Comparison Of The Effect Of Two-dose And One-dose Dexamethasone On Post-inflammatory Complications In Third Molar Surgery

2017 ◽  
Vol 2 (1) ◽  
pp. 8-17
Author(s):  
AM Adetayo ◽  
TA Oyedele ◽  
AO Ajomoko ◽  
MO Adetayo ◽  
MO Adeyemi ◽  
...  
Keyword(s):  
Third Molar ◽  
Mouth Opening ◽  
University Teaching ◽  
Third Molar Surgery ◽  
Pain Scores ◽  
Facial Swelling ◽  
Reduction Of Pain ◽  
Group A ◽  
Group B ◽  
Double Blinded

Objective: This study aimed to compare the effects of administration of both preoperative and postoperative dexamethasone with that of only preoperative dexamethasone, and with that of a no dexamethasone (control) on reduction of pain, trismus and swelling following lower impacted 3rd molar surgery. Methods: A prospective randomized controlled double blinded study at the dental clinic of Babcock University Teaching Hospital on 84 subjects that were divided into 3 groups. Group A had both preoperative and postoperative dexamethasone, while group B had only preoperative dexamethasone and group C was a 'no dexamethasone' group. Differential mean facial swelling, mouth opening and pain scores were compared within the three groups. Results: The pattern of postoperative swelling, pain and trismus showed a general decrease from day 1 to 7, with group A showing the highest rate of decrease. On postoperative day 1, there was a difference between the swelling of groups A and C (p =0.01) and groups B and C (p = 0.02) and also between the pain scores of group A and group C (p = 0.01). On postoperative day 3, there was only a difference between the swelling of groups A and C (p = 0.02), but not in pain and trismus and no difference was seen in all the measured variables on postoperative day 7. Conclusion: Administration of a combination of both preoperative and post operative dexamethasone to reduce the postoperative inflammatory sequelae that follows lower third molar surgery gave better results than administration of only a single preoperative dose.

scholarly journals Efficacy of various administrative techniques of methylprednisolone on oedema, trismus and pain after lower third molar surgery

2017 ◽  
Vol 5 (2) ◽  
pp. 186 ◽  
Author(s):  
Vaibhav Mukund ◽  
Sukumar Singh ◽  
Sanjeev Kumar ◽  
Rishi Rath ◽  
Siddharth Tevatia
Keyword(s):  
Third Molar ◽  
Mouth Opening ◽  
Controlled Study ◽  
Third Molar Surgery ◽  
Surgical Removal ◽  
Routes Of Administration ◽  
Group A ◽  
Maximal Mouth Opening ◽  
Level Of Significance ◽  
Group B

Due to their anatomical position, the surgical removal of impacted third molars results in oedema, pain, and trismus. The purpose of this study was to evaluate the efficacy of four different routes of administration of methylprednisolone on oedema, trismus and pain after lower third molar surgery. This randomized, perspective, and controlled study included 150 patients. The patients were randomly divided into five groups: Group A (control; no steroids), Group B (Submucosal injection), Group C (oral tablets), Group D (i.v. injection) and Group E (Intramuscular Injection). On days 2 and 7 following surgery, linear oedema was determined using facial landmarks, and maximal mouth opening was measured. Postoperative mouths opening and swelling were evaluated for each route of methylprednisolone administration and compared. The female (59%) to male (41%) ratio was 1.44; the mean age of the patients was 29.6 years. The level of significance was set at P < 0.01 for mouth opening and P < 0.05 for oedema. With regard to trismus, all four routes of administration demonstrated better efficacy in comparison to the control. While oral administration and i.v. injection of methylprednisolone achieved similar results, masseter injection provided better results in reducing oedema and trismus when compared with the control following lower third molar surgery.

scholarly journals Comparison of twin mix and revamped twin mix in mandibular third molar surgery - A randomised controlled double blinded study

2020 ◽  
Vol 11 (4) ◽  
pp. 5821-5827
Author(s):  
Dyna Albert ◽  
Sudarssan Subramaniam Gouthaman ◽  
Muthusekhar M R
Keyword(s):  
Third Molar ◽  
Mouth Opening ◽  
Third Molar Surgery ◽  
Mandibular Third Molar ◽  
Significant Difference ◽  
Facial Swelling ◽  
Blinded Study ◽  
Mandibular Third Molar Surgery ◽  
Randomised Controlled ◽  
Double Blinded

