scholarly journals Effects of Lactobacillus reuteri-containing lozenges on healing after surgical removal of mandibular third molars: a randomised controlled trial

2019 ◽  
Vol 10 (6) ◽  
pp. 653-659
Author(s):  
D.-Å. Wälivaara ◽  
I. Sjögren ◽  
N. Gerasimcik ◽  
T. Yucel-Lindberg ◽  
S. Twetman ◽  
...  
Keyword(s):  
Wound Healing ◽  
Lactobacillus Reuteri ◽  
Controlled Trial ◽  
Test Group ◽  
Subjective Perception ◽  
Surgical Removal ◽  
Third Molars ◽  
Post Surgery ◽  
Surgical Extraction ◽  
Mandibular Third Molars

We investigated the effect of probiotic supplements on oral wound healing, swelling, pain and discomfort after surgical removal of mandibular third molars. A second aim was to evaluate if the intervention could influence the concentrations of oxytocin in saliva. Sixty-four consecutive volunteers (18-34 years) were enrolled to a double-blind randomised placebo-controlled trial with two parallel arms. Following surgery, the patients were asked to take three lozenges per day containing two strains of Lactobacillus reuteri (DSM 17938 and ATCC PTA 5289) or placebo for two weeks. The clinical healing and extra-oral swelling were scored two weeks post-operatively. Samples of wound exudate were cultivated for the presence of Staphylococcus aureus and β-haemolytic streptococci. Salivary oxytocin concentrations were analysed from pre- and post-surgery samples using ELISA technique. Compliance and the subjective perception of swelling, pain and discomfort were reported daily through visual analogue scales in a logbook. All patients except three completed the protocol and the postoperative course was uneventful in most cases. Minor extra-oral swellings were noted in five patients, but none required antibiotic treatment. At the 2-week follow-up, there were no significant differences in clinical wound healing index, extra-oral swelling, bacterial growth or salivary oxytocin levels between the groups. The self-reported data unveiled, however, a significantly reduced sense of swelling, in particular during the second week after surgery in the probiotic test group (P<0.05). Likewise, significantly fewer nights with disturbed sleep and fewer days with sick-leave from work were reported among the participants in the test group (P<0.05). No differences were found in the post-operative use of analgesics. In conclusion, we found no significant influence of probiotic supplements on objective wound healing after surgical extraction of impacted mandibular third molars. However, since the patients’ perceived significant post-operative ameliorations, further studies are needed to explore the patient’s value of the intervention.

scholarly journals Comparison of Piezosurgery and Conventional Rotary Instruments for Removal of Impacted Mandibular Third Molars: A Randomized Controlled Clinical and Radiographic Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Hani Arakji ◽  
Mohamed Shokry ◽  
Nayer Aboelsaad
Keyword(s):  
Statistical Significance ◽  
Third Molar ◽  
Test Site ◽  
Surgical Removal ◽  
Third Molars ◽  
Randomized Controlled ◽  
Surgical Extraction ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
Bone Quantity

The purpose of this study was to test the effect of the surgical removal of impacted mandibular third molars using piezosurgery versus the conventional surgical technique on postoperative sequelae and bone healing.Material and Methods.This study was carried out as a randomized controlled clinical trial: split mouth design. Twenty patients with bilateral mandibular third molar mesioangular impaction class II position B indicated for surgical extraction were treated randomly using either the piezosurgery or the conventional bur technique on each site. Duration of the procedure, postoperative edema, trismus, pain, healing, and bone density and quantity were evaluated up to 6 months postoperatively.Results.Test and control sites were compared using pairedt-test. There was statistical significance in reduction of pain and swelling in test sites, where the time of the procedure was statistically increased in test site. For bone quantity and quality, statistical difference was found where test site showed better results.Conclusion.Piezosurgery technique improves quality of patient’s life in form of decrease of postoperative pain, trismus, and swelling. Furthermore, it enhances bone quality within the extraction socket and bone quantity along the distal aspect of the mandibular second molar.

scholarly journals Incidence of neurosensory deficits following surgical removal of mandibular third molars: a prospective clinical study

2019 ◽  
Vol 7 (5) ◽  
pp. 1546
Author(s):  
Thaufiq Ahamed M. I. ◽  
Naveen Jayakumar ◽  
Neelakandan R. S.
Keyword(s):  
Tamil Nadu ◽  
Statistical Significance ◽  
Maxillofacial Surgery ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Lingual Nerve ◽  
Surgical Removal ◽  
Third Molars ◽  
Post Surgery ◽  
Mandibular Third Molars

Background: The aim of this prospective study was to determine the incidences of inferior alveolar nerve and lingual nerve deficit following surgical removal of impacted mandibular third molars and to evaluate the risk factors responsible for these postoperative neurosensory deficits.Methods: A total of 80 patients who reported to department of oral and maxillofacial surgery, Meenakshi Ammal Dental College, Chennai, Tamil Nadu, India requiring surgical removal of impacted mandibular third molar were included in this cross-sectional study. Standard surgical procedure was performed. All patients were reassessed one week post-surgery. Subjectively reported altered sensations were recorded and objective assessments were performed with light touch test, two-point discrimination threshold and pin-pick pain threshold. The collected data was analyzed using the chi square test to find out any clinical relevance.Results: There was no inferior alveolar nerve related neurosensory deficits and 6 (7.5%) resulted in lingual nerve related neurosensory deficits. The incidence of LN deficit for mesioangular, horizontal, distoangular was 1.3%, 3.8% and 2.5% respectively. Type of impaction assumed a mild statistical significance (p = 0.050).Conclusions: This study highlights the importance of careful preoperative clinical and radiographic assessment of patients where third molar surgery is planned. The surgical technique of third molar removal is also likely to have great impact on the outcome.

