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Shalabi M, Mahran AH, Elsewif T. Effect of submucosal cryotherapy compared with steroids and NSAIDs injections on Substance P and Interleukin 6 pulpal release in experimentally induced pulpal inflammation in rabbits. J Appl Oral Sci 2024; 32:e20240017. [PMID: 38775598 DOI: 10.1590/1678-7757-2024-0017] [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: 01/10/2024] [Accepted: 04/05/2024] [Indexed: 05/30/2024] Open
Abstract
OBJECTIVE To compare the effect of submucosal cryotherapy using cold saline to dexamethasone sodium phosphate and diclofenac sodium injections on substance P and interleukin 6 release in experimentally induced pulpal inflammation in rabbits' molar teeth. METHODOLOGY Fifteen rabbits were randomly classified into 3 groups according to the submucosal injection given: cold saline, dexamethasone sodium phosphate, and diclofenac sodium. A split-mouth design was adopted, the right mandibular molars were experimental, and the left molars served as the control without injections. Intentional pulp exposures were created and left for 6 hours to induce pulpitis. Pulpal tissue was extracted and examined for SP and IL-6 levels using ELISA. Within each group, the level of cytokines released was measured for both control and experimental groups for intragroup comparison to determine the effect of injection. The percentage reduction of each mediator was calculated compared with the control side for intergroup comparison then the correlation between SP and IL-6 levels was analyzed using Spearman's rank order correlation coefficient. Statistical analysis was performed, and the significance level was set at p<0.05. RESULTS Submucosal cryotherapy, dexamethasone sodium phosphate, and diclofenac sodium significantly reduced SP and IL-6 pulpal release. Submucosal cryotherapy significantly reduced SP more than and IL-6 more than dexamethasone sodium phosphate and diclofenac sodium. Pulpal reduction of SP and IL-6 showed a strong positive significant correlation. CONCLUSIONS Submucosal cryotherapy reduces the pulpal release of SP and IL-6 and could be tested as an alternative to premedication to potentiate the effect of anesthesia and control postoperative endodontic pain.
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Affiliation(s)
- Mai Shalabi
- Ain Shams University, Faculty of Dentistry, Endodontic Department, Cairo, Egypt
| | - Abeer H Mahran
- Ain Shams University, Faculty of Dentistry, Endodontic Department, Cairo, Egypt
| | - Tarek Elsewif
- Ain Shams University, Faculty of Dentistry, Endodontic Department, Cairo, Egypt
- Gulf Medical University, College of Dentistry, Restorative Dental Sciences Department, Ajman, UAE
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Kakei Y, Ioroi T, Miyakoda K, Ito T, Kashin M, Shirai T, Hasegawa T, Sakane T, Yano I, Akashi M. Assessment of Patient Characteristics Influencing the Analgesic Effects of Ibuprofen Gargle After Mandibular Third Molar Extractions. Cureus 2024; 16:e57516. [PMID: 38572179 PMCID: PMC10989207 DOI: 10.7759/cureus.57516] [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: 04/03/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction In our previous work, we investigated the analgesic effects of ibuprofen gargle after mandibular third molar extractions. However, a subsequent detailed review of individual patient data revealed variations in postoperative pain reduction among patients. Consequently, the present study was designed to conduct post-hoc subanalyses that identified factors contributing to variation in the analgesic response to ibuprofen gargle after third molar extractions. Materials and methods This study involved thirty-five Japanese patients from a prior randomized, double-blind, placebo-controlled, crossover study, which focused on the analgesic effects of ibuprofen gargle after mandibular third molar extractions. Participants were categorized as responders (n = 13) and non-responders (n = 22) based on the within-subject difference (ibuprofen-placebo, IP) of visual analog scale (VAS) changes. Baseline characteristics were compared, along with variables, such as age, sex, the reason for extraction, extraction site, Pell Gregory (space and depth) classification, Winter's classification, surgeon's experience, and surgery time. Baseline characteristics predicting responder status were examined using multivariate logistic regression. Results In the univariate analysis, variables such as age, sex, and baseline VAS scores with p-values <0.2 were evaluated using a stepwise approach. This analysis identified age (per -10 years) with an odds ratio of 4.163 (95% confidence interval (CI): 1.170-31.952, p = 0.0233) and sex (female) with an odds ratio of 9.977 (95% CI: 1.336-208.256, p = 0.0213) as significant predictors of responder status. Conclusions In young and female patients, ibuprofen gargle decreased postoperative pain after mandibular third molar extractions.
