽  
2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Rosalina I. Saputri ◽  
Rizky M. Boedi
Keyword(s):  
Predictive Factor ◽  
Third Molar ◽  
Third Molars ◽  
Panoramic Radiographs ◽  
Second Molar ◽  
Stomatognathic System ◽  
Third Molar Extraction ◽  
Irregular Pattern ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars

Abstract: Third molar development is a concern in dental care because of its influence on stomatognathic system. Due to third molar irregular pattern of eruption, different clinical and radiographic considerations on how to decide an extraction were studied. This study was aimed to evaluate the effect of mandibular third molar mesial angulation (MA) towards the extractions on panoramic radiographs. This was a retrospective study. A longitudinal study of mandibular third molars (n=192) of 102 individuals (50 Female and 52 Male) was conducted. Development of the mandibular third molar was staged according to modified Köhler et al. staging technique. Mesial angulation was measured from the intersection between axes of third molar and adjacent second molar of the most developed stage for extraction cases or before root completion for non-extraction cases. Of 102 subjects, 107 mandibular third molars were extracted. The increase of 1° of MA would increase the odds ratio (OR) of extraction by 1.113 (95% CI 1.070-1.158, p<0.01). The ROC curve showed the MA of 18.5o as the threshold of extraction with 76% of sensitivity and 68% of specificity. In conclusion, MA has the possibility as a predictive factor of mandibular third molar extraction. Future studies using bigger sample sizes and variations of third molar development are suggestedKeywords: third molar, angulation, extraction, predictive factor, panoramic radiographs Abstrak: Pertumbuhan molar ketiga menjadi perhatian pada perawatan dental karena pengaruh-nya pada sistem stomatognasi. Terdapat banyak penelitian tentang berbagai pertimbangan klinis dan radiografis untuk melakukan ekstraksi molar ketiga karena pola erupsinya yang tidak menentu. Penelitian ini bertujuan untuk mengevaluasi efek angulasi mesial (AM) dari molar ketiga rahang bawah terhadap tindakan ekstraksi pada radiografi panoramik. Jenis penelitian ialah retrospektif. Pengamatan molar ketiga rahang bawah (n=192) secara longitudinal dilakukan pada 102 individu (50 perempuan dan 52 laki-laki). Pertumbuhan molar ketiga diukur berdasarkan tahap pertumbuhan dari teknik modifikasi Köhler et al. AM diukur dari pertemuan aksis molar ketiga dan molar kedua di sebelahnya, pada tahap pertumbuhan paling akhir pada kasus ekstraksi, atau sebelum akar gigi terbentuk sempurna pada kasus non-ekstraksi. Pada sampel penelitian, ekstraksi dilakukan pada 104 molar ketiga rahang bawah. Peningkatan 1o dari AM akan meningkatkan rasio peluang dari ekstraksi sebesar 1,113 (95% CI 1,070-1,158, p<0,01). Pada kurva ROC, AM sebesar 18,5o menunjukan 76% sensitivitas dan 68% spesifisitas. Simpulan penelitian ini ialah AM dapat digunakan sebagai faktor prediksi terhadap ekstraksi molar ketiga rahang bawah. Perkembangan penelitian selajutnya dapat dilakukan dengan jumlah sampel yang lebih besar dan dengan memperhatikan pertimbahan klinis serta parameter radiografik lainnya.Kata kunci: molar ketiga, angulasi, ekstraksi, faktor prediksi, radiografi panoramik

scholarly journals Mesial Migration Effect on Root Morphology of Mandibular Third Molars

2007 ◽  
Vol 77 (1) ◽  
pp. 73-76 ◽  
Author(s):  
A. Altuğ Bıçakçı ◽  
Oral Sökücü ◽  
Hasan Babacan ◽  
H. Hüseyin Köşger
Keyword(s):  
Third Molar ◽  
Root Apex ◽  
Central Line ◽  
Occlusal Plane ◽  
Third Molars ◽  
Migration Effect ◽  
Mandibular Third Molar ◽  
Root Curvature ◽  
History Of ◽  
Mandibular Third Molars