Mandibular third molar surgery is one of the most common minor oral surgical procedures performed by oral and maxillofacial surgeons. It is vital to provide the most comfortable postoperative phase to the patient and for this reason dexamethasone, a corticosteroid, is popularly used in various routes. The intraspace injection of dexamethasone mixed with 2% lignocaine and 4% articaine named, Twin Mix and Modified Twin Mix respectively is gaining increasing popularity. 0.5% Centbucridine is a safe alternative to 2% lignocaine with more cardio stable properties. In this study we aimed to evaluate the comparability of Twin Mix(TM) and Revamped Twin Mix(RTM) (mixture of dexamethasone and centbucridine) with respect to its anesthetic properties and its effectiveness in managing postoperative sequelae following mandibular third molar surgery. For this, a randomised controlled double blinded study was conducted among patients reporting to the Out Patient Department of a dental college. The sample size of the population studied was 32, 16 in Group A (RTM) and 16 in Group B (TM). The primary outcomes measured were facial swelling and mouth opening on postoperative day(POD) 1, 3 and 7. The secondary outcomes were VAS score during the surgical procedure, duration and latency of anesthesia. The data were analysed descriptively and using Student’s t Test. Representations were given in graphical and tabular forms. The mean postoperative mouth opening and facial swelling on POD 1, 3 and 7 were comparable and did not show any statistically significant difference. Similarly, the VAS score during procedure, latency and duration of anesthesia were comparable with no statistically significant difference. In conclusion, RTM can be used as an alternative to TM due to its comparable properties.

Comparison of stent related symptoms in patients taking mirabegron, solifenacin, or tamsulosin: A double blinded randomized clinical trial

2021 ◽  
pp. 039156032110481
Author(s):  
Abhishek Chandna ◽  
Santosh Kumar ◽  
Kalpesh M Parmar ◽  
Aditya P Sharma ◽  
Sudheer K Devana ◽  
...  
Keyword(s):  
General Health ◽  
Bodily Pain ◽  
Ureteroscopic Lithotripsy ◽  
Health Indices ◽  
Pain Scores ◽  
Robotic Pyeloplasty ◽  
Group A ◽  
Group B ◽  
Double Blinded ◽  
To Receive

Background: The present study aims to assess the efficacy of mirabegron, a novel beta-3 agonist for ameliorating stent related symptoms (SRSs) as compared to tamsulosin and solifenacin. Methods: Total of 150 patients undergoing ureteral stent placement following ureteroscopic lithotripsy, percutaneous nephrolithotomy, or laparoscopic/robotic pyeloplasty were randomized in 1:1:1 fashion to receive mirabegron 50 mg (group A), solifenacin 5 mg (group B), and tamsulosin 0.4 mg (group C) OD respectively. Patients were followed at POD10 (I visit), 4 weeks (II visit) after surgery, and 2 weeks post-stent removal. Validated vernacular version of ureteric stent symptoms questionnaire (USSQ) was administered to the patients at each visit. Results: Out of 150 patients randomized, 123 patients (A; n = 41, B; n = 40, and C; n = 42) completed the study. The groups were comparable in terms of urinary index score of USSQ at I and II visits ( p = 0.119 and 0.076, respectively). A lower proportion of patients in group B experiencing bodily pain at II visit ( p = 0.039), however, pain scores were comparable. Significantly lower general health index scores were observed in group A at I visit and over 4 weeks ( p = 0.007). No significant differences were observed in other domains of USSQ. Age, sex, and surgical procedure undertaken did not significantly impact the scores in various USSQ domains. Conclusion: Mirabegron demonstrates comparable benefit in alleviating SRSs with better general health indices and may be an effective alternative for SRSs, especially when tamsulosin or solifenacin are contra-indicated or poorly tolerated.

scholarly journals IMPACTED MANDIBULAR THIRD MOLAR SURGERY;

