Comparison of Two Chlorhexidine Rinse Protocols on the Incidence of Alveolar Osteitis following the Surgical Removal of Impacted Third Molars

2006 ◽  
Vol 7 (2) ◽  
pp. 79-86 ◽  
Author(s):  
Ismail Şener ◽  
Murat Metin ◽  
Mustafa Tek
Keyword(s):  
Third Molar ◽  
Permanent Teeth ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Third Molars ◽  
Surgery Group ◽  
Group I ◽  
Alveolar Osteitis ◽  
Molar Teeth ◽  
Group Ii

Abstract Principles Alveolar osteitis (dry socket) is the most common complication following the extraction of permanent teeth. This study was undertaken to compare the effect of two chlorhexidine rinse protocols on the incidence of alveolar osteitis in patients undergoing surgical removal of impacted mandibular third molar teeth. Methods A prospective randomized clinical trial was conducted among 99 subjects. Patients were randomly assigned into two groups. Subjects were instructed to rinse twice daily with 15 ml of chlorhexidine rinse 30 seconds for one week before and one week after surgery (group I) or one week after surgery (group II). Postoperatively, all patients were instructed to return in one week or sooner if bothersome pain increased or persisted. Data were collected regarding abnormal healing, presence of necrotic tissue, exposed bone, and absence of clot. Results The results indicated group I and group II were not statistically significant different in the reduction of alveolar osteitis. Conclusions To reduce alveolar osteitis after impacted third molar surgery, it was observed use of postoperative chlorhexidine rinse was adequate. The postoperative use of chlorhexidine is more feasible than both preoperative and postoperative use. Citation Metin M, Tek M, Şener I. Comparison of Two Chlorhexidine Rinse Protocols on the Incidence of Alveolar Osteitis following the Surgical Removal of Impacted Third Molars. J Contemp Dent Pract 2006 May;(7)2:079-086.

scholarly journals Lingual split bone technique – Revisited as a standard operating procedure for surgical removal of third molar during COVID pandemic

2021 ◽  
Vol 7 ◽  
pp. 18-22
Author(s):  
Sushmitha Mohan ◽  
Annamalai Thangavelu ◽  
Aravindraj
Keyword(s):  
Operating Procedure ◽  
Third Molar ◽  
Standard Operating Procedure ◽  
Surgical Removal ◽  
Third Molars ◽  
Standard Operating ◽  
Infectivity Rate ◽  
Alveolar Osteitis ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Objectives: The objective of the study is to revisit the forgotten art of Lingual split bone technique during the COVID pandemic as a Standard Operating Procedure (SOP) for the surgical removal of impacted mandibular third molars. It was originally introduced in early 90’s by Sir William Kelsey Fry and also we have compared its advantages over the bone guttering technique. Materials and Methods: Twenty seven cases were operated during COVID pandemic in our institution using Davi’s modified lingual split technique under strict COVID protocol. Results: All impacted mandibular third molars were successfully removed. With regards to post-operative complication; 3 patients had nerve injury (11%), 2 patients had lingual paraesthesia (7.6%), 1 patient had alveolar osteitis (3.8%), 2 patients had postoperative infection (7.6%), 3 patients had trismus (19%). The overall success rate was 100%. Also the results of a comparison between bone guttering and chisel-mallet technique were stated. Conclusion: The use of lingual split bone technique deserves consideration during this COVID time as an alternate for bone guttering in surgical removal of third molar as it ensures minimal cross infectivity rate among both dentists and patients. Thus, patient care can be delivered with confidence even during pandemic.

scholarly journals Efficacy of platelet rich plasma (PRP) on mouth opening and pain after surgical extraction of mandibular third molars

2020 ◽  
Vol 27 (1) ◽  
pp. 9
Author(s):  
Maidah Hanif ◽  
Muhammad Azhar Sheikh
Keyword(s):  
Platelet Rich Plasma ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Mouth Opening ◽  
Third Molar Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Removal ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
Molar Teeth

