scholarly journals Comparison of Propofol-Remifentanil Versus Propofol-Ketamine Deep Sedation for Third Molar Surgery

2012 ◽  
Vol 59 (3) ◽  
pp. 107-117 ◽  
Author(s):  
Kyle J. Kramer ◽  
Steven Ganzberg ◽  
Simon Prior ◽  
Robert G. Rashid
Keyword(s):  
Deep Sedation ◽  
Third Molar ◽  
Controlled Study ◽  
Third Molar Surgery ◽  
Control Group ◽  
Oral Surgical Procedures ◽  
Third Molar Extraction ◽  
Surgical Extraction ◽  
Recovery Times ◽  
Double Blinded

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.

scholarly journals The effect of zinc lozenge on pain, oedema, and trismus after impacted third molar surgery: A prospective randomized, double-blinded, placebo-controlled study

2021 ◽  
Vol 9 (1) ◽  
pp. 13-18
Author(s):  
Tejashree Rajanna ◽  
Hemalatha B R
Keyword(s):  
Third Molar ◽  
Mouth Opening ◽  
Controlled Study ◽  
Third Molar Surgery ◽  
Control Group ◽  
Chi Square ◽  
Third Molar Extraction ◽  
Scale Scores ◽  
Immune System Modulation ◽  
Molar Extraction

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 < 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 >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.

scholarly journals A Comparative Study on Efficacy of Amoxicillin and Azithromycin in Prevention of Postoperative Sequelae Following Third Molar Surgery

2019 ◽  
Vol 21 (3) ◽  
pp. 224-229
Author(s):  
Rashmi Shakya Gurung ◽  
K. Bimb ◽  
D. Shrestha
Keyword(s):  
Maxillofacial Surgery ◽  
Third Molar ◽  
Controlled Study ◽  
Third Molar Surgery ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
Operative Complications ◽  
Alternative Drug ◽  
Group B ◽  
Post Operative Complications

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.

scholarly journals Efficiency of gaseous ozone in reducing the development of dry socket following surgical third molar extraction

2016 ◽  
Vol 10 (03) ◽  
pp. 381-385 ◽  
Author(s):  
Jehona Ahmedi ◽  
Enis Ahmedi ◽  
Osman Sejfija ◽  
Zana Agani ◽  
Vjosa Hamiti
Keyword(s):  
Recovery Period ◽  
Third Molar ◽  
Control Group ◽  
Third Molars ◽  
Dry Socket ◽  
Third Molar Extraction ◽  
Surgical Extraction ◽  
Prophylactic Use ◽  
Experimental Group

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.

scholarly journals Randomized Split-Mouth Study on Postoperative Effects of Palmitoylethanolamide for Impacted Lower Third Molar Surgery

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Christian Bacci ◽  
Giulia Cassetta ◽  
Bruno Emanuele ◽  
Mario Berengo
Keyword(s):  
Postoperative Pain ◽  
Repeated Measures ◽  
Third Molar ◽  
Third Molar Surgery ◽  
Third Molar Extraction ◽  
Drug Tolerability ◽  
Repeated Measures Analysis ◽  
Surgical Extraction ◽  
Over Time ◽  
Molar Extraction

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.

scholarly journals Microbiological Evaluation of the Antibacterial Vicryl Suture in the Mandibular Third Molar Surgery

2021 ◽  
Author(s):  
Milad Etemadi Sh ◽  
Sameen Rahgozar ◽  
Golnaz Tajmiri ◽  
Javad Alizargar ◽  
Shu-Fang Vivienne Wu
Keyword(s):  
Third Molar ◽  
Third Molar Surgery ◽  
P Value ◽  
Suture Materials ◽  
Number Of Patients ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
Significant Difference ◽  
Vicryl Suture ◽  
Double Blinded

Background: Selection and application of suture materials, has gained more importance especially with the increasing number of patients seeking oral surgeries. Since lying in a bacterial-filled environment, sutures make the tissue prone to infection. Suture material plays an important role in the reduction of the risk of infection. This study aimed to assess the success rate of an antibacterial suture named Vicryl Plus in preventing bacterial growth in the surgical site of the mandibular third molar. Methods: 27 patients were included in this double-blinded randomized clinical trial study. Surgical Extraction of the mandibular wisdom tooth was done and the incision was managed by randomly using Vicryl Plus and Vicryl sutures. After 7 days, sutures were removed and assessed microbiologically. Predominant species of Streptococcus mutans and Lactobacillus were assessed as well as the total number of colonies on each suture. Results: There was a significant difference between two suture materials in colony number-length ratio of lactobacillus (p-value= 0.031) and total bacterial colonies (p-value=0.016); but not for S. mutans species (p-value=0.201). Conclusion: Antibacterial Vicryl suture can be a useful tool for the reduction in the rate of surgical site infection in high-risk cases and situations.

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 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

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.

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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