2014 ◽  
Vol 21 (06) ◽  
pp. 1272-1278
Author(s):  
Muhammad Ilyas Shaikh ◽  
Safia Khatoon ◽  
Fozia Rajput, ◽  
Syed Yousif Ali Shah
Keyword(s):  
Social Life ◽  
Maxillofacial Surgery ◽  
Third Molar ◽  
Mouth Opening ◽  
Third Molar Surgery ◽  
Control Group ◽  
Random Allocation ◽  
Significant Difference ◽  
Facial Swelling ◽  
And Gender

Objective: The objective of this study was to evaluate the therapeutic effect of dexamethasone in post-operative edema and trismus after impacted third molar surgery. Materials & Methods: It was a prospective randomized control study carried in Department of Oral & Maxillofacial surgery, BADC, Larkana from March 2012 to Feb 2013. Patients age between 20-45 years of either gender; unilateral mandibular impacted third molars (right or left) were included. Patients divided in two groups by using random allocation number. Patients in Group-A were given intramuscular 8 mg dexamethasone 1 hour before surgery and four tablets (2mg) dexamethasone orally immediate postoperatively and 24 hours after surgery. The facial swelling was checked before surgery, after 24 hours (1st day), after 48 hours (2nd day), after 72 hours (3rd day) and on 7th postoperative day Inter-incisor distance was checked on every follow up. Data was analyzed by SPSS version 17. Mean and standard deviation was calculated for age and gender. Mean and SD of facial swelling and mouth opening was calculated before extraction, on 1st, 2nd, 3rd and on 7th post-operative day in both groups. Results: The dexamethasone group showed significant reduction in swellingcompared with control group at all intervals. Dexamethasone resulted in significantly less trismus than controls on day 2 postoperatively, but there was no significant difference among the groups at 7thday. Conclusions: Dexamethasone is effective in minimizing swelling and trismus after removal of impacted lower third molar and improves the social life of individual.

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.

A Comparative Study of Lignocaine, Pethidine, Ketamine and Placebo for Prevention of Pain on Propofol Injection

2021 ◽  
Vol 12 (6) ◽  
pp. 29-33
Author(s):  
Shagufta Naaz ◽  
Erum Ozair ◽  
Adil Asghar
Keyword(s):  
Saline Group ◽  
Good Choice ◽  
The Other ◽  
Double Blind ◽  
Pain Scores ◽  
Hepatic Diseases ◽  
Reduction Of Pain ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Pain caused by propofol injection is a common occurrence. Aims and Objectives: The aim of this study was to compare and evaluate the efficacy of three drugs, lignocaine, pethidine and ketamine for prevention of pain during propofol injection. Materials and Methods: This double blind, placebo-controlled, parallel multi-arm study was done after written informed consent and ethics clearance. Hundred patients of ASA I and II, 18-65 years of age, and with body mass index 18-30 kg/m2 were included. Exclusion criteria were significant cardiovascular or hepatic diseases, renal insufficiency, and a history of allergy to the study drugs. Group A (Normal Saline), Group B (Ketamine 25 mg), Group C (Lignocaine 20 mg) and Group D (Pethidine 25 mg) were pre-treated with 2 ml of the study agents before propofol injection. The primary outcome was the incidence of pain with propofol injection and the secondary outcomes were the induction time, pain scores at various time intervals, the incidence of recall of pain after surgery, haemodynamic changes and adverse effects. Results: There were highly significant differences (p<0.001) in the incidences of pain during propofol injection in group A and the other three groups. The difference in incidence of pain was also significant between Group C and other groups. The differences in the pain scores (p<0.001) and recall of pain (p<0.05) between group A and the other three groups were significant. Conclusion: Lidocaine may be considered as a good choice for the purpose of reduction of pain during propofol injection.

scholarly journals Comparison of postoperative complications after impacted mandibular third molar extraction with conventional suturing versus tube drainage.

