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Soltaninia O, Shojaee M. Mannitol Reduces Pain and Trismus After Impacted Mandibular Third Molar Surgery. J Oral Maxillofac Surg 2024; 82:572-580. [PMID: 38387857 DOI: 10.1016/j.joms.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND The removal of the lower third molar is a routine procedure in oral surgery, yet it often leads to postoperative side effects, particularly inflammation. Despite various interventions explored in prior studies, there is still a need for effective strategies, such as anti-inflammatory substances, to address postoperative side effects. PURPOSE The purpose of this study is to answer the following clinical question: Does the local injection of 0.9 M mannitol reduce postoperative pain, trismus, and swelling in patients undergoing bilateral symmetrically impacted mandibular third molar extraction? STUDY DESIGN, SETTING, SAMPLE This prospective, single-blind, split-mouth study at Hamadan Dental School involved 30 patients with bilateral symmetrically impacted mandibular third molars. Inclusion criteria were: no current medication, no anesthesia allergies, bilateral symmetrically impacted mandibular third molars, non-smokers, and the absence of systemic diseases. Exclusion criteria were: poor oral hygiene, alcohol/cigarette use, drug consumption, diabetes, systemic/gastrointestinal disorders, infection at the surgical site, lack of patient cooperation, and mannitol/anesthetic allergy. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE The predictor variable was therapeutic injection, and it was grouped into two categories, 0.9 M mannitol solution or distilled water. MAIN OUTCOME VARIABLE The primary outcome variable was pain. Secondary outcomes are trismus, swelling, patient satisfaction, and analgesic consumption. COVARIATES Covariates included demographic information and operative details. ANALYSES Statistical analyses included repeated measures and paired t-tests with a significance level set at P < .05. RESULTS The study comprised 30 participants (mean age: 22.6 ± 3.59 years; 6 men, 24 women). In the test group, pain intensity significantly decreased from 5.30 on surgery day to 0.00, with subsequent values of 2.97, 1.30, 0.40, 0.17, and 0.03. The control group also decreased from 7.68 to 0.00, with values of 4.73, 2.67, 0.97, 0.23, and 0.07. The difference was statistically significant (P < .001). No significant swelling differences at T1, T3, T5, and T7 (P > .05). The intervention group had improved maximum mouth opening at T1, T3, T5, and T7 (P = .011) compared to the control group. CONCLUSION AND RELEVANCE Mannitol infiltration significantly reduces postoperative pain and trismus in impacted third molar surgery. This finding underscores the potential for improved patient comfort and recovery in this context.
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Affiliation(s)
- Omid Soltaninia
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Dentistry School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahdi Shojaee
- Doctor of Dentistry, Department of Oral and Maxillofacial Surgery, Dentistry School, Hamadan University of Medical Sciences, Hamadan, Iran.
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Todorić Z, Milošević M, Mareković I, Biočić J. Impact of Pericoronary Microbiota Composition on Course of Recovery after Third Molar Alveotomy. Life (Basel) 2024; 14:580. [PMID: 38792601 PMCID: PMC11122129 DOI: 10.3390/life14050580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/19/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024] Open
Abstract
Although the role of microbiota has been investigated in relation to different oral diseases, it is unknown if its composition has any effect on the course of recovery after third molar alveotomy. Our aim was to determine the influence of patient clinical characteristics as well as pericoronary microbiota composition on the course of recovery after a semi-impacted third molar alveotomy. Thirty-six patients were included and samples obtained with paper points, swabs, and tissue samples were analyzed using DNA hybridization and culture methods. Among the 295 organisms detected, the most frequent were Streptococcus spp. (22.4%; 66/295) followed by Fusobacterium spp. (11.9%; 35/295), and T. forsythia (9.1%; 27/295). A comparison of microbiota composition in patients with better and worse recovery did not show significant differences. Worse recovery outcomes were more frequent in patients with a grade 2 self-assessment of oral health (p = 0.040) and better recovery courses were observed in patients with a grade 4 self-assessment (p = 0.0200). A worse recovery course was statistically significant more frequently in patients with previous oral surgical procedures (p = 0.019). Although we demonstrate that worse recovery outcomes were more frequent when certain bacteria were detected, there was no statistically significant difference. Further research is needed to identify microbial profiles specific to the development of worse outcomes after a third molar alveotomy.
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Affiliation(s)
- Zrinka Todorić
- Department of Clinical Microbiology, Infection Prevention and Control, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Milan Milošević
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department for Environmental Health and Occupational and Sports Medicine, Andrija Stampar School of Public Health, 10000 Zagreb, Croatia
| | - Ivana Mareković
- Department of Clinical Microbiology, Infection Prevention and Control, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Josip Biočić
- Department of Oral and Maxillofacial Surgery, University Hospital Dubrava, 10000 Zagreb, Croatia
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
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Sainz de Baranda B, Silvestre FJ, Márquez-Arrico CF, Silvestre-Rangil J. Surgical difficulty and postoperative course of the third molar extraction under general anesthesia: An intervention trial. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101663. [PMID: 37890774 DOI: 10.1016/j.jormas.2023.101663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/23/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Third molar extractions are one of the most common surgical procedures in the area of stomatology. However, we know that even if they are minor surgeries, they can cause a postoperative period with local and systemic repercussions. Thus, the aim of this intervention trial is to determine the relationship between clinical parameters (pain, inflammation and trismus) and serum parameters (C-reactive protein (CRP), IL-6 and fibrinogen) that are modified in the first postoperative week, and the appearance of complications after extraction with general anesthesia, using the Pederson scale. METHODS The research question was: Can postoperative discomfort after third molar extraction under general anesthesia be predicted using Pederson scale? An interventional trial was carried out of third molar extractions under general anesthesia in Dr. Peset University Hospital. Patient selection was performed randomized using MS Excel. Then were divided into two groups (n = 126): group A (2 complex extractions) and group B (4 extractions: 2 simple and 2 complex). All parameters were collected at the surgery and 7 days after surgery. RESULTS The clinical postoperative parameters showed significant differences in relation to surgical difficulty. In summary, the degree of surgical difficulty can be predicted with the Pederson scale before extracting mandibular third molars. CRP and fibrinogen levels increase significantly with the degree of surgical difficulty. CONCLUSION Significant differences (p < 0.001) were observed in all the intraoperative parameters according to surgical difficulty as assessed by the Pederson scale. Therefore, this scale was a good indicator to estimate the patient's postoperative period.