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Affiliation(s)
- Yasumasa Kakei
- Oral and Maxillofacial Surgery, Kobe University Hospital, Kobe, JPN
| | | | - Keiko Miyakoda
- Clinical and Translational Research Center, Kobe University Hospital, Kobe, JPN
| | | | - Masahiko Kashin
- Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, JPN
| | - Tatsuya Shirai
- Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, JPN
| | - Takumi Hasegawa
- Oral and Maxillofacial Surgery, Kobe University Hospital, Kobe, JPN
| | - Toshiyasu Sakane
- Pharmaceutical Technology, Kobe Pharmaceutical University, Kobe, JPN
| | - Ikuko Yano
- Pharmacy, Kobe University Hospital, Kobe, JPN
| | - Masaya Akashi
- Oral and Maxillofacial Surgery, Kobe University Hospital, Kobe, JPN
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Ioroi T, Kakei Y, Ito T, Shirai T, Okazaki Y, Hasegawa T, Akashi M, Yano I. Efficacy and safety of ibuprofen gargle for postoperative pain after mandibular third molar extraction: A phase II, placebo-controlled, double-blind, randomized crossover trial. Clin Exp Dent Res 2023; 9:1058-1068. [PMID: 38031263 PMCID: PMC10728546 DOI: 10.1002/cre2.821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/07/2023] [Accepted: 11/16/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE This study was designed to evaluate the postoperative efficacy and safety of using an ibuprofen gargle as a pain management strategy for patients who have undergone mandibular third molar extraction. We also ensured that the quality of treatment was not compromised throughout the study. MATERIAL AND METHODS Patients were randomized in a 1:1 ratio into two groups: the ibuprofen-placebo (IP) group and the placebo-ibuprofen (PI) group. On postoperative Day (POD) 1, the IP group initiated ibuprofen administration, while the PI group started taking placebo. On POD 2, the IP group switched to using placebo, whereas the PI group switched to ibuprofen. From PODs 3-5, both groups were prescribed ibuprofen gargle. The primary endpoint was within-subject visual analog scale (VAS) score before and 5 min after the first use of the ibuprofen or placebo gargle on PODs 1 and 2 (ΔVAS5_ibuprofen - ΔVAS5_placebo ). The incidence and severity of adverse events were assessed using the Common Terminology Criteria for Adverse Events version 5.0 and a subjective rating scale. RESULTS This study enrolled 40 patients. The within-subject VAS5 of the IP and PI groups were 1.25 ± 12.0 and -5.26 ± 8.93 mm, respectively. The treatment effect of ibuprofen gargle was -2.01 ± 10.62 mm (p = .246). None of the patients in each group presented with serious adverse events or clinically significant complications (including dry sockets) after extraction. Transient adverse events, such as throat tingling and oral discomfort (grade 1), were observed in each group. CONCLUSION Ibuprofen gargle was safe but did not provide significant pain relief when used after mandibular third molar extraction.
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Affiliation(s)
- Takeshi Ioroi
- Department of PharmacyKobe University HospitalHyogoJapan
| | - Yasumasa Kakei
- Department of Oral and Maxillofacial SurgeryKobe University Graduate School of MedicineHyogoJapan
| | - Takahiro Ito
- Department of PharmacyKobe University HospitalHyogoJapan
| | - Tatsuya Shirai
- Department of Oral and Maxillofacial SurgeryKobe University Graduate School of MedicineHyogoJapan
| | - Yutaro Okazaki
- Department of PharmacyKobe University HospitalHyogoJapan
| | - Takumi Hasegawa
- Department of Oral and Maxillofacial SurgeryKobe University Graduate School of MedicineHyogoJapan
| | - Masaya Akashi
- Department of Oral and Maxillofacial SurgeryKobe University Graduate School of MedicineHyogoJapan
| | - Ikuko Yano
- Department of PharmacyKobe University HospitalHyogoJapan
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Siritham A, Powcharoen W, Wanichsaithong P, Supanchart C. Analgesics effect of local diclofenac in third molar surgery: a randomized, controlled trial. Clin Oral Investig 2023; 27:6073-6080. [PMID: 37606721 DOI: 10.1007/s00784-023-05221-w] [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: 05/09/2023] [Accepted: 08/15/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVES This study aimed to evaluate the effect of locally diclofenac application on postoperative pain, sequalae, and adverse effects following mandibular third molar (MTM) surgery. METHODS A randomized, crossover, double-blind, controlled trial was conducted in 20 patients