Efficacy of Naproxen Plus Gabapentin Vs Naproxen Alone in Relieving Post-Extraction Pain of Impacted Mandibular 3rd Molar

Background: Evaluate the efficacy of using combination drug treatment to relieve post extraction pain of impacted mandibular third molar by using Naproxen plus Gabapentin versus Naproxen alone. Aim: To evaluate the efficacy of using combination drug treatment to relieve post extraction pain of impacted mandibular third molar by using Naproxen plus Gabapentin versus Naproxen alone. Methods: Randomized control study, outcome was evaluated by measuring Pre – Operative and 24-Hour Post – Operative Pain status on Visual Analogue Scale and Wong Baker’s Face Pain Rating Scale. Results: Combination therapy (Naproxen and Gabapentin) was effective in significant pain reduction at 12 Hour and 24-Hour Post Extraction period. With 26 patients out 31 presented with Pain Scale of 0 on combination therapy while only 3 out of 31 for naproxen alone after 24 hours. Conclusion: Enhanced effect of combination therapy of naproxen with gabapentin in reducing post extraction pain of impacted mandibular third molar with respect to naproxen alone. Keywords: Naproxen, Gabapentin, Combination Therapy, Post Extraction Pain, Post Extraction Analgesia, Efficacy.

Impact of Mesioangular Mandibular Impacted 3rd Molar on Peridontal Health of Adjacent Tooth

Objective: The aim of this study is to determine the impact of mesioangular mandibular 3rd molar impaction on periodontal health of adjacent tooth in patients. Study Design: Retrospective/observational study Place and Duration: Department of Oral & Maxillofacial Surgery, MMDC Multan, during from Oct 2020 to September 2021. Methods: Total of seventy patients of both genders was presented in this study. Detailed demographic data of enrolled cases age, sex, body mass index, symptoms and complications were recorded after taking informed written consent. All the patients had mesioangular impactions of mandibular third molars. The impaction depth, relationship with ramus, and angulation of 70 IMTMs and their association with 2nd molar distal caries and root resorption, pathological states, and closeness to the mandibular canal were assessed on panoramic radiographs. Pell and Gregory classification was used to determine position of impacted third molar. The odds ratio (OR) and 95% confidence interval (CI) of IMTM's position on the related complications (credible interval for Bayesian models). Statistical significance was defined as a two-tailed p-value 0.05. SPSS 24.0 version was used to analyze complete data. Results: There were 42 (60%) males and 28 (40%) females with mean BMI 23.13±6.46 kg/m2. Most of patients 31 (44.3%) were aged between 20-35 years. Mean attachment level was 3.03±2.34 and probing depth was 3.34±3.35. Caries, pain and swelling were the most common symptoms found among cases. Distal second molar root caries 21 (30%) and pocket formation 17(24.3%) were the most common pathologies. As per histological findings periapical inflammation was majority found in 37 (52.9%) cases followed by dental follicle in 19 (27.1%) and cyst in 11 (15.7%). Conclusion: In this study, we found that the impacted mandibular third molar was most linked with distal second molar root caries and the creation of a pocket between the impacted tooth and the second molar tooth. The most common pathology associated with the impacted molar was distal second molar root caries and the creation of a pocket between the affected tooth and the second molar. Keywords: Mesioangular, Impacted mandibular third molar, Pathology, Complication

Impact of the Mesioangular Mandibular on the Peridontal Health of Adjacent Tooth by the Third Molar