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Affiliation(s)
| | - Francisco Javier Silvestre
- Department of Stomatology, University of Valencia, 46010 Valencia, Spain; Department of Stomatology, University Hospital Doctor Peset-FISABIO, 46017 Valencia, Spain
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Ahmed F, Baliga SD, Baliga SS, Rathi P, Jha G. Efficacy of Hydrocortisone, Povidone-Iodine, and Normal Saline as an Irrigating Solution During Surgical Removal of Impacted Mandibular Third Molars: A Randomized Controlled Trial. Cureus 2024; 16:e53370. [PMID: 38435159 PMCID: PMC10907926 DOI: 10.7759/cureus.53370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Background The surgical removal of mandibular third molars is one of the most common procedures in dentistry. Researchers have extensively studied the treatment of postoperative sequelae such as pain, edema, trismus, and alveolar osteitis throughout the past six decades. Many approaches have been used to address clinical difficulties after third molar surgery, including various flap designs and irrigating solutions. The aim of this study was to compare the effects of three irrigating solutions, hydrocortisone, povidone-iodine, and normal saline, on pain, trismus, and edema following surgical removal of the impacted mandibular third molar. Methodology The study involved 105 participants who required surgical extraction of mandibular third molars. The patients' ages ranged from 18 to 40 years, and they fulfilled the inclusion criteria. Using a simple random sampling technique, they were divided into three groups (group 1: hydrocortisone, group 2: povidone-iodine, group 3: normal saline). The parameters evaluated were edema, pain, and trismus on the second and seventh postoperative days. All data were input into Microsoft Excel (Microsoft® Corp., Redmond, USA) worksheets and analyzed using Stata 17.0 (StataCorp LLC, College Station, USA). The visual analog scale (VAS) score was used to measure postoperative pain, and postoperative swelling was measured using linear measurements from four fixed anatomical points and compared to preoperative values. To assess trismus, the inter-incisal distance was measured in millimeters with a caliper. A p-value of <0.01 was considered statistically significant. Results The mean VAS score for pain in group 1 was lower than the other two groups. The effect of group 1 was significant on the second postoperative day but insignificant on the seventh postoperative day for swelling. The effect of all three groups on trismus was significant on the second and seventh days. Conclusions Hydrocortisone as an irrigating solution showed promising results in managing postoperative swelling in the first 48 hours, but its effect gradually declined by the seventh postoperative day. Additionally, it was effective in controlling postoperative pain and trismus. This suggests that utilizing hydrocortisone as an irrigating solution, compared to povidone-iodine, has been proven to be a significantly effective option in reducing postoperative pain, edema, and trismus resulting from the surgical removal of impacted teeth.
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Affiliation(s)
- Faheem Ahmed
- Oral and Maxillofacial Surgery, KAHER's (KLE Academy of Higher Education and Research's) KLE Vishwanath Katti Institute of Dental Sciences, Belagavi, IND
| | - Shridhar D Baliga
- Oral and Maxillofacial Surgery, KAHER's (KLE Academy of Higher Education and Research's) KLE Vishwanath Katti Institute of Dental Sciences, Belagavi, IND
| | - Sulakshana S Baliga
- Community Medicine, KAHER'S (KLE Academy of Higher Education and Research's) Jawaharlal Nehru Medical College, Belagavi, IND
| | - Pranjal Rathi
- Oral and Maxillofacial Surgery, KAHER's (KLE Academy of Higher Education and Research's) KLE Vishwanath Katti Institute of Dental Sciences, Belagavi, IND
| | - Gaurav Jha
- Department of Oral and Maxillofacial Surgery, Bharati Vidyapeeth Deemed to be University Dental College and Hospital, Pune, IND
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Karpe T, Sanober A, Nasyam FA, Soumya S, Seethamsetty S, Sarepally G. To Study the Impact of Tooth Sectioning on Postoperative Pain, Swelling and Trismus After Surgical Extraction of Impacted Mandibular Third Molars. Cureus 2023; 15:e51207. [PMID: 38283454 PMCID: PMC10818164 DOI: 10.7759/cureus.51207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
AIM To study the impact of tooth sectioning on postoperative pain, swelling, and trismus after surgical extraction of impacted mandibular third molars. MATERIALS AND METHODS The present research was conducted on a sample of 100 individuals who were in good health. The participants had an average age of 28 years and were seeking treatment at the Department of Oral and Maxillofacial Surgery for the extraction of impacted mandibular third molars. The participants were allocated randomly to one of the two experimental conditions. The patients in Group A are receiving a surgical procedure to remove the mandibular third molar without the need for tooth sectioning. The study focuses on patients classified as Group B who are having a surgical procedure for the extraction of the mandibular third molar using dental sectioning. RESULTS The Group B patients saw a notable decrease in pain intensity on the third and seventh days after the surgery. The mean difference in pain scores was 4.15±0.54 and 1.69±0.11, respectively, indicating statistically significant findings with a p-value of less than 0.05. The study observed statistically significant differences in swelling between the 1st, 3rd, and 7th postoperative days for group II. The mean differences were recorded as 149.85±5.86, 119.25±4.22, and 107.52±, respectively. The significance level was determined to be P<0.05. The study observed that the degree of mouth opening in Group B exhibited a significant rise on the 3rd and 7th postoperative days, with a mean difference of 40.87±3.69 and 43.15±3.29, respectively, as compared to Group A. This difference was found to be statistically significant, with a p-value of less than 0.05. Conclusion: The findings of our research indicate that the technique of sectioning the tooth is the preferable approach for surgical extraction of impacted third molars, as it effectively reduces the occurrence of post-operative problems.
