Multifocal Analysis of Acute Pain After Third Molar Removal

Background: To analyze the pain modulation capacity profile in a Brazilian population, the relationship between opioid receptor (OPRM1) and Catechol-O-methyltransferase (COMT) 1polymorphisms and pain modulation capacity was determined through preoperative pain modulation tests and acute postoperative pain control evaluation, swelling, and trismus in 200 volunteers undergoing lower third molar removal.Methods: Psychologic and clinical parameters were measured. Patient DNA was sequenced for single nucleotide polymorphisms in OPRM1 and COMT, and the salivary concentration of interleukin (IL)-2 (IL)-6, interferon (IFN)-γ and tumor necrosis factor (TNF)-α was evaluated. Primary outcomes were the influence of all predictors on the fluctuation of pain intensity using a visual analogue scale (VAS), and swelling and trismus on the 2nd and 7th postoperative days. Preoperative pain modulation capacity (CPM), pain catastrophizing scale (PCS), body mass index (BMI), and surgery duration and difficulty were evaluated.Results: Salivary concentration of IFN-γ and IL-2 as well as the duration of surgery influenced the fluctuation of postoperative pain in the VAS, and in the sum of the differences in pain intensity test at 8, 48, and 96 h. BMI influenced swelling, while both BMI and COMT haplotype influenced trismus on the 2nd postoperative day.Conclusion: Polymorphisms in COMT, salivary concentrations of IL-2 and IFN-γ, BMI, and duration of surgery were predictors for pain fluctuation, swelling, and trismus on the 2nd day after lower third molar extraction. This therapy was effective in controlling inflammatory symptomatology after lower third molar extraction and ibuprofen was well tolerated by patients.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT03169127.

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Effect of Age, Gender, Side and Impaction Types on Surgical Difficulty During Mandibular Third Molar Extraction.

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v17i2.18950 ◽

2018 ◽

Vol 17 (2) ◽

pp. 11

Author(s):

Krishna Gopal Bhuju ◽

Sujita Shrestha ◽

Riwaj Karki ◽

Sameer Aryal

Keyword(s):

Third Molar ◽

Objective Measure ◽

Operation Time ◽

Significance Level ◽

Third Molar Extraction ◽

Mandibular Third Molar ◽

Duration Of Surgery ◽

Surgical Difficulty ◽

Effect Of Age ◽

Molar Extraction

Aim: To study the effect of age, gender, side and impaction types on surgical difficulty during mandibular third molar extraction through the data collected over a period of one year by single maxillofacial surgeon. All the extractions were performed under the same environment and conditions.Methods: Descriptive clinical study of 401 patients was carried out between the ages of 16 to 45years. Age, gender, impaction side and impaction types (according to the winter classification) were recorded on proforma. Duration of surgery for each patient was recorded after starting incision to the completion of suture which was divided into less than 10 minutes (mild), 11 to 20 minutes (moderate) and above 21 minutes (severe). Pearson’s Chi-square test was used for data analysis and significance level was less than or equal to 0.05.Results: Among 401 participants, 225 (56.1%) were male and 176 (43.9%) were female. Mean age was 31.5 years and mean operation time was 17.59 minutes. After statistical analysis there was a significant correlation among gender and side of impaction where p value is 0.043 0.048 respectively.Conclusion: There is a statistically significant correlation between gender and side of impaction with duration of surgery which is considered as the objective measure of surgical difficulty whereas age and impaction types didn’t show any significant correlation.

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Oral pregabalin for postoperative pain relief after third molar extraction: a randomized controlled clinical trial

Clinical Oral Investigations ◽

10.1007/s00784-015-1657-3 ◽

2015 ◽

Vol 20 (7) ◽

pp. 1819-1826 ◽

Cited By ~ 7

Author(s):

Maria Victoria Olmedo-Gaya ◽

Francisco J. Manzano-Moreno ◽

Rafael Galvez-Mateos ◽

Maria Paloma González-Rodriguez ◽

Cristina Talero-Sevilla ◽

...

