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

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

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

scholarly journals Evaluation of efficacy of submucosal tramadol after mandibular third molar surgery: a prospective pilot study

2019 ◽  
Vol 7 (11) ◽  
pp. 4320
Author(s):  
Karan V. Panchal ◽  
Navin S. Shah ◽  
Pratik Agrawal ◽  
Parshwa N. Shah
Keyword(s):  
Pilot Study ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Mouth Opening ◽  
Analgesic Efficacy ◽  
Third Molar Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Third Molar Extraction ◽  
Mandibular Third Molar ◽  
Surgical Extraction

Background: Surgical extraction of mandibular third molar is one of the most commonly performed procedure in oral and maxillofacial surgery. Its removal causes swelling, trismus, and moderate to severe pain which can be treated with various NSAID’s drugs, which have numerous side effects and gastric disturbances. In order to bypass such disturbances, Tramadol may be considered as an alternative for such patients. The aim of the study was to evaluate analgesic efficacy of submucosal tramadol and its implication over swelling and mouth opening after mandibular third molar surgery.Methods: This is a prospective study where in after post-surgical extraction of mandibular third molar, efficacy of submucosal injection of tramadol is evaluated in terms of pain and its implication over swelling and mouth opening.Results: The present study suggested there was statistically significant VAS score for pain after submucosally injecting tramadol post-surgical extraction of mandibular third molar in the following visits- 4hourly, 8hourly and 24hourly. In respect to swelling, statistically significant values was noted during 24hr and 72 h our post extraction. Also in case of mouth opening, statistically significant values were found 24 hourly.Conclusions: The present pilot study concluded that submucosal tramadol post mandibular third molar extraction has been effective in reducing pain, limiting post-extraction swelling and less impacting mouth opening by inducing less complications thereby bypassing gastric disturbances.

scholarly journals A Comparative Study on Efficacy of Amoxicillin and Azithromycin in Prevention of Postoperative Sequelae Following Third Molar Surgery

2019 ◽  
Vol 21 (3) ◽  
pp. 224-229
Author(s):  
Rashmi Shakya Gurung ◽  
K. Bimb ◽  
D. Shrestha
Keyword(s):  
Maxillofacial Surgery ◽  
Third Molar ◽  
Controlled Study ◽  
Third Molar Surgery ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
Operative Complications ◽  
Alternative Drug ◽  
Group B ◽  
Post Operative Complications

Amoxicillin is the commonly prescribed antimicrobial for prevention of post-operative complications following surgical extraction of mandibular third molar. However recently, the use of macrolideantibiotics had been encouraged in dentistry. The aim of this study was to compare the efficacy of Amoxicillin and Azithromycin in preventing post-operative sequelae following third molar surgery. An open- labeled randomized controlled study was carried out in Department of Oraland Maxillofacial surgery, college of Dental Sciences and Hospital, Nepal Medical College (CODSHNMC), Attarkhel, Kathmandu, Nepal from May 2018 to June 2019. One hundred and twenty patients undergoing surgical extraction of impacted mandibular third molar were randomized by lottery method into two groups: Group A received Amoxicillin and Group B received Azithromycin. Both the groups were assessed postoperatively on 1st, 3rd and 7th days for post-operative complications- pain, swelling, trismus and pus discharge. The present study revealed no significant differences between the efficacy of Amoxicillin and Azithromycin in preventing postoperative sequelae following surgical extraction of impacted third molar. Amoxicillin and Azithromycin were therefore found to be equally effective. Thus, Azithromycin can be used as an alternative drug to Amoxicillin in case of resistance and intolerance to Amoxicillin.

scholarly journals Piezo-surgery technique and intramuscular dexamethasone injection to reduce postoperative pain after impacted mandibular third molar surgery: a randomized clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wissam Nehme ◽  
Youssef Fares ◽  
Linda Abou-Abbas
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Third Molar ◽  
Mouth Opening ◽  
Mean Difference ◽  
Third Molar Surgery ◽  
Third Molars ◽  
Dexamethasone Group ◽  
Mandibular Third Molar ◽  
Surgical Extraction