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Affiliation(s)
- Tanveer Karpe
- Department of Oral and Maxillofacial Surgery and Diagnostic Science, Faculty of Dentistry, Taif University, Taif, SAU
| | - Arshiya Sanober
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Hyderabad, IND
| | - Fazil A Nasyam
- Department of Oral and Maxillofacial Surgery and Diagnostics Sciences, College of Dentistry, Prince Sattam Bin Abdul Aziz University, Al Karj, SAU
| | - Sureddy Soumya
- Department of Oral and Maxillofacial Surgery, Swetha Reddy Multi Speciality Dental Clinic, Hyderabad, IND
| | - Swetcha Seethamsetty
- Department of Oral and Maxillofacial Surgery, Leela Dental Specialities, Kakinada, IND
| | - Godvine Sarepally
- Department of Oral and Maxillofacial Surgery, Panineeya Mahavidyalaya Institute of Dental Sciences, Hyderabad, IND
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Assessment of Difficulty in Mandibular Third Molar Surgery by Lambade-Dawane-Mali's Index. J Oral Maxillofac Surg 2023:S0278-2391(23)00210-0. [PMID: 36924791 DOI: 10.1016/j.joms.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE The evaluation of mandibular third molar (M3) difficulty is extremely important. This study aims to measure the association between preoperative Lambade-Dawane-Mali's (LDM) M3 difficulty index and postoperative assessment of difficulty score. MATERIAL AND METHODS This prospective cohort study included patients with impacted M3 reported to the Department of OMFS, RRK Dental College, Akola, from 2017 to 2022. The preoperative surgical difficulty was estimated using the predictor, LDM index with scores, easy (15-25), moderate (25-30), and difficult (>30). The postoperative surgical difficulty was analyzed with the primary outcome variable, total time intervention measured from the beginning of incision to the final suturing, wherein extraction was classified as easy if time (<15 minutes), moderate (15-30 minutes), and difficult (>30 minutes). The secondary outcome variable, Modified Parant's Scale (MPS), defines four levels of difficulty required for extraction of M3: Easy I (forceps extraction), Easy II (requiring osteotomy), Difficult III (coronal sectioning), and Difficult IV (complex extraction). Data were analyzed using agreement between LDM difficulty with three established criteria (time, MPS, Pederson index) and were assessed with Cohen's Kappa statistics. McNemar's test for paired data was used to assess concordance between two criteria of evaluation with a P-value <.05 was considered statistically significant. RESULTS The study sample included 1000 patients with a mean age of 26.7 ± 7.6 years and 456 (45.6%) females. Preoperative LDM difficulty assessed postoperatively by MPS indicated 99% were correctly identified by LDM preoperatively to have difficult and 99% easy outcomes. Inter-criteria agreement and Kappa statistics suggested a positive Kappa value (κ) and statistically significant agreement between the LDM index with perioperative time (κ = 0.8930), MPS (κ = 0.6488), and Pederson index (κ = 0.4920) at P-value 0.0001. Pair-wise comparisons of LDM criteria with perioperative time, MPS, and Pederson scale were assessed by McNemar's test, which evaluated concordance between the two criteria. CONCLUSION Postoperative evaluation of surgical difficulty in M3 extraction was strongly correlated with preoperative variables in the LDM difficulty-scoring index. Preoperative evaluation helps in envisaging the difficulty, planning surgical management, and helps in better time scheduling.
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Kohli A, Anehosur V, Radder K. Comparative Study of the Efficacy of Low-Level Laser Therapy and Dexamethasone in Reducing the Severity of Post-Operative Inflammatory Response Following Surgical Extraction of Mandibular Third Molars. J Maxillofac Oral Surg 2023; 22:165-171. [PMID: 36703670 PMCID: PMC9871140 DOI: 10.1007/s12663-021-01681-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/12/2021] [Indexed: 01/29/2023] Open
Abstract
Objectives To assesses the efficacy of low-level laser therapy (LLLT) over dexamethasone in reducing postoperative edema and trismus following surgical removal of mandibular third molars. Study design A single-center, parallel group, randomized, prospective, single-blind clinical trial on 50 patients between the age 18-40 years, requiring surgical extraction of mandibular third molars classified as mesioangular, class II and position B impactions, was selected for the study. The selected patients were randomly divided into two groups:Group 1, n = 25, Soft Tissue Diode laser was applied intra-orally and extra-orally at the insertion of the masseter.Group 2, n = 25, 8 mg of Dexamethasone was given intravenously preoperatively.Trismus and edema were calculated preoperatively and on the 1st and 5th postoperative day. The collected data were subjected to statistical analysis using student's t test. Results Trismus (4.61 ± 0.26 cm [p = 0.0001]) in the LLLT group was significantly less than the dexamethasone group (trismus: 3.82 ± 0.73 cm). Edema at different anatomic locations in the LLLT group was also significantly less than the dexamethasone group (Angle-tragus [p = 0.0008], angle-canthus [p = 0.0021], angle-ala [p = 0.0258], angle-commissure [p = 0.0168], angle-mentus [p = 0.0227]). Conclusion This study demonstrates that LLLT was beneficial in reduction in edema and trismus compared to dexamethasone following surgical extraction of third molars.
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Affiliation(s)
- Aakash Kohli
- Department of Dentistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Venkatesh Anehosur
- Department-Oral & Maxillofacial Surgery, SDM Craniofacial Center, Dharwad, India
| | - Kiran Radder
- Department-Oral & Maxillofacial Surgery, SDM Craniofacial Center, Dharwad, India
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Njokanma AR, Fatusi OA, Ogundipe OK, Arije OO, Akomolafe AG, Kuye OF. Does platelet-rich fibrin increase bone regeneration in mandibular third molar extraction sockets? J Korean Assoc Oral Maxillofac Surg 2022; 48:371-381. [PMID: 36579909 PMCID: PMC9807374 DOI: 10.5125/jkaoms.2022.48.6.371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 12/30/2022] Open
Abstract
Objectives This study determined the effect of platelet-rich fibrin (PRF) on extraction socket bone regeneration and assessed the patterns and determinants of bone regeneration after the surgical extraction of impacted mandibular third molars. Materials and Methods This prospective study randomly allocated 90 patients into two treatment groups: A PRF group (intervention group) and a non-PRF group (control group). After surgical extractions, the PRF group had PRF placed in the extraction socket and the socket was sutured, while the socket was only sutured in the non-PRF group. At postoperative weeks 1, 4, 8, and 12, periapical radiographs were obtained and HLImage software was used to determine the region of newly formed bone (RNFB) and the pattern of bone formation. The determinants of bone regeneration were assessed. Statistical significance was set at P<0.05. Results The percentage RNFB (RNFB%) was not significantly higher in the PRF group when compared with the non-PRF group at postoperative weeks 1, 4, 8, and 12 (P=0.188, 0.155, 0.132, and 0.219, respectively). Within the non-PRF group, the middle third consistently exhibited the highest bone formation while the least amount of bone formation was consistently observed in the cervical third. In the PRF group, the middle third had the highest bone formation, while bone formation at the apical third was smaller compared to the cervical third at the 8th week with this difference widening at the 12th week. The sex of the patient, type of impaction, and duration of surgery was significantly associated with percentage bone formation (P=0.041, 0.043, and 0.018, respectively). Conclusion Placement of PRF in extraction sockets increased socket bone regeneration. However, this finding was not statistically significant. The patient's sex, type of impaction, and duration of surgery significantly influenced the percentage of bone formation.
