Comparison of Two Different Doses of Dexamethasone to Control Swelling and Trismus following Mandibular Third Molar Surgery

Introduction: Third molar surgery is one of the most common procedures performed by dental surgeons in clinical practice, where postoperative sequelae like pain, trismus, and swelling are often encountered. Thus, in this study, we compared medications employed to reduce such complications. Objective: To compare the effect of two different doses (4 and 8 mg) of dexamethasone in the control of swelling and trismus after the surgical extraction of mandibular impacted third molars. Methods: An experimental study consisted of twenty-seven (27) healthy adult patients of both genders with bilateral impacted lower third molars, where surgical extraction was indicated, 4 mg and 8 mg of dexamethasone were given orally to the patients 1 hour before the surgical procedure at both the surgeries. The swelling was recorded by measuring the length of 3 facial planes using a measuring tape. Trismus was evaluated by measuring the maximum interincisal distance. Recording of facial swelling and maximum interincisal distance was done preoperatively and on the 1st and 2nd days postoperatively. Results: Based on statistical analysis (Independent T-test), the results showed a difference in the measurements of the degree of swelling and trismus of the treated sample. 8 mg of dexamethasone promoted a greater reduction of symptoms than 4mg of dexamethasone though there was no statistically significant (p-value >0.05) difference between the two doses. Conclusions: 8 milligrams of the dexamethasone had better effectiveness than 4 milligrams of the dexamethasone in reducing the degree of swelling and trismus. Keywords: Dexamethasone; impacted third molars; swelling; trismus.

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A Comparative Study of Surgical Morbidity Associated with Mandibular Third-Molar Surgery in Young and Aging Populations

The Journal of Contemporary Dental Practice ◽

10.5005/jcdp-11-4-1 ◽

2010 ◽

Vol 11 (4) ◽

pp. 1-8 ◽

Cited By ~ 8

Author(s):

Wasiu L. Adeyemo ◽

Mobolanle O. Ogunlewe ◽

Akinola L. Ladeinde ◽

Olufemi O. Hassan ◽

Olanrewaju A. Taiwo

Keyword(s):

Third Molar ◽

Third Molar Surgery ◽

Third Molars ◽

Surgical Morbidity ◽

Surgical Extraction ◽

Aging Populations ◽

Group A ◽

Mandibular Third Molar Surgery ◽

Group B ◽

Mandibular Third Molars

Abstract Aim Prophylactic surgical extraction of impacted third molars is a common practice throughout the world justified on the presumption that the risk of surgical morbidity increases with increasing age, among other reasons. The aim of this study was to analyze and compare surgical morbidity associated with third-molar extractions in young and aging populations. Methods and Materials A review of records for all patients who underwent the surgical extraction of impacted third molars between April 2001 and June 2006 at the Lagos University Teaching Hospital was carried out. Results A total of 506 patients had surgical extractions of impacted third molars under local anaesthesia during the period of the study. Of these, 470 (92.9 percent) patients were below the age of 40 years (Group A) and 36 (7.1 percent) patients were 40 years of age and older (Group B). No incidences of severe intraoperative complications (excessive bleeding or mandibular fractures) were recorded in either group, but other postoperative complications were reported in 70 (13.8 percent) patients. Of these 70 patients, 65 (92.9 percent) were from Group A and 5 (7.1 percent) were from Group B, and their complications included infected socket, dry socket, paraesthesia, and buccal space abscess. Conclusions No significant difference in postoperative complications following surgical removal of mandibular third molars was found between patients 40 years old and greater and those below age 40. Prophylactic surgical extraction of impacted mandibular third molars, based on the assumption that surgical morbidity increases with age, may not be justifiable. Clinical Significance Age does not predispose patients who had surgical extraction of mandibular third molars above 40 years of age to any additional surgical complications when compared to patients below the age of 40 years receiving comparable treatment. Citation Adeyemo WL, Ogunlewe MO, Ladeinde AL, Hassan OO, Taiwo OA. A Comparative Study of Surgical Morbidity Associated with Mandibular Third-Molar Surgery in Young and Aging Populations. J Contemp Dent Pract [Internet]. 2010 July; 11(4):001-008. Available from: http:// www.thejcdp.com/journal/view/volume11-issue4- adeyemo