Abstract Background Surgical extraction of the impacted mandibular third molar is commonly associated with postoperative pain, swelling, and trismus. Usually, rotatory instruments like burs have been used for osteotomy, while Piezosurgery is an innovative technique introduced to overcome the weaknesses related to the conventional technique. In addition, Dexamethasone administration before the extraction of impacted third molars is an efficient way to reduce postoperative pain due to robust anti-inflammatory activity. The purpose of the study is to evaluate the effect of piezo-surgery and dexamethasone injection on postoperative sequelae after the surgical extraction of impacted mandibular third molars, and ultimately to compare their effect on reducing postoperative pain. Methods A randomized controlled clinical trial was conducted with a sample of 80 patients. Participants were divided into four groups: Group 1 (Conventional rotatory), Group 2 (Conventional rotatory with 8 mg dose of dexamethasone 30 min before surgery), Group 3 (Piezo-surgery), and Group 4 (Piezo-surgery with 8 mg dose of dexamethasone 30 min before surgery). The outcome variables were surgical working time calculated in minutes, maximal mouth opening measured in millimeters using Vernier Caliper at baseline and day 3 and postoperative pain assessed using a Visual Analog Scale (VAS) on days 1, 3, and 7. Results The surgical working time was longer in piezo-surgery groups compared with the conventional rotatory instruments groups (15.82 ± 3.47 vs 23.33 ± 2.54; p value < 0.0001). The lowest reduction in mouth opening between baseline and 3rd-day post-op was found in the Piezo-surgery with Dexamethasone group (mean difference = 5.0, SD = 3.9, p value < 0.0001) followed by the Piezosurgery without Dexamethasone group (mean difference = 5.8, SD = 4.5, p value < 0.0001) and the highest average was reported by the Conventional rotatory without Dexamethasone (mean difference = 9.7, SD = 4.5, p value < 0.0001. In the four groups, the mean pain score was highest on the 1st day and gradually decreased over the following days. Comparison of the 1st and 3rd postoperative pain between groups revealed a lowest mean pain score in the Piezo-surgery with Dexamethasone group, followed by Conventional rotatory with Dexamethasone group and a highest mean score in the Conventional rotatory without Dexamethasone group (p value < 0.0001). Conclusion The association of Piezosurgery osteotomy and Dexamethasone intramuscular injection could be an effective combination to reduce postoperative pain and trismus after impacted third molar surgery. Trial registration: NCT04889781 (https://clinicaltrials.gov/), Date of Registration: 17/05/2021 (retrospectively registered), https://clinicaltrials.gov/ct2/show/NCT04889781?term=NCT04889781&draw=2&rank=1

scholarly journals Effect of age on immediate postoperative tissue reaction following surgical extraction of impacted mandibular third molar

2016 ◽  
Vol 7 (2) ◽  
pp. 120 ◽  
Author(s):  
Chandan Kumar Paul ◽  
Quazi Billur Rahman ◽  
Shamiul Alam ◽  
Gokul Chand Kundu ◽  
Helal Uzzaman
Keyword(s):  
Third Molar ◽  
Mouth Opening ◽  
Tissue Reaction ◽  
Third Molar Surgery ◽  
Aged Patient ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
Tissue Reactions ◽  
Effect Of Age

<p><strong>Background:</strong> Postoperative morbidity following third molar surgery is affected by a number of factors. The aim of this study was to determine the effect of age on immediate postoperative tissue reactions following mandibular impacted third molar surgery. <strong>Objectives:</strong> To assess the discomforts after impacted mandibular third molar extraction in different aged patient. <strong>Methods:</strong> 100 patients, 54 Female and 46 male, aged 18 to 42 years comprised the study materials. Tooth extrac­tion was performed with buccal guttering technique after adequate elevation and reflection of full thickness mucoperiosteal flap. Pain, swelling and trismus were evaluated preoperatively and on 2nd POD and 7th POD. Data was processed and analyzed using SPSS and was compiled and test of significance was done using Chi square (x2) test and un-paired 't' test. <strong>Results:</strong> Statistical analysis of the data indicated that pain and swelling was significantly less and significant maximum mouth opening was achieved in early aged patient than late age when preoperative and postoperative results were compared. <strong>Conclusion:</strong> As postoperative immediate tissue reactions are more in late aged patient than younger so impacted mandibular third molar should extract in early age.</p>

scholarly journals Clinical Evaluation of Corticosteroid on Post Operative Morbidity in Impacted Lower Third Molar Surgery