Keyword(s):

Clinical Trial ◽

Postoperative Pain ◽

Pain Relief ◽

Third Molar ◽

Postoperative Pain Relief ◽

Controlled Clinical Trial ◽

Randomized Controlled Clinical Trial ◽

Randomized Controlled ◽

Third Molar Extraction ◽

Molar Extraction

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Oral hygiene level influences the level of postoperative pain after third molar extraction

Journal of Evidence Based Dental Practice ◽

10.1067/med.2002.125676 ◽

2002 ◽

Vol 2 (2) ◽

pp. 154-155

Keyword(s):

Postoperative Pain ◽

Oral Hygiene ◽

Third Molar ◽

Third Molar Extraction ◽

Molar Extraction

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

ISRN Surgery ◽

10.5402/2011/917350 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 10

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.

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A Comparison of Opioids and Non-Opioids in Management of Postoperative Pain Following Third Molar Extraction

Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.joms.2019.06.100 ◽

2019 ◽

Vol 77 (9) ◽

pp. e74-e75

Author(s):

S. Mir ◽

J. Bishop ◽

S. Swaroop ◽

A. Viswanath

Keyword(s):

Postoperative Pain ◽

Third Molar ◽

Third Molar Extraction ◽

Molar Extraction

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Third Molar Extraction: Irrigation and Cooling with Water or Sterile Physiological Solution: A Double-Blind Randomized Study

Dentistry Journal ◽

10.3390/dj9040040 ◽

2021 ◽

Vol 9 (4) ◽

pp. 40

Author(s):

Luca Sbricoli ◽

Alessia Cerrato ◽

Anna Chiara Frigo ◽

Gastone Zanette ◽

Christian Bacci

Keyword(s):

Postoperative Pain ◽

Randomized Study ◽

Third Molar ◽

Physiological Solution ◽

Wilcoxon Test ◽

University Hospital ◽

Double Blind ◽

Third Molar Extraction ◽

Surgical Field ◽

Molar Extraction

Background: The present study aimed to ascertain whether any significant reduction in patients’ postoperative pain and inflammation could be achieved by using sterile physiological solution instead of normal water to irrigate the surgical field and cool the dental bur during third molar extractions. Methods: The study concerned 22 patients (11 females and 11 males) in good general health, who were referred to the Dental Clinic at Padova University hospital for lower third molar extractions. They were randomly assigned to two groups. Only the fluid used to irrigate the surgical field and cool the dental bur differed between the two study groups, being sterile physiological solution for group A, and mains water for group B. Postoperative pain, swelling, trismus and inflammation with high sensitivity CRP where measured and statistically evaluated. The numerosity of our sample was calculated on the grounds of an endpoint based on data in the literature. Results: Eighteen patients needed bilateral extractions, and 4 required only one extraction, so a total of 40 third molars were extracted. A sterile physiological solution was used to irrigate the surgical field in 20 extractions, while water was used in the other 20 cases. Data analysis with Wilcoxon test show no differences between the two groups (p < 0.05). Conclusions: no differences between groups for any of the parameters considered, after third molar extraction procedures undertaken using either sterile physiological solution or water for irrigation and cooling purposes.

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A Double-Blind Placebo-Controlled Comparison of a Novel Formulation of Intravenous Diclofenac and Ketorolac for Postoperative Third Molar Extraction Pain

Anesthesia Progress ◽

10.2344/0003-3006-58.2.73 ◽

2011 ◽

Vol 58 (2) ◽

pp. 73-81 ◽

Cited By ~ 20

Author(s):

Kyle Christensen ◽

Stephen Daniels ◽

Donald Bandy ◽

Cynthia C. Ernst ◽

Douglas A. Hamilton ◽

...