Objective: The purpose of this study is to assess the impact of mesioangular mandibular 3rd molar impaction on the periodontal health of neighbouring teeth in patients. Study Design: Dental College HITEC-IMS Taxilla/Gulraiz Dental Clinic Quaid Avenue Main Road, Gulraiz 3, Rawalpindi. Jan 2021-Aug 2021 Place and Duration: Methods: Total of ninety patients of both genders was presented in this study. After receiving informed written consent, detailed demographic information about the recruited cases was collected, including age, gender, body mass index, symptoms, and complications. All of the patients experienced mesioangular third molar impactions on their mandibular teeth. A total of 90 IMTMs were evaluated using panoramic radiographs to determine their impaction depth, relationship with the ramus, and angulation, as well as their association with 2nd molar distal caries and root resorption, pathological states, and proximity to the mandibular canal. The position of the impacted third molar was determined using the Pell and Gregory categorization system. The odds ratio (OR) and 95 percent confidence interval (CI) of IMTM's position on the associated problems are shown in the table below (credible interval for Bayesian models). P-values with two-tailed confidence intervals of less than 0.05 were considered statistically significant. SPSS 27.0 version was used to analyze complete data. Results: There were 55 (61.1%) males and 35 (38.9%) females with mean BMI 24.61±5.22 kg/m2. Most of patients 41 (45.6%) were aged between 20-35 years. Mean attachment level was 2.99±4.74 and probing depth was 3.78±4.61. Caries, pain, and swelling were the most often reported symptoms, according to our research. The most common diseases were distal second molar root caries, which accounted for 30 (33.3%) of all cases, and pocket development, which accounted for 21 (23.3%). According to histological findings, periapical inflammation was the most common finding in 46 (51.1%) of the cases, followed by dental follicle in 24 (26.7%), cyst in 16 (17.8%), and other malignancies in 4 (4.4%) cases. Conclusion: According to the findings of this study, the impacted mandibular third molar was most closely associated with distal second molar root caries and the formation of a pocket between the impacted tooth and the second molar tooth in the lower jaw. Most common pathology linked with the impacted molar was distal second molar root caries and the formation of a pocket between the affected tooth and the second molar. Keywords: Mesioangular, Impacted mandibular third molar, Pathology, Complication

ASSESSMENT OF NEUROSENSORY DISTURBANCES AND RECOVERY FOLLOWING SURGICAL REMOVAL OF IMPACTED MANDIBULAR THIRD MOLAR – A PROSPECTIVE STUDY

Aim: This prospective study aim to determine the incidence and pattern of recovery of IAN and LN decits after surgery while comparing which nerve, site, side, age group and type of impaction was most likely to suffer from neurosensory disturbances and to evaluate the risk factors such as duration of surgery, proximity to inferior alveolar canal, excessive hemorrhage, clinical observation of neurovascular bundle, contributing to these postoperative neurosensory decits. Materials&Methods: This study was conducted on 30 patients who underwent surgical removal of impacted mandibular third molar between 2017-2019 in the Department of Oral and Maxillofacial Surgery, College of Dental Sciences, Davangere. Clinically, all the patients underwent objective evaluation by using pin prick test, two-point discrimination and blunt test. Sensory function was evaluated 1 week, 1, 3 and 6 months post-operatively. The areas that were evaluated are those supplied by IAN and LN. Result: The incidence of NSD in our study was 10%, the IAN 6.7% and LN decit 3.3%. No permanent NSD was observed in this study. Statistically signicant association was found between excessive hemorrhage from the socket and NSD (p=0.009). No signicant association was found between gender, age, side, type, difculty score and duration, observation of neurovascular bundle during surgery and proximity of roots to the inferior alveolar canal with NSD.

Comparison of Wound Healing Using Envelope and Triangular Flap for Impacted Mandibular Third Molar Surgery

Objective: To compare the wound healing with triangular flap versus envelope flap techniques among patients undergoing surgical removal of the impacted mandibular third molar (IMTM). Study Design: An open label randomized controlled trial. Place and Duration of the Study: The Department of Oral & Maxillofacial Surgery, Bakhtawar Amin Medical and Dental College, Multan from January 2021 to June 2021. Material and Methods: A total of 70 patients (35 in each group) of both genders aged 20 to 50 years requiring surgical removal of IMTM were included. Patients were asked to follow up on third and seventh day while observations regarding wound healing and pain were noted on 7th day among all cases completing the final follow up. Chi square was applied to compare data between both study groups taking p-value below 0.05 as significant. Results: In a total of 70 patients, there were 42 (60.0%) female and 28 (40.0%) female. Majority of the patients, 36 (51.4%) were above 30 years of age while mean age was noted to be 32.4+9.1 years. Sixty two patients completed the follow up so they were included in the final analysis for the assessment of wound healing and pain. Overall, wound healing was observed to be in 55/62 (88.7%) patients while wound healing was found to be 30/32 (93.8%) patients in envelope flap group in comparison to 25/30 (83.3%) in triangular flap group (p=0.1953). Overall, there was no statistically significant difference in between both study group with regards to evaluation of pain (p=0.3271) Conclusion: Both envelop flap and triangular flap techniques resulted in similar outcomes regarding wound healing among patients undergoing surgical removal of IMTM. Both flap techniques resulted in relatively similar degrees of post-surgery pain. Keywords: Third molar, pain, wound healing.