who required surgical removal of bilateral symmetrical impacted MTM at two separate appointments. The 40 MTMs were randomly allocated to two groups. One side was assigned 0.1% w/v diclofenac sodium as the diclofenac group. The contralateral side was assigned phosphate-buffered saline (PBS) as the control group. Postoperative pain intensity was measured by visual analogue scale (VAS), where the time when the first pain emerged, the time to first rescue medication, pain at 6 and 24 h after surgery, and the total number of analgesics consumed were recorded. Postoperative swelling and trismus were assessed on postoperative days 2 and 7. The differences of continuous outcomes between two groups were analyzed by paired t-test or Wilcoxon signed-rank test. RESULTS VAS scores were significantly lower when the first pain emerged and 6 h after surgery in diclofenac group (p < 0.05). The onset of pain in the diclofenac group was significantly longer than in the control group (p < 0.05). Two patients reported mild nausea and dizziness in the diclofenac group. CONCLUSION This study demonstrates the analgesic effectiveness of 0.1% local application of diclofenac within 6 h postoperative with few side effects. CLINICAL RELEVANCE Locally diclofenac application is an alternative of postoperative analgesic in MTM surgery which provides pain-free periods within 6 h.
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Affiliation(s)
- Anya Siritham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand
| | - Warit Powcharoen
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand
| | - Pinpinut Wanichsaithong
- Department of Family and Community Dentistry, Faculty of Dentistry, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand
| | - Chayarop Supanchart
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand.
- Center of Excellence in Materials Science and Technology, Chiang Mai University, Suthep, A. Muang, Chiang Mai, 50200, Thailand.
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Li H, Cheng Y, Lu J, Zhang P, Ning Y, Xue L, Zhang Y, Wang J, Hao Y, Wang X. Extraction of high inverted mesiodentes via the labial, palatal and subperiostal intranasal approach:A clinical prospective study. J Craniomaxillofac Surg 2023; 51:433-440. [PMID: 37550118 DOI: 10.1016/j.jcms.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/04/2023] [Accepted: 04/30/2023] [Indexed: 08/09/2023] Open
Abstract
The aim of this study is to provide criteria for the choice of the surgical approach for extraction of high inverted mesiodens. The operation statistics, life quality of postoperative patients, and the operative injury/recovery were compared and analysed. The laser Doppler blood flowmetry, laser speckle contrast imaging, and electric pulp testing were explored to detect the postoperative pulp and gingiva blood supply of adjacent teeth. For the clinician's primary concerns, the surgical time, the volume of osteotomy, and the amount of bleeding in the labial approach group (The p values are 0.0001, <0.0001, and 0.0131, respectively.) and intranasal approach group (All p values were <0.0001.) were significantly less than that in the palatal approach group. However, from the patient's perspective, the postoperative swelling in the labial approach was far more than that in the intranasal approach group (p =0.0044), with unsurprisingly lower satisfaction (p <0.0001). There were no significant differences in pulp and gingival blood supply of adjacent teeth and jaw development. Trauma was manageable in all patients. Within the limitations of the study it seems that extraction of mesiodens by the intranasal approach achieves a delicate balance between reducing surgical trauma and optimizing postoperative recovery.
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Affiliation(s)
- Huifei Li
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, China
| | - Yongfeng Cheng
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China
| | - Jun Lu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China
| | - Pengfei Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China
| | - Yi Ning
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China
| | - Lei Xue
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China
| | - Yuan Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, China
| | - Jie Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, China
| | - Yujia Hao
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, China
| | - Xing Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, China.