Keyword(s):

Pain Relief ◽

Pain Intensity ◽

Third Molar ◽

Global Evaluation ◽

Onset Of Action ◽

Double Blind ◽

Double Blind Placebo ◽

Third Molar Extraction ◽

Secondary Endpoints ◽

Molar Extraction

Abstract Dyloject is a novel formulation of diclofenac intended for intravenous (IV) administration. This formulation employs the solubilizing agent hydroxypropyl-β-cyclodextrin to permit bolus IV administration. The efficacy and safety of 5 dose levels of IV diclofenac were compared with IV ketorolac and placebo following third molar extraction. This was a single-dose, randomized, double-blind, placebo- and comparator-controlled, parallel-group study. A total of 353 subjects with moderate to severe pain received placebo; ketorolac 30 mg; or IV diclofenac 3.75, 9.4, 18.75, 37.5, or 75 mg (N = 51 for all groups, except N = 47 for ketorolac). The primary endpoint was total pain relief over 6 hours (TOTPAR6) as measured by the visual analog scale (VAS). Secondary endpoints included multiple measures of pain intensity and relief; patient global evaluation; and times to pain relief and rescue medication. Dropouts and adverse effects (AEs) were also monitored. IV diclofenac was superior to placebo as measured by TOTPAR6 (P < .0001 for all doses except 3.75 mg, for which P = .0341). IV diclofenac 3.75 mg was statistically superior to placebo for TOTPAR2 and TOTPAR4. IV diclofenac at both 37.5 and 75 mg was superior to placebo (P < .05) at the earliest (5 minute) assessments of pain intensity and pain relief, but ketorolac was not. The proportion of patients reporting 30% or greater pain relief at 5 minutes was significantly greater after IV diclofenac 37.5 and 75 mg than after ketorolac 30 mg or placebo. Secondary endpoints confirmed the primary findings. Treatment-related AEs were generally mild to moderate and were typical for nonsteroidal anti-inflammatory drugs (NSAIDs). The more rapid onset of action of IV diclofenac compared with the reference injectable NSAID ketorolac suggests additional clinical benefit. If confirmed in larger series, these findings may improve the safety and efficacy of postoperative NSAID analgesia.

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Comparison of oral versus sublingual piroxicam during postoperative pain management after lower third molar extraction

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2010.10.026 ◽

2011 ◽

Vol 40 (3) ◽

pp. 292-297 ◽

Cited By ~ 10

Author(s):

P.A.K. Trindade ◽

F.P.M. Giglio ◽

B.L. Colombini-Ishikiriama ◽

A.M. Calvo ◽

K.C.S. Modena ◽

...

Keyword(s):

Pain Management ◽

Postoperative Pain ◽

Third Molar ◽

Postoperative Pain Management ◽

Third Molar Extraction ◽

Molar Extraction

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Effect of Age, Gender, Side and Impaction Types on Surgical Difficulty During Mandibular Third Molar Extraction.

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v17i1.18950 ◽

2018 ◽

Vol 17 (1) ◽

pp. 11-17

Author(s):

Krishna Gopal Bhuju ◽

Sujita Shrestha ◽

Riwaj Karki ◽

Sameer Aryal

Keyword(s):

Third Molar ◽

Operation Time ◽

P Value ◽

Significance Level ◽

Third Molar Extraction ◽

Mandibular Third Molar ◽

Duration Of Surgery ◽

Surgical Difficulty ◽

Effect Of Age ◽

Molar Extraction

Aim: To study the effect of age, gender, side and impaction types on surgical difficulty during mandibular third molar extraction through the data collected over a period of one year by single maxillofacial surgeon. All the extractions were performed under the same environment and conditions.Methods: Descriptive clinical study of 401 patients was carried out between the ages of 16 to 45years. Age, gender, impaction side and impaction types (according to the winter classification) were recorded on proforma. Duration of surgery for each patient was recorded after starting incision to the completion of suture which was divided into less than 10 minutes (mild), 11 to 20 minutes (moderate) and above 21 minutes (severe). Pearson’s Chi-square test was used for data analysis and significance level was less than or equal to 0.05.Results: Among 401 participants, 225 (56.1%) were male and 176 (43.9%) were female. Mean age was 31.5 years and mean operation time was 17.59 minutes. After statistical analysis there was a significant correlation among gender and side of impaction where p value is 0.043 0.048 respectively.Conclusion: There is a statistically significant correlation between gender and side of impaction with duration of surgery which is considered as the objective measure of surgical difficulty whereas age and impaction types didn’t show any significant correlation.

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