Introduction: Surgery of mandibular third molar teeth for removal is one of the most common procedures undertaken in oral and maxillofacial surgery departments. The complications created by the post extraction wound healing and physiological consecution of third molar surgery can affect patients' quality of life. Platelet rich plasma (PRP) is an autologous concentrate of platelets suspended in the Plasma that accelerates healing by concentration of growth factors which lessen the inflammation and as a result pain and trismus. Materials and methods: A Study was conducted on 130 patients at the department of Oral and Maxillofacial Surgery, FUCD Islamabad, for a period of 6 months after ethical approval. The patients with impacted mandibular wisdom teeth were selected and divided equally into two equal groups. The pain score was measured using the visual analogue scale (VAS) and trismus was measured using Vernier caliper before the surgery, immediately after surgery, on 3rd and 7th follow up visits. Results: The mean postoperative pain on 7th day was significantly lower in the PRP group with statistically significant P-value <0.0001. Trismus was also less reported in the PRP group with P-value <0.00065. Conclusion: Platelet Rich Plasma is effective to lessen trismus and pain after surgical removal of mandibular third molar teeth.

scholarly journals Evaluating the Presence of Paresthesia in Patients with Juxta-apical Radiolucency after Third Molar Surgery: A Case-control Study

2021 ◽  
Author(s):  
Mahvash Hasani ◽  
Nasim Razavi ◽  
Abdolaziz Haghnegahdar ◽  
Motahhareh Zarifi
Keyword(s):  
Significant Relationship ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cortical Plate ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Third Molars ◽  
Chi Square ◽  
Exact Test ◽  
Increased Risk

Abstract Background: Juxta-apical radiolucency (JAR) has been presented as a radiographic sign, suggestive of the IAN injury through third molar surgery. This study aimed to evaluate the relation of JAR with paresthesia in cone-beam computed tomography (CBCT) images and to determine whether the presence of JAR is related to tooth angulation, proximity to the mandibular canal, position to the IAN and thinning of the cortical plates.Methods: Of an initial sample of 545 mandibular third molars, a total of 75 JAR and 75 control teeth were evaluated by CBCT. The association of JAR with the IAN, position to IAN, lingual cortical plate thinning, and tooth angulation was investigated in this study. Temporary and permanent paresthesia were also examined in the subjects. Descriptive statistics, Chi-square test, and Fisher’s exact test were performed for statistical analysis.Results: A significant relationship was found between JAR and temporary paresthesia (P=0.034). However, there was no case of permanent paresthesia. JAR showed no significant relationship with the tooth angulation, cortical plate thinning, position to IAN and proximity to the mandibular canal. The lingual position of JAR relative to the mandibular canal was related to the presence of paresthesia in the JAR group. Also, most cases of paresthesia showed some degree of lingual cortical plate thinning (P=0.012). Conclusion: JAR is generally in contact with the mandibular canal, and some degree of cortical thinning can be found in most cases. In this study, JAR was significantly related to temporary paresthesia. The present findings may indicate the increased risk of nerve injury during the surgical removal of third molars.

Effects of different polyvinylpyrrolidone iodine concentrations on trismus and swelling following third molar surgery

2020 ◽  
pp. 1-16
Author(s):  
Esra Yüce ◽  
Omur Dereci ◽  
Nazli Altin ◽  
Cansugul Efeoglu Koca ◽  
Murude Yazan
Keyword(s):  
Povidone Iodine ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Group Iv ◽  
Controlled Study ◽  
Third Molar Surgery ◽  
Group Iii ◽  
Group I ◽  
Facial Swelling ◽  
Group Ii

Abstract Objective: To compare the clinical efficacy of different povidone iodine concentrations for the management of postoperative pain and swelling following mandibular third molar surgery. Methods: The randomised, prospective, double-blind and controlled study was conducted from October 2016 to January 2018 at the Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Biruni University, Istanbul, Turkey, and comprised individuals aged 18-30 years who underwent surgical removal of pathology-free completely unerrupted mandibular lower third molars. The participants were randomly assigned to four groups: Group I had saline-only controls, Group II was given 0.5% concentration of povidone iodine, Group III had 1% concentration of povidone iodine, and Group IV had 3% concentration of povidone iodine. Facial swelling and trismus were assessed on the 2nd and 7th postoperative days. Data was analysed using SPSS 22. Results: Of the 80 patients, 34(42.5%) were males and 46(57.5%) were females with an overall mean age of 24.6±3.68 years. Each group had 20(25%) subjects. All three concentrations of povidone iodine provided significant reduction in postoperative trismus compared to the controls. Trismus was less in Group III and Group IV compared to Group II up to 7 days after surgery. Conclusion: Irrigation with 3% povidone iodine concentration was found to be more effective in reducing the level of facial swelling after impacted third molar surgery. (Clinical Trials.gov Identifier: NCT03894722) Key Words: Maxillofacial surgery, Third molar, Povidone-Iodine, Swelling, Tismus