2020 ◽  
Vol 32 (1) ◽  
pp. 5-9
Author(s):  
Mohammad Iqbal Kabir ◽  
Muhammad Mizanur Rahaman ◽  
Md Atiqul Islam Rabby ◽  
Samira Taufique Reshma ◽  
Md Abdur Rab ◽  
...  
Keyword(s):  
Maxillofacial Surgery ◽  
Third Molar ◽  
Study Groups ◽  
Military Hospital ◽  
Third Molar Surgery ◽  
Control Group ◽  
Surgical Removal ◽  
Early Recovery ◽  
Operative Morbidity ◽  
Mandibular Third Molar

Introduction: Mandibular third molar is most commonly dental impacted and it’s removal is not without morbidity. Post operative pain, swelling and trismus are universal. This study was carried out to compare the effect of co-administered corticosteroid and diclofenac Na+/K+ with diclofenac Na+/K+ alone on the post operative morbidity like pain, swelling and trismus after surgical removal of impacted lower third molars. Materials and Methods: The study was a prospective study done over a period of 01.01.13 to 30.06.14 in Department of Oral & Maxillofacial Surgery (OMS), Military Dental Center, Combined Military Hospital, Dhaka and the department of OMS Dhaka Dental College and Hospital, Dhaka. Sixty patients were included in the study and were randomly divided into two study groups: Control group received only diclofenac Na+/K+, Experimental group received corticosteroid and diclofenac Na+/K+. Pain, swelling and trismus were evaluated before, 1st, 2nd and 7th POD after surgery. Results: Among the 60 cases common type of impaction was horizontal and vertical type (30%) followed by Mesioangular (23%) and Distoangular (17%). All corticosteroid groups showed statistically significant (p < 0.01) improvement in pain and trismus at 1st and 2nd pod, but statistically significant (p < 0.01) improvement of swelling occur only on 2nd pod as compared to control group. Conclusion: Corticosteroid and diclofenac Na+/K+ combination was found effective for early recovery and the patients who used this combination suffered less pain, swelling and trismus after impacted mandibular third molar surgery. Medicine Today 2020 Vol.32(1): 5-9

scholarly journals Use of chlorhexidine 0.2% gel to prevent alveolar osteitis in mandibular third molar surgical extraction.

2020 ◽  
Vol 27 (08) ◽  
pp. 1606-1611
Author(s):  
Shuja Hamid ◽  
Mahwish Memon ◽  
Raza Ali ◽  
Salman Shams
Keyword(s):  
Maxillofacial Surgery ◽  
Third Molar ◽  
Mouth Opening ◽  
Control Group ◽  
Dry Socket ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
Alveolar Osteitis ◽  
Group A ◽  
Group B

Objectives: To evaluate the efficacy of 0.2% chlorhexidine gel placed intra alveolar in the prevention of alveolar osteitis after the surgical extraction of mandibular third molar. Study Design: Randomized Control trial. Setting: Department of Oral and Maxillofacial Surgery, LUMHS, Jamshoro/Hyderabad. Period: January 2016 to July 2016. Material & Methods: This study consisted of 40 patients in control group A and 40 patients of Chlorohexidine gel group B used after surgical extraction. A single dose of 0.2% bio-adhesive gel was introduced in group B while the control group A was left alone. Postoperative complications like pain, swelling, limited mouth opening, and dry socket were seen. Frequency and percentages were calculated. Mean +/- SD were calculated for quantitative variables. Results: On 3rd day patients reported with pain in group A were 24 and in group B were 15. Pain was seen in 4 patients (10%) on 15th day in group A while in group B no patient came with pain. 19 patients reported with dry socket on day 3 in group A and 4 patients in group B, While none of the patient encountered with Dry socket on 15th day in group in both groups. Conclusion: The data presented indicates that the bio-adhesive gel containing 0.2% chlorohexidine, applied post-extraction produced a better patient recovery.