2020 ◽  
Vol 27 (07) ◽  
pp. 1408-1413
Author(s):  
Wajid Ali Rajper ◽  
Kashif Ali Channar ◽  
Munawar Din Larik ◽  
Sajid Ali Majeedano ◽  
Aftab Ahmed Soomro ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Third Molar ◽  
Mouth Opening ◽  
P Value ◽  
Third Molars ◽  
Mandibular Third Molar ◽  
Group A ◽  
Impacted Mandibular Third Molars ◽  
Group B ◽  
Mandibular Third Molars

Objectives: To determine the effectiveness of tube drain compared with conventional suturing on postoperative complications after extraction of impacted mandibular third molars. Study Design: Cross Sectional study (Comparative). Setting: Department of Oral & Maxillofacial Surgery, Institute of Dentistry, LUMHS Jamshoro/Hyderabad. Period: Six months duration from 12-11-2015 to 13-05-2016. Material & Methods: All the patient age from 18 to 45 years irrespective of gender, having mesioangular impacted mandibular third molar were included in the study. Patients were divided into two groups, Group-A and group-B. The severity of pain was recorded by using Visual Analog Scale from 0 no pain to 10 worst pain, degree of swelling was measured by facial size through Amin and Laskin criteria and mouth opening was measured by interincisal distance through ruler. All data was recorded on the 3rd and 7th day by the clinician. Results: Mean age of group A was 31.22+7.21 years, and mean age of group B was 28.34+5.33 years. Male were found slightly more as compared to female. On 3rd day the post-operative pain assessment was almost equal in both groups p-value 0.06 and assessment of post-operative swelling on 3rd day was found with insignificant difference p-value 0.22. Assessment of pain on 7th post-operative day was that the severe pain was found significantly reduced in group B as compared to group A p-value 0.01, swelling was significantly reduced in group B p-value 0.04. While mouth opening was also found significantly more in group B as compared to group A p-value 0.022. Conclusion: After removal of impacted mandibular third molars, incorporating tube drain is very effective as compared to conventional suturing in reducing the facial swelling, trismus and postoperative pain.

scholarly journals Comparison of the use of levobupivacaine with dexamethasone versus plain levobupivacaine in patients undergoing forearm surgeries under an infraclavicular block - a double-blinded randomized controlled trial

2020 ◽  
Vol 11 (1) ◽  
pp. 39-43
Author(s):  
Anandbabu Medidi ◽  
Serina Ruth Salins
Keyword(s):  
Controlled Trial ◽  
Motor Blockade ◽  
Rescue Analgesia ◽  
Pain Scores ◽  
Group A ◽  
Infraclavicular Block ◽  
Group B ◽  
Double Blinded ◽  
Larger Sample

Regional anesthesia can provide greater patient satisfaction. An infraclavicular approach to block the brachial plexus aided with ultrasound is proven to be safe. Lesser toxic, levobupivacaine, advocates its use, with the addition of dexamethasone, to prolong the action. After approval from the ethics committee, the consenting patients, for orthopedic forearm surgeries, were recruited, randomized into two groups of 20 patients. Group-A, received 30mls of 0.5% levobupivacaine with dexamethasone 4mgs(1ml) and Group-B,30mls of 0.5% levobupivacaine and 1ml normal saline.18-70 Year olds, ASA I-III, weight greater than or equal to 50 kg, were included and non-consenting, coagulopathic, local infection, pregnant women, general anesthesia requirement, less than 50kg, allergy to local anesthetic, were excluded. Both groups received the infraclavicular block. The onset and duration of sensory and motor blockade were noted. Comparisons made at 3 and 20 minutes. Required data was acquired. Visual Analogue Scale(VAS)used to assess pain. The onset of sensory and motor blockade was assessed and graded separately on radial, median and ulnar nerves, with significant findings of about 70-80% in Group-A at 4-5 minutes,80-87% complete at 20 minutes.87.5% Patients in both groups achieved adequate surgical anesthesia. There was a significant improvement in sensory grading of the median nerve and ulnar nerve between at 3 minutes and 20 minutes and also in motor grading improvement at 20 minutes duration in the Group-A than Group-B. Postoperatively, the VAS score showed scores hovering around 1-4, over 24 hours, with no difference, in scores, duration, and use of rescue analgesia in both arms. There were no statistical differences in the onset and duration of sensory and motor blockade in both groups, with some difference in the quality of analgesia between the nerves studied in group-A. Although a larger sample size might have brought out some difference in pain scores, with the addition of dexamethasone, its clinical implication is doubtful.

scholarly journals Evaluation of the Effect of Tenoxicam Compared to Diclofenac Sodium in Controlling Postoperative Pain in Third Molar Surgery