scholarly journals Effect of Single Dose Intramuscular Methylprednisolone Injection into the Masseter Muscle on the Surgical Extraction of Impacted Lower Third Molars: a Randomized Controlled Trial

2015 ◽  
Vol 12 (1) ◽  
pp. 4-8 ◽  
Author(s):  
N Vyas ◽  
S Agarwal ◽  
N Shah ◽  
D Patel ◽  
P Aapaliya
Keyword(s):  
Single Dose ◽  
Masseter Muscle ◽  
Surgical Removal ◽  
Methylprednisolone Acetate ◽  
Third Molars ◽  
Oral Aperture ◽  
Group I ◽  
Surgical Extraction ◽  
Facial Swelling ◽  
Group Ii

Background Lower impacted third molar surgical extraction usually causes post-surgical sequelae like pain, trismus and swelling as a result of postoperative inflammatory response.Objective The aim of this study was to evaluate and compare the efficacy of single dose 40-mg (1cc) of methylprednisolone acetate, injected into the masseter muscle, preoperatively one hour before the surgery or post-operatively, immediately following the surgical removal of impacted lower third molars, in controlling most common postoperative sequelae, i.e. trismus, pain and swelling of facial soft tissue.Methods A randomized control study was done of 60 patients. Each patient was categorized in two groups, group I and group II, according to the time of receiving methylprednisolone acetate. Group I was injected 40mg of methylprednisolone acetate into the masseter muscle via the intrabuccal approach, one hour before the surgery. Group II was injected 40mg of methylprednisolone acetate into the masseter muscle via the intrabuccal approach, immediately after suturing of the surgical wound. The washout period was one month after the first operation. Evaluation were made of postoperative pain, trismus and swelling. The numeric pain scale (NPS) was used for pain assessment.Results When the patients were administered methylprednisolone acetate preoperatively, showed superior results in terms of oral aperture, pain and all the facial swelling parameters, with statistically significant differences versus the postoperatively administered methylprednisolone acetate (p < 0.05).Conclusions A single dose of 40 mg (1cc) methylprednisolone acetate injected into the masseter muscle preoperatively is more effective in reducing pain, trismus and swelling, when compared to that administered postoperatively.Kathmandu University Medical Journal Vol.12(1) 2014: 4-8

scholarly journals Impact of electro-neuro-feedback on postoperative outcome of impacted lower third molar surgery

2018 ◽  
Vol 12 (01) ◽  
pp. 077-088
Author(s):  
Giacomo Oteri ◽  
Antonia Marcianò ◽  
Gabriele Cervino ◽  
Matteo Peditto
Keyword(s):  
Clinical Outcome ◽  
Biochemical Parameters ◽  
Oral Surgery ◽  
Third Molar ◽  
Postoperative Outcome ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Third Molars ◽  
School Of Dentistry ◽  
The Impact

ABSTRACT Objective: The purpose of this study was to evaluate the impact of a treatment with electro-neuro-feedback (ENF), a portable transcutaneous electrical nerve stimulation (TENS) device, on the clinical outcome and inflammatory biochemical parameters related to the impacted lower third molar surgery. Materials and Methods: A randomized, split-mouth, and single-blind study was conducted on 32 patients requiring lower third molars extractions and referred to the Oral Surgery Unit of the School of Dentistry of the University of Messina. Every patient underwent surgical removal of both lower third molars. The first extraction included a placebo (electrodes placement with turned-off device) treatment following the surgery, while the second had the ENF used next to the avulsion and the following days. Clinical parameters were collected 4 days before, immediately after, 2, 4, and 7 days after the surgical procedure. Biochemical parameters were obtained 1 day before the surgical removal and 7 days after. Data were processed using Wilcoxon–Mann–Whitney test, with significance being set at P < 0.05. Results: Clinical outcome parameters showed a significant improvement after the ENF treatment, while considered inflammatory markers expressed different patterns. Conclusions: ENF, a reliable portable TENS device, has demonstrated to be a useful tool in the managing of the postsurgical phases, reducing edema, pain, and consequent pain-killers consumption.

