Overall morbidity after 3M surgery was low. Compared to patients subjected to therapeutic removal of 3Ms, patients undergoing prophylactic removal seem to have less pain and a faster return to normal activities.

word count: 200 Statement of Clinical Relevance word count: 40 Total word count: 3456 Number of references: 23 Number of figures: 1 Number of tables: 3 ACCEPTED MANUSCRIPT A C C E P T E D M A N U S C R I P T 3 STATEMENT OF CLINICAL RELEVANCEDecreasing morbidity after mandibular third molar surgery is of great clinical importance. In our study, we showed that use of a tetracyclin-impregnated drain is a simple and effective way to reduce the incidence of alveolar osteitis and overall postoperative morbidity. ABSTRACT ObjectivesOur aim was to investigate the effect of an oxytetracycline impregnated gauze drain on the incidence of alveolar osteitis (AO) and postoperative pain during the first week after mandibular third molar surgery. Study DesignTwo hundred consecutive patients undergoing third molar surgery under local anaesthesia were randomized into a drain group (n=100), with an oxytetracycline drain placed in the extraction socket, and a control group (n=100). An experienced surgeon performed the surgery. Systemic antibiotics were not used. ResultsThe incidence of AO was 23% in the control group and 5% in the drain group (p<0.001). The risk of developing AO was approximately six times higher in the control group, and females had a 2.5 times higher risk than males. Patients in the control group had significantly more pain at the day of surgery and days 4-7. Presence of AO was associated with continued use of analgesics (p<0.001). No patients experienced postoperative infections or had complications requirering hospitalisation. ConclusionThe present study showed that an oxytetracycline drain drastically reduced the incidence of AO after third molar surgery. The described treatment strategy, without the use of systemic antibiotics, seemed efficient in lowering overall postoperative morbidity and downtime after third molar surgery.

Objectives:The aims of the present study were to evaluate the relative incidence of alveolar osteitis (AO) after mandibular third molar surgery, post-operative findings and local expression of bone markers and cytokines. Study design: In 445 patients, unilateral surgical third molars extractions were undertaken (584 teeth). Bone markers and cytokines were explored at the AO side and on the un-operated contralateral side and compared with the levels in samples from a control group of 18 persons without AO.Results: The relative incidence of AO was 4.6%. Patients (n ¼ 27) with AO were invited to participate in the study and 21 (77.8%) did so. Patients with AO had 1-4 extra visits for treatment of AO, the mean follow-up time was 2.6 days for all patients. There were significantly higher levels of bone markers and cytokines in the AO site compared with the un-operated contralateral site, except for Epidermal growth factor (EGF). No significant difference in expression of bone markers and cytokines between the AO and control groups was found. Lower maximum inter-incisor opening (MIO) was correlated with increased Macrophage inflammatory protein 1 alpha. A negative correlation between patients' complaint of trismus and MIO was seen. Conclusions: The relative incidence of AO was low in our patient group treated with surgical removal of third molars. AO was more frequently seen in female patients. Treatment of AO required up to four extra visits. The study provides some information on the role of cytokines in AO; but further studies are required.

Botulinumtoksin -en oversikt over mulige bruksområder innen oral og maxillofacial kirurgi ForfattereHauk Øyri, cand.odont., spesialistkandidat og assistenttannlege. Avdeling for oral kirurgi og oral medisin, Institutt for klinisk odontologi, Universitetet i Oslo og Avdeling for kjevekirurgi og sykehusodontologi, Oslo universitetssykehus HF -Rikshospitalet Per Skjelbred, dr.med., professor og avdelingsoverlege. Avdeling for kjevekirurgi og sykehusodontologi, Oslo universitetssykehus HF -Ullevål Heming Olsen-Bergem, cand.odont., universitetslektor og PhDstipendiat. Avdeling for oral kirurgi og oral medisin, Institutt for klinisk odontologi, Universitetet i Oslo

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