scholarly journals Comparison of Post-Operative Symptom Severity (PoSSe) Scores in patients undergoing Mandibular Third Molar surgery in Ile-Ife, Nigeria

2019 ◽  
Vol 5 (1) ◽  
pp. 29-35
Author(s):  
Olufemi Ogundipe ◽  
Azuka Ralph Njokanma
Keyword(s):  
Symptom Severity ◽  
Third Molar ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Subjective Feeling ◽  
Mandibular Third Molar ◽  
Surgical Extraction ◽  
Significant Difference ◽  
The Mean ◽  
A Prospective Study

Background: The Post-Operative Symptom Severity (Posse) score is useful in the assessment of patients after third molar surgery. Objective: To evaluate patients' perceptions of quality of life after surgical extraction of an impacted mandibular third molar by comparing their Post-operative Symptom Severity (PoSSe) scores at Post-operative Weeks (POW) 1 and 4. Methods: Seventy patients (age 18 to 35 years) at the Out-Patient Department were enrolled in a prospective study prior to surgical removal of third molars. Each patient was given a PoSSe questionnaire to be completed at POW 1 and POW 4. The scale assessed recovery in seven key domains on patients’ subjective feeling about pain, eating, speech, sensation, appearance, sickness and interference with daily activities. Results: All but one patient returned completely filled questionnaires. The mean age of the study population was 25.7 ± 4.5 years. The mean PoSSe score at POW 1 and POW 4 were 35.0 ± 7.2 and 33.2 ± 6.9 respectively with statistically significant difference (p = 0.010). The PoSSe score was higher among males compared to females at POW 1 (37.2 ± 7.6 vs 33.5 ± 6.6) and also higher among males at POW 4 (33.8 ± 9.4 vs 32.7 ± 4.6). Conclusion: The severity of symptoms was perceived to be worse at POW 1 when compared to POW4 but the symptoms were still severe at POW4. There is a need for surgeons need to pay more attention to management of symptoms in the post-operative intermediate period.

scholarly journals Analysis of the Effectiveness of Lornoxicam and Flurbiprofen on Management of Pain and Sequelae Following Third Molar Surgery: A Randomized, Controlled, Clinical Trial

2019 ◽  
Vol 8 (3) ◽  
pp. 325 ◽  
Author(s):  
Gaetano Isola ◽  
Angela Alibrandi ◽  
Eugenio Pedullà ◽  
Vincenzo Grassia ◽  
Sebastiano Ferlito ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Third Molar ◽  
Mouth Opening ◽  
Placebo Treatment ◽  
Third Molar Surgery ◽  
Controlled Clinical Trial ◽  
Postoperative Phase ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
Surgical Extraction

The aim of this study was to analyze the effectiveness of Lornoxicam and Flurbiprofen in reducing perioperative sequelae after impacted mandibular third molar surgery. Ninety-one patients who needed surgical extraction of an impacted mandibular third molar were selected for the study. All subjects were randomly allocated to receive one of the following treatments twice a day for 5 days after surgery: placebo (n = 29), Flurbiprofen (n = 31), or Lornoxicam (n = 31). The primary outcome was postoperative pain, evaluated using the visual analogue scale (VAS) score at 30 min, 2, 6, 12, 24, 48 h, 7 and 10 days following surgery. The secondary outcomes chosen were changes in postoperative swelling and maximum mouth opening values compared to preoperative ones. Compared to placebo, treatment with Flurbiprofen and Lornoxicam was characterised by an improvement in the primary outcome. Moreover, the treatment with Lornoxicam presented significantly lower median pain scores at 2 h (p < 0.001) and at 6 h (p = 0.016) compared to Flurbiprofen and at 2 h (p < 0.001), 6 h (p = 0.01), and at 24 h (p = 0.018) after surgery compared with placebo. Swelling and maximum mouth opening values were not significantly different between the groups at each follow-up session. This trial demonstrated that treatment with Lornoxicam showed a decrease in the incidence and severity of pain in the first postoperative phase following third molar surgery compared to Flurbiprofen and placebo.