Abstract Objective: To test the hypothesis that there is a relationship between forward mandibular third molar migration and root curvature of the mandibular third molars. Materials and Methods: The study is comprised of 64 patients who had a history of unilateral mandibular first molar extraction before 16 years of age with no other missing teeth or prosthetic restorations in the mandible. The extraction space was fully or partly closed. The mean remaining space was 1.1 ± 0.41 mm. The root angles for the mesial and distal roots of the mandibular third molars were measured on the panoramic radiographs by calculating the differences between the angle formed by the long axis drawn perpendicular to the occlusal plane of the crown of mandibular third molar and the central line of the lower one ninth of the root through the root apex. The differences between the extracted and nonextracted sides for mesial and distal roots were analyzed using a paired sample t-test. Results: Both mesial and distal roots were approximately 8° more vertical on the extraction sides than on the nonextraction sides. The differences were statistically significant. Conclusion: Mesial tooth migration of mandibular third molars reduces the amount of root curvature developing on this tooth.

scholarly journals The Frequency of Mandibular Third Molar Impaction in Different Types of Vertical Skeletal Faces

2021 ◽  
Vol 30 (02) ◽  
pp. 118-123
Author(s):  
Sana Viqar ◽  
◽  
Sadia Rizwan ◽  
Syed Shah Faisal ◽  
Syed Sheeraz Hussain
Keyword(s):  
Third Molar ◽  
Third Molars ◽  
Skeletal Malocclusion ◽  
Mandibular Third Molar ◽  
Lateral Cephalograms ◽  
Significant Difference ◽  
Pre Treatment ◽  
Mandibular Third Molars ◽  
Facial Types ◽  
Third Molar Eruption

OBJECTIVE: To determine the frequency of mandibular third molar impaction in different vertical skeletal facial types. METHODOLOGY: Data was collected using pre-treatment records including orthodontic files, pre-treatment lateral cephalograms and OPGs of 90 orthodontic patients. Patients from both genders were included. The age group of selected patients was 18-30 years. Vertical skeletal malocclusion was measured using facial angle and mandibular plane angle on cephalogram to group the subjects into Mesiofacial, Brachyfacial and Dolichofacial patients. Third molar eruption status was assessed using OPG. RESULTS: Results showed that erupted third molars were mostly found in brachyfacial patients. Among 32 erupted mandibular third molars, 16 belong to brachyfacial, 11 belonged to mesiofacial and 5 belonged to dolichofacial group. Complete impaction of mandibular third molar was most common among dolichofacial patients. Among 29 completely impacted mandibular third molars, 14 belong to dolichofacial, 9 belonged to mesiofacial and 6 belonged to brachyfacial group. No significant difference was found for partially impacted third molars among the three groups of facial types. There was higher prevalence of mandibular third molar impaction in females as compared to males. CONCLUSION: Frequency of third molar impaction was found to be highest in dolichofacial patients and lowest in brachyfacial patients due to forward direction of mandibular growth contributing to greater resorption of the anterior border of ramus and the additional space required for third molar eruption.

scholarly journals Calcifying cystic odontogenic tumor in radiologically normal dental follicular space of mandibular third molars: report of two cases

2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Gargi S. Sarode ◽  
Sachin C. Sarode ◽  
Ghevaram Prajapati ◽  
Mahesh Maralingannavar ◽  
Shankargouda Patil
Keyword(s):  
Cell Transformation ◽  
Histopathological Examination ◽  
Third Molar ◽  
Odontogenic Tumor ◽  
Third Molars ◽  
Radiographic Evidence ◽  
Odontogenic Epithelium ◽  
Mandibular Third Molar ◽  
One Year ◽  
Mandibular Third Molars

Two cases of calcifying cystic odontogenic tumor (CCOT) of the dental follicle in an impacted third molar without clinical and radiological evidence are reported during routine histopathological examination. In both the cases left mandibular third molar was mesioangularly impacted with pericoronal radiolucency of less than 2.5 mm, which was not indicative of any pathology. As a routine protocol (which is not practiced widely) of our institution, dental follicles associated with extracted molars were sent for histopathological examination. Histopathological features were consistent with CCOT with pathognomonic ghost cell transformation of odontogenic epithelium. The patients were followed for one year with no recurrence. This paper emphasizes the importance of routine histopathological examination of dental follicles associated with asymptomatic impacted teeth without any clinical or radiographic evidence of follicular lesion.

scholarly journals Is prophylactic extraction of mandibular third molar indicated? A retrospective study.