scholarly journals Comparison of Szmyd incision over envelope incision during the surgical removal of impacted third molar for evaluating postoperative prognosis: a prospective randomized study

2018 ◽  
Vol 5 (7) ◽  
pp. 2600
Author(s):  
Siji J. Chiramel ◽  
Shaju Chammanam ◽  
Ranjith Kalliath ◽  
Arjun Gopinath
Keyword(s):  
Wound Healing ◽  
Randomized Study ◽  
Third Molar ◽  
Wound Dehiscence ◽  
Surgical Removal ◽  
Third Molars ◽  
Flap Design ◽  
Mandibular Third Molars ◽  
Periodontal Healing

Background: Manipulation of both hard and soft tissues during the surgical removal of mandibular third molars is usually associated with a number of postoperative complications. This study was aimed to compare the effects of two types of flap designs used during the impacted mandibular third molar removal and the consequences of choosing Szmyd incision over envelope incision in terms of primary wound healing and periodondal healing.Methods: A prospective, randomized study was conducted in healthy 50 patients with partially or completely impacted mandibular third molars were selected. The patients were divided into two groups of 25 each. In one group envelope flap design was used and in the other group Szmyd flap design was used. The influence of these incisions on accessibility to third molar, primary wound healing and periodontal healing was evaluated and compared.Results: The incidence of wound dehiscence at 7th day follow-up is more in envelop incision (p=0.123) and 20% more at 14th day follow-up (p=0.087) when compared to Szmyd design. Significant differences were noted with respect to the periodontal healing distal to adjacent second molar. Distal periodontal pocket depth was significantly lower for the Szmyd incision as compared to the Envelop incision. Effect size of Envelop flap is 1.84 times more than Szmyd flap.Conclusions: The Szmyd flap design makes primary wound healing easier, less wound dehiscence and periodontal complication than envelop flap design.

scholarly journals Reliability of Pederson Scale in Surgical Extraction of Impacted Lower Third Molars: Proposal of New Scale

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Mohamed Yasser Kharma ◽  
Salah Sakka ◽  
Ghassan Aws ◽  
Basel Tarakji ◽  
Mohammed Zakaria Nassani
Keyword(s):  
Sensitivity And Specificity ◽  
Preoperative Assessment ◽  
Surgical Removal ◽  
Third Molars ◽  
Tooth Roots ◽  
Surgical Extraction ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
Low Sensitivity

The aim of this study was to evaluate the clinical reliability of the Pederson index in preoperative assessment of the difficulty of surgical removal of impacted mandibular third molars. Pederson index was found to be unreliable predictor of true difficulty with low sensitivity and specificity. A new index (Kharma scale), which takes into consideration the anatomical form of tooth roots, is proposed and evaluated both pre- and postoperatively. The results of the evaluation indicate that the new estimating index is more reliable and accurate measure than Pederson scale.

scholarly journals Factors affecting the Duration of Surgical Extraction of Impacted Mandibular Third Molars

2018 ◽  
Vol 9 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Salwan Y Bede
Keyword(s):  
Statistical Significance ◽  
Demographic Data ◽  
Surgical Removal ◽  
Third Molars ◽  
Factors Affecting ◽  
Surgical Extraction ◽  
Duration Of Surgery ◽  
Impacted Mandibular Third Molars ◽  
Unerupted Teeth ◽  
Mandibular Third Molars

ABSTRACT Aim The aim of this study is to evaluate the effect of demographic, clinical, and radiographic factors on the duration of surgical extraction of impacted lower third molars. Materials and methods This retrospective study included patients who underwent surgical removal of impacted lower third molars, and the investigated factors were demographic data including age and gender, radiographic data including the impacted tooth angulation and depth of impaction and ramus relation, and clinical data including the state of eruption of the impacted teeth. These factors were evaluated for association with the duration of surgery. Descriptive statistical analysis included percentages and mean ± standard deviation (SD). Student's t-test was used to compare means between two groups, while for comparing the means among three or more groups for statistical significance, analysis of variance (ANOVA) test was used. Results Forty patients were included: 20 (50%) males and 20 (50%) females. The age range was from 17 to 37 years with a mean ± SD of 23.4 ± 5.016 years. The duration of surgery (± SD) in all the patients ranged from 10 to 40 minutes with a mean of 25.8 ± 8.56 minutes. Clinically unerupted teeth and deep ramus relationship were associated with statistically significant increase in duration of surgical extraction. Conclusion This study identifies state of eruption and ramus relation to be significant predictive factors, whereas other investigated factors, namely, age of patient, sex, angulation of teeth, and depth of impaction, were found to be not significant in determining the duration of surgery and hence, the difficulty of extraction. Clinical significance Duration of surgical extraction of impacted mandibular third molars can be considered as an indicator for difficulty of surgical extraction. Difficult surgical extraction of impacted mandibular third molars can be anticipated in clinically unerupted teeth and those with deep ramus relationship. How to cite this article Bede SY. Factors affecting the Duration of Surgical Extraction of Impacted Mandibular Third Molars. World J Dent 2018;9(1):8-12.

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