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Affiliation(s)
- Azuka Raphael Njokanma
- Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria,Azuka Raphael Njokanma, Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ilesa Road, PMB 5538 Ile-Ife, Nigeria, TEL: +234-8062882989, E-mail: , ORCID: https://orcid.org/0000-0001-7093-8748
| | - Olawunmi Adedoyin Fatusi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Olufemi Kolawole Ogundipe
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Ayodele Gbenga Akomolafe
- Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Olasunkanmi Funmilola Kuye
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Lagos State University College of Medicine, Ikeja, Nigeria
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Qi J, Yue H, Liu E, Chen G, Liu Y, Chen J. Effects of Kinesio tape on pain and edema following surgical extraction of the third molar: A meta-analysis and systematic review. J Back Musculoskelet Rehabil 2022; 35:1097-1107. [PMID: 35570478 DOI: 10.3233/bmr-210209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Kinesio tape (KT) has been in extensive use for the rehabilitation of injuries related to sports, however, only a handful of studies have focused on the efficacy of KT following extraction of a third molar tooth. OBJECTIVE The study aims to assess whether pain and edema following surgical extraction of the third molar can be reduced by KT. METHOD This research was carried out following the principles of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Web of Science, Embase, PubMed, The Cochrane Library, CNKI, VIP, and WanFang Data databases were searched for trials published from their inception to eighth October 2021. They included published randomized controlled trials in Chinese or English languages. The methodological quality of the included studies was assessed using the Physiotherapy Evidence Database scale. Mean differences (MDs) with 95% confidence intervals (CIs) were used for the analysis of continuous data. The heterogeneity was measured using the I2 statistics. Then, Revman 5.4 software was employed for performing the meta-analysis. RESULTS Eight studies comprising 453 participants in total were included. In comparison to the no kinesio tape group, KT did not furnish improved results on mouth opening ([MD = 0.36, 95% CI (-0.67, 1.40), p= 0.49]), and swelling ([MD =-1.24, 95% CI (-3.43, 0.95), p= 0.79]). However, KT manifested a reduction in operation time ([MD =-1.00, 95% CI (-1.93, -0.07), P= 0.04]), edema ([MD =-0.53, 95% CI (-0.88, -0.19), P= 0.003]), and pain intensity ([MD =-1.29, 95% CI (-1.86, -0.73), P< 0.00001]), favouring the kinesio tape group. Overall, the size of the effect was found in the small to moderate range. CONCLUSION Despite the fact that KT can reduce pain and has been shown to have positive effects in several studies, there is no convincing evidence that it can reduce the swelling after surgical extraction of the third molar.
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Affiliation(s)
- Jing Qi
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China.,Department of Stomatology, Gansu Provincial People's Hospital, Lanzhou, Gansu, China.,The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Haiquan Yue
- Department of Stomatology, Gansu Provincial People's Hospital, Lanzhou, Gansu, China.,The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - E Liu
- Department of Stomatology, Gansu Provincial People's Hospital, Lanzhou, Gansu, China
| | - Guang Chen
- Department of Stomatology, Affiliated Hospital of Northwest University for Nationalities, Lanzhou, Gansu, China
| | - Yuting Liu
- Department of Radiology, Gansu Provincial People's Hospital, Lanzhou, Gansu, China
| | - Jiahui Chen
- Department of Clinical Skills Training Center, The First Clinical Medical College, The First Affiliated Hospital of Lanzhou University, Lanzhou, Gansu, China
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Hallab L, Azzouzi A, Chami B. Quality of life after extraction of mandibular wisdom teeth: A systematic review. Ann Med Surg (Lond) 2022; 81:104387. [PMID: 36147052 PMCID: PMC9486647 DOI: 10.1016/j.amsu.2022.104387] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 11/06/2022] Open
Abstract
Objective The objective of this systematic review was to evaluate the impact of mandibular wisdom tooth extraction on a patient's quality of life “QoL”. Methods An electronic search was conducted through September 2021 on MEDLINE database, ELSEVIER- ScienceDirect, Ebsco, Scopus and Google Scholar to collect sufficient articles relevant to our subject. Data were extracted and analyzed from selected studies including study type, sample size and characteristics, duration of the observation after removal wisdom teeth, the questionnaire used for evaluation of this QoL and, the result. Results Of 107 studies, fourteen representing 4990 cases met the inclusion criteria. The quality of life has deteriorated but different factors contributed to his improvement. Thus, different instruments have been used in these studies: 24 the OHIP-14, 10 the OHQoLUK, 8 the HRQOL, 2 the EQ-5D-3L QOL, and 1 used UW-QOL. Conclusion The extraction of mandibular wisdom teeth has a negative effect on the quality of life during the first postoperative days but improved progressively by following the medical instructions given by the dental surgeon. Extraction of mandibular wisdom teeth has a negative effect on the quality of life “QOL” during the immediate postoperative period. Several instruments have been used for the assessment of this “QOL”. General and local factors were also involved in the improvement or deterioration of this quality of life.