2020 ◽  
Author(s):  
Zhouxi Ye ◽  
Wenhao Qian ◽  
Yubo Wu ◽  
Bing Sun ◽  
Zhiyao Li ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Older Patients ◽  
Third Molar ◽  
P Value ◽  
Third Molars ◽  
Impacted Teeth ◽  
Second Molar ◽  
Mandibular Third Molar ◽  
Mandibular Second Molar ◽  
Mandibular Third Molars

Abstract Background To evaluate the associations of impaction patterns of mandibular third molars (M3Ms) with pathologies caused by them. Methods In this study, 262 patients with 432 impacted M3Ms were included. The pathologies include pericoronitis, mandibular second molar (M2M) caries, and M2M distal periodontal pathology. The impaction patterns of M3Ms and the pathologies were examined, and the M2Ms outcomes after the surgeries were evaluated. χ2 test was used to analyze the data and a P value of <0.05 was considered statistically significant. Results Pericoronitis was the major symptom in all patients, whereas the propensities of M2M distal caries and periodontal pathologies increased in older patients. Soft tissue impacted and vertically angulated teeth were more associated with the pericoronitis (p <0.05); Mesio-angular impacted teeth in less deep positions had greater risks of M2Ms distal caries (p <0.05); Mesio-angular and horizontal impacted teeth in relative deep positions were more likely to cause M2Ms distal periodontal pathologies (p <0.05). Conclusions Extractions of soft tissue impacted teeth in vertical angulations should be considered. While removals of mesially and horizontally angulated or bony impacted teeth could be delayed.

scholarly journals Presence and Maturation Dynamics of Mandibular Third Molars and Their Influence on Late Mandibular Incisor Crowding: Longitudinal Study

2021 ◽  
Author(s):  
Martina Žigante ◽  
Andrej Pavlic ◽  
Luka Morelato ◽  
Vaska Vandevska-Radunovic ◽  
Stjepan Spalj
Keyword(s):  
Third Molar ◽  
Third Molars ◽  
Mandibular Incisor ◽  
Dental Maturation ◽  
The Third ◽  
Irregularity Index ◽  
Mandibular Third Molar ◽  
Mandibular Third Molars ◽  
Dental Plaster ◽  
The Relationship

Abstract OBJECTIVE: To investigate the relationship between the presence and dynamics of mandibular third molar development and the occurrence and amount of late mandibular incisor crowding. MATERIALS AND METHODS: Dental plaster casts and panoramic radiographs of 72 orthodontically untreated subjects from the Nittedal growth study, Norway were analysed. The subjects were recalled for check-up at 12, 15, 18 and 21 years of age. Mandibular incisor crowding was assessed using the Little’s irregularity index and dental maturation of the third molars by the Cameriere’s index.RESULTS: The majority of the subjects (64%) had ≥1mm increase in irregularity; 22% experienced increase of 0.1-0.9mm and 14% had unchanged or decreased irregularity. Incisor irregularity increased with age, regardless of absence or presence of third molars. The amount of change in incisor irregularity from 12 to 21 years did not differ significantly between subjects with hypodontia of third molars, extraction and those with third molars present. No differences were observed between erupted, unerupted or impacted third molars. No correlation was found between the amount of change in irregularity and maturation of the third molars.CONCLUSIONS: Occurrence and amount of mandibular late incisor crowding is not significantly influenced by presence or development dynamics of mandibular third molars.

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