2021 ◽  
pp. 237-243
Author(s):  
Ramvihari Thota ◽  
Senthilnathan Periasamy ◽  
N. Mahathi
Keyword(s):  
Postoperative Pain ◽  
Pain Control ◽  
Diclofenac Sodium ◽  
Third Molar ◽  
Third Molar Surgery ◽  
Surgical Trauma ◽  
Treatment Groups ◽  
Average Pain ◽  
Group A ◽  
Group B

Aim: The aim of this study is to evaluate the effect of tenoxicam compared to diclofenac sodium in controlling postoperative pain after third molar surgery. Materials and Methods: 36 patients with mean age 30 were selected randomly and placed them in two groups A and B, under group A there are 18 patients and in group B 18 patients were placed, group a is given with tenoxicam 30 mg and for  group b diclofenac sodium 50 mg. Results: Group A experienced significantly less pain than those patients in group b. at 24 hr on the day of surgery, average pain scores of patients in both treatment groups did not differ significantly. On the evening of the third day postoperatively, the group a (tenoxicam) patients experienced significantly less pain than those in group b (diclofenac sodium). Discussion: It is generally accepted that pain following third molar surgery reaches moderate to severe intensity within the first 5 hr after surgery. Pain control in this period is thus of vital importance to the oral surgeon. NSAIDs have shown considerable analgesic activity for the relief of pain after surgery. Prostaglandin concentrations do not peak until 4 hr after surgical trauma. tenoxicam has been shown in our study to produce significant analgesia when compared to diclofenac sodium, especially at 3 to 4 hr postoperatively, the period when there is maximum prostaglandin formation in the tissue. Conclusion: Tenoxicam as administered in the present study was significantly more efficacious than diclofenac sodium and useful for pain control in these cases.

scholarly journals A Comparative Study of Surgical Morbidity Associated with Mandibular Third-Molar Surgery in Young and Aging Populations

2010 ◽  
Vol 11 (4) ◽  
pp. 1-8 ◽  
Author(s):  
Wasiu L. Adeyemo ◽  
Mobolanle O. Ogunlewe ◽  
Akinola L. Ladeinde ◽  
Olufemi O. Hassan ◽  
Olanrewaju A. Taiwo
Keyword(s):  
Third Molar ◽  
Third Molar Surgery ◽  
Third Molars ◽  
Surgical Morbidity ◽  
Surgical Extraction ◽  
Aging Populations ◽  
Group A ◽  
Mandibular Third Molar Surgery ◽  
Group B ◽  
Mandibular Third Molars

Abstract Aim Prophylactic surgical extraction of impacted third molars is a common practice throughout the world justified on the presumption that the risk of surgical morbidity increases with increasing age, among other reasons. The aim of this study was to analyze and compare surgical morbidity associated with third-molar extractions in young and aging populations. Methods and Materials A review of records for all patients who underwent the surgical extraction of impacted third molars between April 2001 and June 2006 at the Lagos University Teaching Hospital was carried out. Results A total of 506 patients had surgical extractions of impacted third molars under local anaesthesia during the period of the study. Of these, 470 (92.9 percent) patients were below the age of 40 years (Group A) and 36 (7.1 percent) patients were 40 years of age and older (Group B). No incidences of severe intraoperative complications (excessive bleeding or mandibular fractures) were recorded in either group, but other postoperative complications were reported in 70 (13.8 percent) patients. Of these 70 patients, 65 (92.9 percent) were from Group A and 5 (7.1 percent) were from Group B, and their complications included infected socket, dry socket, paraesthesia, and buccal space abscess. Conclusions No significant difference in postoperative complications following surgical removal of mandibular third molars was found between patients 40 years old and greater and those below age 40. Prophylactic surgical extraction of impacted mandibular third molars, based on the assumption that surgical morbidity increases with age, may not be justifiable. Clinical Significance Age does not predispose patients who had surgical extraction of mandibular third molars above 40 years of age to any additional surgical complications when compared to patients below the age of 40 years receiving comparable treatment. Citation Adeyemo WL, Ogunlewe MO, Ladeinde AL, Hassan OO, Taiwo OA. A Comparative Study of Surgical Morbidity Associated with Mandibular Third-Molar Surgery in Young and Aging Populations. J Contemp Dent Pract [Internet]. 2010 July; 11(4):001-008. Available from: http:// www.thejcdp.com/journal/view/volume11-issue4- adeyemo

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