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Use of Transcutaneous Electrical Nerve Stimulation (TENS) for the Recovery of Oral Function after Orthognathic Surgery. J Clin Med 2022; 11:jcm11123268. [PMID: 35743339 PMCID: PMC9225233 DOI: 10.3390/jcm11123268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/07/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023] Open
Abstract
The oral functions of patients are markedly diminished immediately after orthognathic surgery, and novel approaches are needed to accelerate their recovery. The aim of this study was to examine the usefulness of weekly applications of transcutaneous electrical nerve stimulation (TENS) for this purpose, based on the evidence of its effectiveness in other types of patients with muscle alterations. Maximum jaw opening, bite force, pain, and facial inflammation were compared between patients receiving TENS and those receiving sham-TENS for 30 min at baseline and weekly over a four-week period after orthognathic surgery and were also compared between the before and after of each procedure. TENS was applied at 220 Hz, applying the maximum intensity tolerated by each individual patient. The TENS procedure was identical for all patients, but the device was not turned on in the sham-TENS group. Patients were blinded to their group membership. Results were analyzed separately in skeletal class II and III patients. Improvements in jaw opening and inflammation were significantly greater in the TENS than in the sham-TENS group, attributable to the muscle relaxation achieved with the procedure. Research is warranted on the benefits of a more frequent application of TENS.
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Abdulkareem E, Ali M, Rasool Hammoodi S, Talib R. Assessment of the Correlation between Gender and Third Molar Surgery Duration. DENTAL HYPOTHESES 2022. [DOI: 10.4103/denthyp.denthyp_101_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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ANALGESIC EFFICACY OF TRAMADOL/DEXKETOPROFEN VS IBUPROFEN AFTER IMPACTED LOWER THIRD MOLAR EXTRACTION: A RANDOMIZED CONTROLLED CLINICAL TRIAL. J Evid Based Dent Pract 2021; 21:101618. [PMID: 34922724 DOI: 10.1016/j.jebdp.2021.101618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/29/2021] [Accepted: 07/15/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Impacted third molar extraction is associated with acute moderate-to-severe pain for up to 48 hours post-surgery. This trial was designed to compare the analgesic effectiveness, swelling, and adverse events after impacted third molar surgery following multimodal therapy with 75 mg tramadol hydrochloride plus 25 mg dexketoprofen or monotherapy with 400 mg ibuprofen. METHODS Seventy-two patients were randomly assigned to receiving ibuprofen (n = 36) or tramadol-dexketoprofen (n = 36). Postoperative pain intensity and swelling were measured using a visual analog scale (VAS); pain relief experienced was reported using a 4-point verbal rating scale; the rescue medication requirement, adverse effects, and global impression of the medication were recorded. RESULTS No statistically significant between-group difference in pain intensity was observed at any time point; however, pain relief was significantly higher in the tramadol-dexketoprofen treated-group at 6 and 36 hours. Self-reported verbal rating scale assessments showed significantly lower swelling in the tramadol-dexketoprofen group at 24 hours post-surgery but not at 48 or 72 hours, and VAS-swelling scores showed no significant between-group difference. The frequency of postoperative nausea and dizziness was significantly higher in the tramadol-dexketoprofen group. CONCLUSIONS Multimodal therapy proved more effective to manage moderate-severe pain after impacted third molar surgery in comparison to monotherapy. However, the improvement in relief must be balanced against the increased risk of adverse effects when considering this multimodal approach.
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Assessment of Electrosensitivity of the Pulp of the Mandibular Second Molar after Surgical Removal of an Impacted Mandibular Third Molar. J Clin Med 2021; 10:jcm10163614. [PMID: 34441910 PMCID: PMC8397152 DOI: 10.3390/jcm10163614] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/11/2021] [Accepted: 08/14/2021] [Indexed: 02/06/2023] Open
Abstract
Despite the frequent discussion of complications associated with surgical removal of wisdom teeth in the scientific literature, increased mobility of the second molar, which can affect the clinical status of the pulp, is often downplayed or overlooked. This study aimed to evaluate surgical removal of an impacted third molar on the change in the electrosensitivity of the pulp of the mandibular second molar. Sixty patients consecutively presenting to the Department of Oral Surgery to remove an impacted mandibular third molar were included in the study. Clinical examinations of pulp sensitivity of second molars in both the study and control groups were evaluated before the procedure, seven days after the procedure, and eight weeks after the procedure. The surgical removal of an impacted mandibular third molar significantly affected the pulp sensitivity of the second molar.
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Aniko-Włodarczyk M, Jaroń A, Preuss O, Grzywacz A, Trybek G. Evaluation of the Effect of Surgical Extraction of an Impacted Mandibular Third Molar on the Periodontal Status of the Second Molar-Prospective Study. J Clin Med 2021; 10:2655. [PMID: 34208701 PMCID: PMC8234538 DOI: 10.3390/jcm10122655] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022] Open
Abstract
Dental injury to the second molar (SM) caused by the surgical extraction of the impacted third molar tends to be underestimated. The necessity of assessment of the impact of the removal of the wisdom tooth in the mandible on the second molar arose. The study group (n = 60) was the one with the second molar on the surgical side, and the control group (n = 60) was the one with the tooth on the opposite side of the alveolar arch. Before the surgery, the difficulty level was assessed according to the Pederson scale. The periodontal status of the SM was assessed by probing depth (PD), gingival index (GI), tooth mobility (TM) examination by the percussion method and resonance frequency. Measurements were taken before and after the surgery, 7 days and 8 weeks after the surgery. The study demonstrated the significant impact of the surgical removal of the wisdom tooth on the PD, GI and TM of the SM. The predicted degree of difficulty of the very difficult surgery had an influence on the increase in PD on the distal buccal and lingual surface of the SM, and on the GI in the proximity of the examined tooth. The results of the presented research confirm the necessity of the clinical assessment of the lower SM before and after the surgical removal of the impacted wisdom tooth in the mandible.
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Affiliation(s)
- Magda Aniko-Włodarczyk
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, 72 Powstańców Wlkp. St., 70-111 Szczecin, Poland; (M.A.-W.); (A.J.); (O.P.)
| | - Aleksandra Jaroń
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, 72 Powstańców Wlkp. St., 70-111 Szczecin, Poland; (M.A.-W.); (A.J.); (O.P.)
| | - Olga Preuss
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, 72 Powstańców Wlkp. St., 70-111 Szczecin, Poland; (M.A.-W.); (A.J.); (O.P.)
| | - Anna Grzywacz
- Independent Laboratory of Health Promotion, Pomeranian Medical University in Szczecin, 11 Chlapowskiego St., 70-204 Szczecin, Poland;
| | - Grzegorz Trybek
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, 72 Powstańców Wlkp. St., 70-111 Szczecin, Poland; (M.A.-W.); (A.J.); (O.P.)