scholarly journals Comparison of Efficacy of Oral Bromelain and Serratiopeptidase for the Control of Postoperative Sequelae Following Third Molar Surgery - A Comparative Study

2021 ◽  
Vol 10 (31) ◽  
pp. 2476-2480
Author(s):  
Subhashini Ramasubbu ◽  
Abdul Wahab P. U.
Keyword(s):  
Conventional Treatment ◽  
Diclofenac Sodium ◽  
Third Molar ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Impacted Third Molar ◽  
Group I ◽  
Facial Swelling ◽  
Comparative Clinical Study ◽  
Inflammatory Action

BACKGROUND Surgical removal of impacted third molar is widely carried out in general dental practice and is usually associated with postoperative inflammatory sequelae like pain, swelling, and trismus. The objective of the study was to assess and compare the efficacy of oral bromelain and Serratiopeptidase for the control of post-operative sequelae following surgical removal of impacted third molar. METHODS A randomized, comparative clinical study was conducted on sixty patients who were undergoing impacted third molar surgery, and were allocated into two groups each comprising 30 patients. Conventional drugs included Cap amoxicillin 500 mg bid, Tab. metronidazole 200 mg tid, and Tab. diclofenac sodium 50 mg bid that were given to both the groups. Group I was treated with Tab. bromelain 200 mg tid along with conventional treatment for 5 days. Group II received a combination of conventional treatment and Tab. Serratiopeptidase 10 mg bid for 5 days. The parameters such as measurement of pain, facial width and trismus were analysed on postoperative days 1, 2 and 7. RESULTS The study comprised of totally 60 otherwise healthy patients. The group of patients who received bromelain along with diclofenac sodium seemed to be effective in controlling post-operative sequelae like pain (P < 0.05), swelling (P < 0.05) but not trismus (P < 0.05) when compared to the group who received Serratiopeptidase with diclofenac sodium. CONCLUSIONS The intensified anti-inflammatory action of bromelain, was possibly by inhibiting the generation of bradykinin and negative action on the prostaglandin pathway. The present study assessed the clinical effect of bromelain and serratiopeptidase on pain, facial swelling and trismus. KEY WORDS Bromelain, Oral Bromelain, Serratiopeptidase, Proteolytic Enzyme, Third Molar Surgery

scholarly journals A Comparison of Pre-emptive Analgesic Efficacy of Aceclofenac and Piroxicam for Post-Operative Pain Management after third Molar Surgery: A Prospective, Randomized, Double-blind Study

2020 ◽  
Vol 11 (4) ◽  
pp. 6188-6195
Author(s):  
Jones Jayabalan ◽  
Muthusekhar M R ◽  
Senthil Murugan P
Keyword(s):  
Pain Intensity ◽  
Third Molar ◽  
Analgesic Efficacy ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Double Blind Study ◽  
Third Molars ◽  
Double Blind ◽  
Post Operative Pain ◽  
Significant Difference

The study aimed to compare the analgesic efficacy of 100 mg and 20 mg as a analgesic for preventing post-operative pain after third molar surgery. Fifty patients with impacted mandibular third molars who required surgical removal were included in the study. These patients were divided into two groups randomly. One group consisted of patients receiving 100 mg as a analgesic, and the other group consisted of patients receiving 20 mg as a analgesic 1 hour before the procedure. The study findings show both the drugs were equally effective in managing post-operative pain following third molar surgery. On statistical analysis, there was no significant difference in pain experience among both groups A and B in post-operative period who underwent surgery. However, the study observes a highly significant difference in both the groups in terms of pain intensity scores at different times. Results show that there was a significant difference before, 3rd day and 5th day; Further study shows that the effectiveness of the drug was not confirmed in 24 hours to 3 days. It was observed both the groups shows a significant difference in on the 5thand 3rd day. This comparative research of pain intensity shows after analgesia with and in of third molars, a pronounced effect in the group treated with 20mg was seen. Still, there was no statistically significant difference noted in VAS before and 5th day of both groups.