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Satyanarayana Killampalli DYV, Yuwanati M, Krishnan M, Kumar SP, George M, Lakshmanan S. Preemptive Analgesic Efficacy of Dexamethasone and Diclofenac in Mitigating Post-surgical Complications After Mandibular Third-Molar Surgery: A Systematic Review. Cureus 2023; 15:e42709. [PMID: 37654946 PMCID: PMC10468144 DOI: 10.7759/cureus.42709] [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: 07/14/2023] [Accepted: 07/30/2023] [Indexed: 09/02/2023] Open
Abstract
Mandibular third-molar extraction is a frequently executed minor oral surgical procedure, with a subsequent recovery period lasting several days. Typically, preemptive administration of non-steroid anti-inflammatory drugs (NSAIDs) and steroids has been employed, resulting in a notable decrease in postoperative complications like pain, facial swelling, trismus, and alveolar osteitis. This systematic review's primary goal was to investigate the efficacy of preemptive analgesia with dexamethasone and diclofenac in minimizing the post-surgical complications following the surgical extraction of the mandibular third molars. The systematic search was carried out to identify relevant literature in digital databases including PubMed®, Cochrane Library, Web of Science, and Scopus, from January 1990 to January 2022. The search used specific keywords. The randomized clinical trials assessing the efficacy of dexamethasone and diclofenac or dexamethasone alone compared to diclofenac or placebo as preemptive analgesics were considered inclusion criteria for this systematic review. Case reports, literature reviews, letters to the editor, and non-English publications were not included. Two authors screened the titles and abstracts, and articles fulfilling the study criteria were included. After reading the full text and data collection, analysis was performed. The included article's bias was evaluated by the Risk of Bias 2 (RoB 2) tool. A digital database search yielded a total of 207 articles. After excluding duplicates and articles written in languages other than English, 90 were removed. Based on the title and abstract, out of 177, 95 studies were excluded. After full-text reading of 22 articles, 17 were eliminated because they did not meet the inclusion and exclusion criteria. The remaining five studies were found eligible and included in the systematic review. Four studies were of low risk, while one study had some concerns. Two studies evaluated the combination of dexamethasone with diclofenac, while three evaluated dexamethasone alone. Total samples included samples of 436 third-molar surgeries in 420 patients. There was a substantial decrease in the mean pain score and swelling measurement when diclofenac alone was compared with coadministration of diclofenac and dexamethasone. Preemptive administration of dexamethasone and diclofenac has been shown to effectively reduce pain and facial swelling, with the exception of trismus, in third-molar surgeries when compared to diclofenac alone. As a result, it is recommended to administer these drugs prior to the commencement of third-molar extraction. However, further research is mandatory, specifically good quality randomized controlled trials involving large cohorts, in order to assess any significant variations and validate these findings.
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Affiliation(s)
| | - Monal Yuwanati
- Oral Pathology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Murugesan Krishnan
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Santhosh P Kumar
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Melvin George
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Saravanan Lakshmanan
- Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Kakei Y, Ioroi T, Ito T, Okazaki Y, Hasegawa T, Yano I, Akashi M. Efficacy of ibuprofen gargle for postoperative pain after mandibular third molar extraction: protocol for a phase II, placebo-controlled, double-blind, randomized crossover trial. JMIR Res Protoc 2022; 11:e35533. [PMID: 35459640 PMCID: PMC9159672 DOI: 10.2196/35533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/12/2022] [Accepted: 04/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Extraction of mandibular third molars is one of the most commonly performed oral surgical procedures, and nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for pain management. Oral NSAIDs are associated with adverse events such as gastrointestinal disorders, renal and hepatic dysfunction, and platelet dysfunction. Topical analgesics have been proposed as alternatives to oral and injectable medications to safely improve postoperative pain relief. We will conduct a single-center, placebo-controlled, double-blind, randomized crossover trial to assess the pain-relieving effect of an ibuprofen-containing gargle in patients undergoing extraction of mandibular