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Momeni E, Barati H, Arbabi MR, Jalali B, Moosavi MS. Low-level laser therapy using laser diode 940 nm in the mandibular impacted third molar surgery: double-blind randomized clinical trial. BMC Oral Health 2021; 21:77. [PMID: 33602198 PMCID: PMC7891036 DOI: 10.1186/s12903-021-01434-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background The effect of low-level laser therapy (LLLT) on pain mitigation following the third molar surgery is still controversial. The absence of a standard method for using laser among the studies is related to the types of sample selection, sample size, control, and LLLT parameters, which make pain mitigation following surgery more controversial. Therefore, this study aimed to determine the effect of LLLT on reducing pain, swelling, and trismus following the mandibular impacted third molar surgery. Methods
This study was performed on 25 healthy subjects. After the surgery, amoxicillin 500 mg was prescribed every 8 h for a 7-day period besides oral Ibuprofen (Gelofen) 400 mg every 12 h for a 3-day period. The intraoral Laser diode 940 nm was applied immediately after suture on the tested side, while on the placebo side, a fiber tip was used with no laser radiation following surgery. Eventually, the pain score was evaluated by VAS index from the 1st to the 7th-day post-surgery and then analyzed by SPSS 24. Results The results indicate that the mean swelling and trismus before, during, 2 days after, and 7 days after the intervention did not differ significantly between the two studied groups. However, the results show that on the sixth and seventh days, the pain was significantly lower in the intervention group compared to the control group. Conclusions The results suggest that although the pain, swelling, and trismus following surgery were lower on the radiated side, only pain was found to be significant on the radiated side (p < 0.05). The registration number of the clinical trial in a Primary Registry in the WHO Registry Network is IRCT20141209020258N110 and the date of retrospective registration is 04/05/2019. The related URL is https://www.irct.ir/trial/36321.
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Affiliation(s)
- Ehsan Momeni
- Department of Oral Medicine, School of Dentistry, Arak University of Medical Sciences, Arak, Iran
| | - Hoda Barati
- Department of Oral Medicine, School of Dentistry, Arak University of Medical Sciences, Arak, Iran
| | | | - Behrouz Jalali
- Department of Oral Surgery, School of Dentistry, Arak University of Medical Sciences, Arak, Iran
| | - Mahdieh-Sadat Moosavi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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Jaroń A, Preuss O, Grzywacz E, Trybek G. The Impact of Using Kinesio Tape on Non-Infectious Complications after Impacted Mandibular Third Molar Surgery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020399. [PMID: 33419167 PMCID: PMC7825547 DOI: 10.3390/ijerph18020399] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/17/2020] [Accepted: 12/31/2020] [Indexed: 01/10/2023]
Abstract
Non-infectious complications such as post-extraction pain, trismus, and swelling are extremely common after impacted wisdom tooth removal. The aim of the study was to assess the impact of using kinesio tape on the level of the postoperative swelling of soft tissues, trismus, and pain in patients undergoing the surgical extraction of an impacted mandibular third molar. One hundred patients undergoing the surgical extraction of a lower wisdom tooth were randomly divided into two groups: a study group with kinesio taping (KT) (n = 50) and a control group without kinesio taping (NKT) (n = 50). The surgical procedure was performed according to the same repeatable scheme. Kinesio tape was applied immediately after surgery in the KT group. In both groups, measurements of swelling, trismus, and pain were performed before the surgery and on the third and seventh postprocedural days. Kinesio tape had a significant effect on the decrease in facial swelling on the third day after surgery and a decrease in trismus and pain severity levels on the third and seventh days after surgery. The kinesio tape method is non-invasive, continuously active throughout the entire application period, and requires no additional patient appointments. KT application is an effective method for reducing postoperative edema, pain, and trismus after impacted mandibular wisdom teeth surgery.
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Nayak SS, Arora A, Shah A, Sanghavi A, Kamath AT, Nayak VS. The Influence of the Suture-less Anterior Releasing Incision in a Triangular Flap Design on Postoperative Healing Following Surgical Removal of Impacted Mandibular Third Molars. J Int Soc Prev Community Dent 2020; 10:262-268. [PMID: 32802771 PMCID: PMC7402254 DOI: 10.4103/jispcd.jispcd_444_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/25/2020] [Accepted: 03/31/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives: The objective of this study was to determine the effect of suture-less anterior releasing incisions on postoperative wound healing following surgical removal of impacted mandibular third molars. Materials and Methods: A total of 112 patients were included in the study. Group 1 had 56 patients in which the anterior releasing incision was not sutured postoperatively, and group 2 had 56 patients, in whom the anterior releasing incision was sutured. The two groups were compared in terms of pain, swelling, and trismus at 1 day, 3 days, and 7 days postoperatively. The Univariate Type III Repeated-Measures ANOVA Assuming Sphericity was used to compare the two modes of treatments at different time points. The periodontal healing distal to the second molar was assessed on the first day and at 2 months following the surgical intervention. The independent t test was used to compare the periodontal healing between the two groups at two time points. Results: No significant difference was observed between the two groups for pain and trismus (P > 0.05). However, the swelling was significantly greater in group 2 as compared to group 1 (P < 0.001). Periodontal healing was better in group 2, which showed lower periodontal probing depth distal to the mandibular second molar, compared to group 1 (P < 0.05). Conclusion: Suture-less anterior releasing incision decreases the postoperative swelling and edema, but the periodontal healing was poor when compared to the sutured anterior releasing incision cases. The type of closure technique did not have any significant influence on pain and trismus.