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Low-intensity laser efficacy in postoperative extraction of third molars

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-863720170001000023084 ◽

2017 ◽

Vol 65 (1) ◽

pp. 13-19 ◽

Cited By ~ 1

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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Effect of Preoperative Single Dose Dexamethasone Injection in Masseter Muscle on Postoperative Sequelae Following Lower Impacted Third Molar Surgery

Journal of Isfahan Dental School ◽

10.18502/ijds.v17i1.5919 ◽

2021 ◽

Author(s):

Mehrzad Moghadasi ◽

Arash Golestaneh ◽

Arash Ghodosi ◽

Shayan Golestani

Keyword(s):

Masseter Muscle ◽

Third Molar ◽

Control Group ◽

P Value ◽

Surgical Removal ◽

Third Molars ◽

Bony Tissue ◽

Oral Aperture ◽

Significant Difference ◽

Facial Swelling

Introduction: The surgical removal of impacted lower third molars involves trauma to soft and bony tissue and can result in pain, swelling and trismus. The purpose of this study was to evaluate the efficacy of dexamethasone, as a single 4 mg dose injected into the masseter muscle prior to extraction of impacted lower third molars on theses postoperative sequelae. Materials & Methods: This prospective, randomized clinical research consisted of 43 healthy patients. The study group received 4 mg dexamethasone into the masseter muscle via intrabuccal approach immediately before starting the procedure while the control group received no corticoid. 7 days after surgery. Data were analyzed using t-test (α = 0.05). Results: The patients administered dexamethasone showed superior results after surgery in terms of oral aperture, pain and all the facial swelling parameters, with statistically significant differences versus the controls (p value<0.001). Also there was statistically significant difference in terms of patients trismus between case and controlgroups (p value<0.001). Conclusion: The results obtained showed that 4 mg of dexamethasone injected into the masseter muscle in the immediately before starting the procedure significantly reduces swelling, trism us and pain.

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

BMC Oral Health ◽

10.1186/s12903-021-01759-x ◽

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

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The Effect of Platelet Rich Plasma on Tissue Healing after Mandibular Third Molar Surgery

Journal of Isfahan Dental School ◽

10.18502/ijds.v17i2.6880 ◽

2021 ◽

Author(s):

Negin Karimi ◽

Behnam Khorrami ◽

Reza Nezhadnasrollah ◽

Yamin Haghani

Keyword(s):

Soft Tissue ◽

Third Molar ◽

Test Group ◽

Third Molar Surgery ◽

P Value ◽

Soft Tissue Healing ◽

Tissue Healing ◽

Mandibular Third Molar ◽

The Mean ◽

Mandibular Third Molar Surgery

Introduction: This study aimed, effect of platelet-rich plasma (PRP) on soft tissue healing after mandibular third molar surgery. Materials & Methods: In this semi-blinded clinical trial study,30 selected patients requiring surgical extraction of soft tissue impacted mandibular third molar participated from cases referred to the Department of Surgery, Faculty of Dentistry, Isfahan Azad University 2017.Patients divided into both test and control groups. PRP was placed in the extracted socket of the test group, whereas the control group had no PRP. Arzhangian standard kit utilized for preparation of PRP. The outcome variables in this study were pain, swelling, inter incisal mouth opening, wound dehiscence, dry socket, bleeding, and tissue color. The collected data analyzed using statistical tests followed independent T-test, Mann-Whitney, and fisher (p value < 0.05). Results: The mean postoperative pain score (Visual Analog Scale) lowered for the test group after several wound dehiscence on the third and seventh days after surgery which was statistically significant (p value < 0.001). Although the mean bleeding time on the third day after surgery decreased in the test group, this difference was not statistically significant (p value = 0.59). There were no statistically significant between both groups for The dry socket incidence on the seventh day and the mean of inter incisal mouth opening in the third and seventh days after surgery as well. Conclusion: The usage of topical PRP has beneficial advantages on soft tissue healing after mandibular third molar surgery. Unlike the control group, The PRP group provided reduced pain and better soft tissue healing.