third molars when compared with a placebo gargle. Objective This will be the first clinical study to compare the efficacy of an ibuprofen gargle with that of a placebo for relieving postoperative pain in addition to loxoprofen after mandibular third molar extraction. Methods This study will be performed at Kobe University Hospital. Participants (N=40) will be randomized equally to 1 of 2 groups. The ibuprofen-placebo group will receive an ibuprofen gargle on postoperative day (POD) 1 and a placebo gargle on POD 2. The placebo-ibuprofen group will receive a placebo gargle on POD 1 and an ibuprofen gargle on POD 2. Both groups will receive ibuprofen gargles on PODs 3-5 at least once daily. The primary objective is to estimate the within-subject difference on a visual analog scale (VAS) before and 5 minutes after using the ibuprofen or placebo gargle on PODs 1 and 2. The secondary objectives are to estimate the within-subject differences in ΔVAS before and 15 minutes after using the ibuprofen or placebo gargle on PODs 1 and 2, ΔVAS before and 5 or 15 minutes after using the ibuprofen gargle on PODs 3-5, overall efficacy (self-completion, 5 scales) on PODs 1-5, daily frequency of use (ibuprofen or placebo gargle and analgesics) on PODs 1-7, and the occurrence of adverse events. Results The Certified Review Board of Kobe University approved the study. The intervention was implemented in May 2021. For the primary analysis, we will calculate the mean and SD of ΔVAS5 on PODs 1 and 2 and the within-study difference in ΔVAS5. The treatment effect will be estimated by dividing the mean ΔVAS5 in the within-subject difference by 2 and calculating the P value using an unpaired t test. For the secondary analysis, we will calculate the mean and SD of ΔVAS15 on PODs 1 and 2 and the within-study difference in ΔVAS15. The treatment effect will be estimated as in the primary analysis. Conclusions This trial will provide exploratory evidence of the efficacy and safety of an ibuprofen gargle for pain reduction after mandibular third molar extraction. Trial Registration Japan Registry of Clinical Trials jRCTs051210022; https://tinyurl.com/39ej23zu International Registered Report Identifier (IRRID) DERR1-10.2196/35533
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Affiliation(s)
- Yasumasa Kakei
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-choChuo-ku, Kobe, JP
| | - Takeshi Ioroi
- Department of Pharmacy, Kobe University Hospital, Kobe, JP
| | - Takahiro Ito
- Department of Pharmacy, Kobe University Hospital, Kobe, JP
| | - Yutaro Okazaki
- Department of Pharmacy, Kobe University Hospital, Kobe, JP
| | - Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, JP
| | - Ikuko Yano
- Department of Pharmacy, Kobe University Hospital, Kobe, JP
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, JP
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Fang D, Li D, Li C, Yang W, Xiao F, Long Z. Efficacy and Safety of Concentrated Growth Factor Fibrin on the Extraction of Mandibular Third Molars: A Prospective, Randomized, Double-Blind Controlled Clinical Study. J Oral Maxillofac Surg 2021; 80:700-708. [PMID: 34801470 DOI: 10.1016/j.joms.2021.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE To investigate the efficacy and safety of concentrated growth factor fibrin (CGF) for the extraction of mandibular third molars. PATIENTS AND METHODS This was a randomized, double-blind, and controlled clinical study. Patients who underwent mandibular impacted tooth extraction were randomly divided into 2 groups. In the CGF group, the tooth extraction fossa was utilized to place CGF gel. In the control group, the fossa was filled with serum. The visual analogue scale (VAS), reductions in swelling and trismus, incidence of postoperative dry socket, distal periodontal depth and bone regeneration of the second molar, and bone density (BMD) of the extraction fossa at 24 weeks were evaluated. RESULTS One hundred eighteen patients were enrolled in this study. There was no significant difference in baseline clinical characteristics between the 2 groups. The pain score of the CGF group was significantly lower than that of the control group at 2, 24, and 48 hours after operation. There was no significant difference in the reduction in swelling or trismus between the 2 groups. There were no cases of dry socket in the CGF group and 3 cases of dry socket in the control group. The periodontal probing depth and bone regeneration of the second molar when the socket was implanted with CGF were better than those that healed naturally (P < .05). The bone mineral density of each group was significantly increased at 24 weeks but was significantly different between groups (P < .05). CONCLUSION CGF can effectively reduce reactive tooth extraction pain and help avoid dry sockets. It can promote periodontal tissue and bone healing in distal and extracted sockets.