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Affiliation(s)
- Sunil S Nayak
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anushka Arora
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ashmeet Shah
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Amee Sanghavi
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Abhay T Kamath
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vanishri S Nayak
- Department of Anatomy, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Sainz de Baranda B, Silvestre FJ, Silvestre-Rangil J. Relationship Between Surgical Difficulty of Third Molar Extraction Under Local Anesthesia and the Postoperative Evolution of Clinical and Blood Parameters. J Oral Maxillofac Surg 2019; 77:1337-1345. [PMID: 30878593 DOI: 10.1016/j.joms.2019.02.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 02/12/2019] [Accepted: 02/12/2019] [Indexed: 12/01/2022]
Abstract
PURPOSE To determine whether the Pederson scale is a good predictor of the surgical difficulty of third molar extraction and establish whether such surgical difficulty is directly related to the postoperative course as assessed from clinical (pain, inflammation, and trismus) and blood (C-reactive protein, interleukin-6 [IL-6], and fibrinogen) parameters. MATERIALS AND METHODS A prospective observational study was conducted of 2 groups of patients who underwent simple or surgical third molar extraction under local anesthesia. Clinical and blood parameters and possible complications were recorded for 1 week after extraction. RESULTS A total of 118 patients were studied. Surgical difficulty as predicted by the Pederson scale showed significant differences (P < .001) for osteotomy, sectioning of the crown, root sectioning, duration of intervention, type of closure, and number of sutures. Under conditions of equal surgical difficulty, the evolution of the groups was similar for pain and inflammation, although trismus was greater for patients subjected to surgical extraction. After the operation, marked increments were recorded in serum C-reactive protein, IL-6, and fibrinogen, although without differences among different levels of surgical difficulty. The probability of complications was similar in the routine and surgical extraction groups. The appearance of complications was the principal cause of alterations in clinical and blood parameters. CONCLUSIONS The Pederson scale is a good predictor of the surgical difficulty of third molar removal as assessed from different clinical and blood parameters. C-reactive protein, IL-6, and fibrinogen concentrations varied considerably after the operation but were not influenced by the degree of surgical difficulty. The presence of postoperative complications was associated with a poorer evolution of clinical and blood parameters.
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Alkadi S, Stassen L. Effect of One-Suture and Sutureless Techniques on Postoperative Healing After Third Molar Surgery. J Oral Maxillofac Surg 2019; 77:703.e1-703.e16. [PMID: 30611694 DOI: 10.1016/j.joms.2018.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 10/26/2018] [Accepted: 12/01/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE The wound closure technique for lower third molar surgery (LTMS) is an operative factor that influences wound healing and the occurrence of early postoperative complications. The present study investigated 2 closure techniques (partial closure using 1 suture and the suture-less technique) after use of a modified buccal envelope flap for LTMS. MATERIALS AND METHODS We performed a prospective, randomized, double-blind, split-mouth, controlled trial. Partial closure using 1 suture was compared with closure using the sutureless technique. The surgical sites were divided into 2 groups, group A (1 suture) and group B (sutureless). Each patient received both treatments at the same surgery. During the first postoperative week, all patients were asked to daily assess pain, facial swelling, and bleeding using self-assessment scales. All patients attended the follow-up appointment at 1 week to objectively assess facial swelling and wound healing and at 1 month to assess wound healing. An analysis of data was performed using the statistical package SPSS Statistics, version 24 (IBM Corp, Armonk, NY). A P value ≤ .05 was accepted as statistically significant. RESULTS A total of 37 patients with bilateral impacted third molars of similar surgical difficulty were recruited. Of the 37 patients, 34 successfully completed the study. The results showed a statistically significant difference between the 2 techniques in postoperative pain at days 5 (P = .046) and 6 (P = .034); socket healing at 1 week (P = .002) and 1 month (P = .014), and soft tissue healing at 1 week (P = .016). CONCLUSION We found the 1-suture technique for LTMS to be superior to the sutureless technique in the reduction of postoperative pain and improving wound healing during the early postoperative period. We found no difference between the 2 techniques in the reduction of postoperative swelling.
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Affiliation(s)
- Saleh Alkadi
- Specialist Oral Surgeon, Department of Oral and Maxillofacial Surgery, Dublin Dental University Hospital, Lincoln Place, Dublin, Ireland.
| | - Leo Stassen
- Professor and Chair, The National Maxillofacial Unit, St James's Hospital, Dublin, Ireland; Department of Oral and Maxillofacial Surgery, Dublin Dental University Hospital, Dublin, Ireland
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Gülnahar Y, Kupeli I. Effect of preemptive intravenous ibuprofen on postoperative edema and trismus in third molar tooth extraction: A randomized controlled study. J Dent Anesth Pain Med 2018; 18:161-167. [PMID: 29984320 PMCID: PMC6031972 DOI: 10.17245/jdapm.2018.18.3.161] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 05/30/2018] [Accepted: 06/01/2018] [Indexed: 12/20/2022] Open
Abstract
Background This study aimed to evaluate the anti-inflammatory efficacy of preemptive intravenous ibuprofen on inflammatory complications such as edema and trismus in patients undergoing impacted mandibular third molar surgery. Methods Sixty patients were included and divided into three groups (800 mg IV ibuprofen + 50 mg dexketoprofen, 800 mg IV ibuprofen, and control). In all patients, preoperative hemodynamic values were recorded before the infusions. The operation was started at 15-min post-infusion. Evaluation of edema size on the face and mouth opening (trismus) was conducted in the preoperative period, and at postoperative 48 h and 1 week. Results No difference was determined among the groups in trismus and edema size in postoperative measurements (P > 0.05). There was a difference between group 2 and group 3 only in measurement value of tragus-corner of the mouth on the postoperative day 2 (P < 0.05). A difference was found between the measurement values of trismus preoperatively and at preoperative day 2, and between postoperative day 2 and 1 week in group 3 based on time (P < 0.05). In group 3, edema on the face on postoperative day 2 increased significantly compared to that in the preoperative period (P < 0.001); in addition, edema increased significantly in groups 1 and 2 in the postoperative period but was less than that in group 3 (P < 0.001). Conclusions In this study, intravenous ibuprofen was determined to be more effective alone or in combination in alleviating trismus and to better limit the postoperative edema.