scholarly journals Risk factors of complications subsequent third molar extractions: A prospective cohort study

2021 ◽  
Vol 24 (4) ◽  
Author(s):  
Dena Ali
Keyword(s):  
Risk Factors ◽  
Pearson Correlation ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Removal ◽  
Chi Square ◽  
Surgical Extraction ◽  
Alveolar Osteitis ◽  
Chi Square Test

Objective: The aim of this study was to determine the complications that were associated with the surgical removal of third molars (M3s), and to assess the association of patient, anatomic, and surgical risk factors with the postoperative complications of surgically removed impacted M3s. Material and Methods: This study was a cohort prospective study conducted on patients, aged 17 and older, admitted to the oral and maxillofacial surgery clinic. All patients who needed 1 or more extractions were included and totalled 268 patients with 314 extracted teeth. Risk factors were divided into patient factors, anatomic factors and surgical factors. The postoperative complication variables mainly included: pain, alveolar osteitis, infection, bleeding, swelling, trismus. Statistical analysis used: Chi-square test was used for the bivariate analyses while Pearson correlation coefficient (1- tailed) test was used for the purpose of determining the association between the study variables. The significance of associations was considered statistically significant at P < 0.05. Results: Patients aged of 25 years and above experienced more complications, 39 (88.6%). With respect to gender, females experienced more complications, 29 (65.9%). Mandibular M3s had more complications than maxillary M3s, 34 (8.0%), followed by distoangular inclined M3s, 23 (52.3%), and last was full bony impaction, 13 (29.5%). Pain was the most frequent complication, 18 (40.9%), followed by alveolar osteitis 12 (27.3%). Conclusion: The results indicated that the most frequently complications were pain, infection, alveolar osteitis. These complications were associated with common risk factors such as age, gender, medical history, M3 angulation, impaction level, bone removal, tooth sectioning, and number of M3 removed per session. Keywords  Complications; Surgical extraction; Third molar.

scholarly journals Submucosal administration of dexamethasone versus methyl prednisolone in management of postoperative sequelae after mandibular third molar impaction - A systematic review

2020 ◽  
Vol 11 (3) ◽  
pp. 4479-4486
Author(s):  
Janani Kandamani ◽  
Divya Sanjeevi Ramakrishnan ◽  
Sudarssan Subramaniam Gouthaman ◽  
Santhosh Kumar M P
Keyword(s):  
Sodium Succinate ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Cochrane Library ◽  
Oral And Maxillofacial Surgery ◽  
Third Molar Extraction ◽  
Methylprednisolone Sodium Succinate ◽  
Methyl Prednisolone ◽  
Mandibular Third Molar

Third molar extraction is one of the most commonly performed minor surgical procedure in any dental practice worldwide, often accompanied by various postoperative sequelae such as swelling pain and trismus which intern affects the quality of life of a patient. Over the past few decades, different methods have been proposed in the literature and were clinically evaluated to reduce the postoperative discomfort after mandibular third molar impaction and out of which corticosteroids, have shown promising results. Dexamethasone (administered either orally, submucosally, IV or IM), methylprednisolone acetate and methylprednisolone sodium succinate (IV or IM or submucosal) are most commonly preferred corticosteroids in oral and maxillofacial surgery. The main objective is to systematically review the comparison of the effectiveness of submucosal administration of dexamethasone with methylprednisolone following mandibular third molar impaction in reducing the postoperative sequelae, and its discomfort and searches were performed in the PubMed, Medline, Scopus, and Cochrane Library databases. Two articles were most relevant, and the results of the comparison of the selected articles were analysed. From this deliberate audit, it is very well may be inferred that submucosal injection of dexamethasone plays a promising role in reducing the postoperative sequelae which includes swelling, pain and trismus and its discomfort following mandibular third molar impaction when compared with that of methylprednisolone.

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