scholarly journals Evaluating the presence of IAN injury in patients with juxta-apical radiolucency after third molar surgery: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahvash Hasani ◽  
Nasim Razavi ◽  
Abdolaziz Haghnegahdar ◽  
Motahhareh Zarifi
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Significant Relationship ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cone Beam ◽  
Cortical Plate ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Third Molars

Abstract Background Juxta-apical radiolucency (JAR) has been presented as a radiographic sign, suggestive of the IAN injury through third molar surgery. This study aimed to evaluate the relation of JAR with IAN injury in cone-beam computed tomography (CBCT) images and to determine whether the presence of JAR is related to tooth angulation, proximity to the mandibular canal, position to the IAN, and thinning of the cortical plates. Methods Of an initial sample of 545 mandibular third molars, a total of 75 JAR+ and 75 JAR− teeth were evaluated by CBCT. We assessed the relationship between the presence of JAR in cone-beam computed tomography (CBCT) images and the presence of IAN injury after mandibular third molar surgeries. Moreover, we investigated whether the presence of IAN injury is related to tooth angulation, proximity to the mandibular canal, position to the IAN, and thinning of the cortical plates. Descriptive statistics, Chi-square test, and Fisher’s exact test were performed for statistical analysis. Results A significant relationship was found between JAR and temporary IAN injury (P = 0.036). However, there was no case of permanent IAN injury. IAN injury showed no significant relationship with the tooth angulation, position to IAN and proximity to the mandibular canal, lingual cortical plate thinning, sex, and age. Conclusions JAR is generally in contact with the mandibular canal, and some degree of cortical thinning can be found in most cases. In this study, JAR was significantly related to temporary IAN injury. JAR may increase the risk of nerve injury during the surgical removal of third molars.

Should Degree of Third Molar Eruption Influence Operative Management of Mandibular Angle Fractures? A Systematic Review

2021 ◽  
pp. 194338752110593
Author(s):  
Vikas S. Kotha ◽  
Brandon J. de Ruiter ◽  
M. Grace Knudsen ◽  
Marvin Nicoleau ◽  
Edward H. Davidson
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Third Molar ◽  
Cochrane Library ◽  
Third Molars ◽  
Mandibular Angle ◽  
Group I ◽  
Group Ii ◽  
Angle Fractures ◽  
Third Molar Eruption

Objective There is a growing trend toward evidence-based management of third molars in the fracture line of mandibular angle fractures (MAFs). This study aimed to differentiate MAF fixation complications by degree of third molar eruption and by extraction strategy in patients undergoing Champy fixation. Methods PubMed, EMBASE, OVID, SCOPUS, the Cochrane Library, and clinicaltrials.gov were queried through May 2020 for English-language publications for MAFs with third molar involvement for this systematic review. Bias was assessed using author-defined criteria. Relative risk (RR) of post-operative complications associated with extracted unerupted and retained partially erupted third molars (Group I) was calculated against controls of retained unerupted and extracted partially erupted third molars (Group II). Results Ten studies reported complications by eruption or extraction; however, only one study stratified complications by both eruption and extraction to meet inclusion criteria. The risk of bias was medium as only cases meeting defined follow-up were included. 73 cases (N) were included: 34 qualified for Group I and 39 for Group II. Quantitative synthesis of individual case data demonstrated significantly higher complication rate in Group I compared to Group II (23.5% vs 5.1%) (RR 4.6, 95% CI 1.04–20.1). No significant differences were observed between groups for infectious complications, mechanical complications, nonunion, or dehiscence. Reoperation was required significantly more often for Group I ( P = .043). Conclusions For MAFs involving the third molar, concomitant extraction of unerupted as well as retention of partially erupted third molars increases risk of complications with Champy fixation technique. For these patients, alternative strategies for fixation should be considered.

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