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Affiliation(s)
- Yakup Gülnahar
- Oral and Maxillofacial Surgery Department, Erzincan University, Erzincan, Turkey
| | - Ilke Kupeli
- Anesthesiology and Reanimation Department, Erzincan University, Erzincan, Turkey
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Clinical and Radiographic Characteristics as Predictive Factors of Swelling and Trismus after Mandibular Third Molar Surgery: A Longitudinal Approach. Pain Res Manag 2018; 2018:7938492. [PMID: 29849848 PMCID: PMC5937415 DOI: 10.1155/2018/7938492] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 03/22/2018] [Accepted: 04/05/2018] [Indexed: 12/03/2022]
Abstract
Introduction Factors that contribute to swelling and trismus are complex, and they are originated by surgical trauma. The aim of the present study was to determine whether clinical and radiographic factors could predict the level of swelling and trismus after lower third molar surgery, through longitudinal approach. Methodology A prospective longitudinal trial was carried out. Forty-five patients of both genders with clinical and radiographic diagnosis of asymptomatic mandibular impacted third molar and with no intake of analgesic or anti-inflammatory drugs 12 h prior to surgery were recruited and evaluated in a 72 h follow-up period. A mixed repeated measures model and backward and restricted maximal likelihood methods were used to analyze the data. Results Male gender, body mass index (BMI), the relation to the lingual and buccal walls, and age were determinants for predicting postoperative swelling and for exerting a significant influence (P < 0.05). Conclusions This study suggests the association of male gender, the relation to lingual and buccal walls, BMI, and age with measurement of swelling.
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Martín-Ares M, Barona-Dorado C, Martínez-Rodríguez N, Cortés-Bretón-Brinkmann J, Sanz-Alonso J, Martínez-González JM. Does the postoperative administration of antibiotics reduce the symptoms of lower third molar removal? A randomized double blind clinical study. J Clin Exp Dent 2017; 9:e1015-e1022. [PMID: 28936293 PMCID: PMC5601102 DOI: 10.4317/jced.54024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 06/21/2017] [Indexed: 11/30/2022] Open
Abstract
Background To date there is little scientific evidence that clarifies the therapeutic effect of antibiotics for managing the postoperative symptoms of impacted third molar surgery. The aim of this study was to evaluate the efficacy of antibiotic treatment for reducing non-infectious clinical symptoms. Material and Methods Patient data was collected from the patients´ medical records and the results were statistically evaluated with SPSS versión 21.0; SPSS, IBM; Chicago, IL, USA). This longitudinal prospective study consisted of a randomized simple-blind clinical assay of 293 patients attending the Department of Oral Medicine and Surgery, Faculty of Dentistry at the Complutense University of Madrid (Spain). The predictive variable evaluated was the effect of antibiotic treatment on non-infectious symptoms after third molar extraction. The variables evaluated were pain, swelling, and oral aperture. Results The 293 patients were divided into 2 groups: a control group of 147 patients treated with analgesics and anti-inflammatories after surgery and a study group of 146 patients, who were also administered antibiotics. Better outcomes were observed in the study group treated with antibiotics. Pain, swelling and oral aperture variables presented better results in the antibiotic group with statistically significant difference. Conclusions The results suggest that antibiotic administration decreases the post-operative non-infectious clinical symptoms of impacted third molar surgery. However, the prolonged administration of antibiotics had no real medical indications to justify their use and can cause serious health problems in the long term. Key words:Antibiotic, post-operative, impacted lower third molar.
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Affiliation(s)
- María Martín-Ares
- Oral surgery, Faculty of Dentistry, the Complutense University of Madrid, Spain
| | | | | | | | - Javier Sanz-Alonso
- Oral surgery, Faculty of Dentistry, the Complutense University of Madrid, Spain
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Hamid MA. Low-level Laser Therapy on Postoperative Pain after Mandibular Third Molar Surgery. Ann Maxillofac Surg 2017; 7:207-216. [PMID: 29264287 PMCID: PMC5717896 DOI: 10.4103/ams.ams_5_17] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction: The analgesic effect of low-level laser therapy (LLLT) after mandibular third molar (MTM) extraction is controversial. The aim is to evaluate the effect of intraoral LLLT on postoperative pain after MTMs extraction. Methods: Thirty patients with bilateral symmetrical impacted MTMs underwent surgical extractions. Experimental and control sides were randomly selected to receive LLLT or placebo. Following suturing, a dental assistant applied 810 nm gallium aluminum arsenide (GaAlAs) at three points for 30 s each with a total energy of 9 J. Pain was recorded on a visual analog scale on the 7 successive days. Results: Data analyzed by IBM SPSS Statistics 23 for Windows with P ≤ 0.05 significance level. LLLT appeared to have a high significant effect on pain reduction; however, there was a mild increase in pain after the 4th day. Conclusion: Intraoral 810 nm GaAlAs is effective in reducing postoperative pain when a dose of 32.86 J/cm2 is used.
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Affiliation(s)
- May Ayad Hamid
- Department of Oral Surgery and Implantology, Maktoum Bin Hamdan Dental University College, Dubai, UAE
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Eroglu CN, Keskin Tunc S. Effectiveness of Single Session of Low-Level Laser Therapy with a 940 nm Wavelength Diode Laser on Pain, Swelling, and Trismus After Impacted Third Molar Surgery. Photomed Laser Surg 2016; 34:406-10. [PMID: 27420732 DOI: 10.1089/pho.2016.4101] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION In low-level laser therapy (LLLT), applications are generally performed in repetitive sessions using wavelengths of around 800 nm, at which the depth of penetration of laser is greater. The present study aimed to investigate the effects of LLLT with a 940 nm diode laser, which was performed extraorally on all the primarily and secondarily affected areas immediately after surgery in a single session, on pain, swelling, and trismus that occurred after impacted tooth extraction. MATERIALS AND METHODS Thirty-five outpatients with similarly impacted lower third molars on both sides were selected. The teeth of patients were removed in two separate operations. Postoperatively, the patients received laser therapy with energy of 4 J/cm(2) on one side and no laser energy was applied to the other side (placebo side). Swelling, trismus, and subjective assessment of pain on a visual analog scale were evaluated and compared between the laser-treated and placebo sides. RESULTS There was no statistically significant difference in pain, swelling, or trismus between the sides (Mann-Whitney U test p > 0.05). However, according to the clinical outcomes, swelling and trismus were less in the laser-treated side than in the placebo side. CONCLUSIONS A single-session LLLT that would be applied with a diode laser immediately after impacted tooth extraction might help patients to be less affected by postoperative trismus and swelling.
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Affiliation(s)
- Cennet Neslihan Eroglu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yuzuncu Yil University , Van, Turkey
| | - Serap Keskin Tunc
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yuzuncu Yil University , Van, Turkey
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