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Affiliation(s)
- Dongdong Fang
- Associate Chief of Doctor, Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Dan Li
- Attending Doctor, Department of Scientific Research, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Chengjing Li
- Attending Doctor, Department of Oral and maxillofacial surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Wenyu Yang
- Attending Doctor, Department of Oral and maxillofacial surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Feng Xiao
- Attending Doctor, Department of Oral and maxillofacial surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Zhangbiao Long
- Associate Professor, Department of Hematology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
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Reyes-Fernández S, García-Verónica A, Hernández-Treviño N, Cobos-Cruz XT, Serna-Radilla VO, Romero-Castro NS. Submucosal and intramuscular dexamethasone for the control of pain, trismus and edema after third molar surgeries: ¿Is it necessary? ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [DOI: 10.1016/j.adoms.2021.100117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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ÇEBİ AT. Topikal ve sistemik flurbiprofenin gömülü üçüncü molar cerrahisi sonrası ağrı ve ödem üzerine etkilerinin ve gastrointestinal yan etkilerinin karşılaştırılması. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.631371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Jug M. Cyclodextrin-based drug delivery systems. NANOMATERIALS FOR CLINICAL APPLICATIONS 2020:29-69. [DOI: 10.1016/b978-0-12-816705-2.00002-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Al-Delayme RMA. Randomized clinical study comparing Piezoelectric Surgery with conventional rotatory osteotomy in mandibular third molars surgeries. Saudi Dent J 2019; 33:11-21. [PMID: 33473237 PMCID: PMC7801233 DOI: 10.1016/j.sdentj.2019.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 11/17/2019] [Accepted: 11/21/2019] [Indexed: 01/06/2023] Open
Abstract
Purpose The aim of this study was to evaluate the performance and to assess the postoperative sequel and quality of life after removal of impacted mandibular third molars using piezoelectric surgery compared with conventional rotatory osteotomy. Patients and methods A single blinded, randomized, control clinical study was performed. Sixty-three patients (44 males, 19 females) who presented with bilaterally asymptomatic impacted mandibular third molars were included in this analysis. Each patient was treated, at two separate sessions approximately 4 weeks apart, with a conventional rotatory hand piece on one side of the mandible and a piezoelectric device on the contralateral side. Patients were followed up on postoperative days 1, 3, 5, 7, and 15 to rate the pain, swelling and trismus. Inferior alveolar nerve paresthesia was evaluated up to 12 months postoperatively. Results The severity of the pain, trismus and swelling using the piezosurgery were significantly different from the rotary group. In both groups, pain was most intense and peaked during the first post-operative day, while swelling and trismus reached peak levels on the third postoperative day. The piezoelectric procedure resulted in a significantly longer procedural duration compared to the rotatory surgery (P < 0.001). Conclusion Piezoelectric surgery is considered a viable alternative technique compared to the conventional rotary systems and can improve a patient’s quality of life. Thus, piezoelectric surgery might be a preferred modality for patients undergoing complicated surgical extraction of impacted lower third molars.
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Keyhan SO, Fallahi HR, Cheshmi B, Mokhtari S, Zandian D, Yousefi P. Use of piezoelectric surgery and Er:YAG laser:which one is more effective during impacted third molar surgery? Maxillofac Plast Reconstr Surg 2019; 41:29. [PMID: 31448247 PMCID: PMC6682838 DOI: 10.1186/s40902-019-0212-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/08/2019] [Indexed: 12/20/2022] Open
Abstract
Background Reduction in postoperative complications is of vital considerations in impacted third molar teeth surgery. The aim of this study was to compare postoperative complications of impacted third molar surgeries for bone removal using laser, piezoelectric equipment, and conventional rotary instruments. Methods To address the research purpose, the investigator designed the prospective double-blind clinical trial study. The sample size was determined 20 (40 teeth) by sampling formula in any kind of operation. The data of patients were obtained in the different periods in terms of pain, trismus, swelling, ecchymosis, and patient's satisfaction and then analyzed using SPSS 20 software via paired t test and Wilcoxon and McNemar's tests. Results The pain immediately after surgery and 2 days and 7 days after surgery was higher in the laser group. The swelling immediately after surgery was more in the laser group but not significant. The amount of mouth opening immediately after surgery and 2 days and 7 days after surgery was significantly lower in the laser group than in the piezosurgery group. The total duration of surgery and duration of osteotomy were significantly longer in the laser group. The patient's satisfaction from surgery with piezosurgery was more than that with laser, but this difference was not significant. Conclusion Due to the rising demand for impacted wisdom tooth surgery, the present study suggests that hard tissue laser surgery and piezosurgery can clear the future of impacted molar surgery, and these approaches are more efficient in reducing postoperative complications compared to the conventional surgeries.
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Affiliation(s)
- Seied Omid Keyhan
- 1Stem cell & Regenerative Medicine Network, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Fallahi
- 2School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,3Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behzad Cheshmi
- Faculty of Dentistry, Boroujerd Islamic Azad University, Boroujerd, Iran
| | - Sajad Mokhtari
- 1Stem cell & Regenerative Medicine Network, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Dana Zandian
- 2School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,3Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Yousefi
- 5Department of Prosthodontics, College of Dentistry, Isfahan University of Medical Sciences, Tehran, Iran
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