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Pharmacological Control of Complications Following to Third Molar Removal: Evidence Based on A Meta-Analysis

Drug Research ◽

10.1055/a-0637-8948 ◽

2018 ◽

Vol 69 (01) ◽

pp. 5-11 ◽

Cited By ~ 1

Author(s):

Mario Isiordia-Espinoza ◽

Ronell Bologna-Molina ◽

Ycenna Hernández-Miramontes ◽

Juan Zapata-Morales ◽

Angel Alonso-Castro ◽

...

Keyword(s):

Meta Analysis ◽

Third Molar ◽

Qualitative Evaluation ◽

Clinical Effectiveness ◽

Cochrane Library ◽

Third Molar Surgery ◽

P Value ◽

Facial Swelling ◽

Inflammatory Drugs ◽

Anti Inflammatory

Abstract Aims The purpose of this meta-analysis was to evaluate the clinical efficacy of non-steroidal anti-inflammatory drugs and dexamethasone on the trismus, postsurgical pain, facial swelling, as well as the analgesic consumption after third molar surgery. Material and Methods The reports were identified in the most important medical databases. Those studies that met the requirements were fully assessed according to the inclusion and exclusion criteria. The quality of each report was evaluated with the Oxford Quality Scale and using the Cochrane Collaboration’s risk of bias tool. Each meta-analysis was done using the technique of mean difference and 95% confidence intervals employing a random effects model with the Review Manager 5.3., from the Cochrane Library. Significant statistical difference was accepted when the p value was less than 0.05 on the test of overall effect (Z value). Results Qualitative evaluation was done using the data of 330 patients extracted from seven articles and the quantitative assessment with data of 200 patients from three reports. It was not observed difference among non-steroidal anti-inflammatory drugs and dexamethasone in any of the clinical effectiveness indicators. Conclusion The outcomes of our meta-analysis indicate that non-steroidal anti-inflammatory drugs and dexamethasone have good therapeutic effect for the management of inflammatory complications following to third molar surgery.

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The Effect of Oral Ketorolac Compared to Ibuprofen on Edema, Trismus, and Pain After Mandibular Third Molar Surgery

Avicenna Journal of Dental Research ◽

10.34172/ajdr.2021.25 ◽

2021 ◽

Vol 13 (4) ◽

pp. 130-134

Author(s):

Mostafa Govahi ◽

Hamidreza Ajami ◽

Vahid Khalili ◽

Ayda Paydar ◽

Gooya Kabir

Keyword(s):

Statistical Tests ◽

Third Molar ◽

Mouth Opening ◽

Third Molar Surgery ◽

P Value ◽

Third Molar Extraction ◽

Mandibular Third Molar ◽

Mandibular Third Molar Surgery ◽

The One ◽

Surgery Department

Background: Latent third molar extraction is the most common surgery in dentistry. Common complications of this surgery include pain, swelling, and trismus. To control these side effects, several drugs have been developed and evaluated in various studies. However, the present study is the first one to compare the effects of ibuprofen and ketorolac on pain, swelling, and trismus after molar surgery. Methods: This study was a split-mouth clinical trial. To conduct the trial, 20 candidates were selected from among patients referring to Surgery Department of the Dentistry School at Yazd Shahid Sadoughi University of Medical Sciences for mandibular third molar removal surgery. The patients were divided into two groups after the surgery: one group received ibuprofen, and the other one received ketorolac. Pain, swelling, and trismus were evaluated prior to the surgical procedure, 24 hours later, and one week after the surgery. Data were analyzed by SPSS software version 22 by using Wilcoxon statistical tests and paired t test. Results: Ibuprofen and ketorolac had similar effects on pain relief (P value>0.05). Studying the two groups produced similar results regarding improvement in mouth opening (P value>0.05). Improvement pace of the postoperative swelling was significantly faster in the group receiving ketorolac compared to the one receiving ibuprofen (P value <0.05). Conclusions: It was concluded that ibuprofen and ketorolac had positive and almost similar effects on pain control, edema, and trismus after molar surgery. However, ketorolac was more effective in controlling edema after surgery.

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

10.20944/preprints202105.0207.v1 ◽

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.

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