Cohort study of pain symptoms and management following impacted mandibular third molar extraction

Achiwa, Motonobu; Hidemichi, Yuasa; Eri, Umemura; Takemoto, Takashi; Kurita, K.

doi:10.1111/odi.12576

Cited by 6 publications

(4 citation statements)

References 14 publications

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“…The new technology of low-energy ultrashort-pulsed electron beam (UPEB) accelerators has been developed opening new directions for radiobiology and biomedical research. Low-energy laser has been proved to have anti-inflammatory and anti-infective effects, accelerating the repair of damaged tissues, and analgesic effects [ 7 – 9 ]. One of the advantages is that these electron accelerators can deliver a very high-peak radiation dose with a low beam charge, thus providing ultrashort dose delivery times.…”

Section: Introductionmentioning

confidence: 99%

Effects of Low-Level Laser Therapy on Osseous Defects Distal to Mandibular Second Molar after Extraction of Impacted Third Molar

Chen

et al. 2022

Applied Bionics and Biomechanics

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Objective. To evaluate the efficiency of low-level laser therapy on the distal osseous defects of the mandibular second molar (M2) after the adjacent impacted third molar (M3) extraction. Methods. A total of 59 clinic cases were screened out, whose M3 were impacted and the distal alveolar bone of M2 had been destroyed horizontally. They were randomly divided into 2 groups based on whether they would have laser irradiation or not after M3 extraction. Then, postoperative complications of the 2 groups were compared. The alveolar bone level distal to M2 was established before and 3 to 6 months after M3 extraction by radiographic evaluation, which was compared between two groups. Results. The incidence of severe pain and mouth-opening limitation was significantly lower in the LLLT group than that in the control group. The amount of bone formation in the LLLT group was higher than that in the control group 3 months after the operation, and the difference was statistically significant. But the difference was not statistically significant 6 months after surgery. Conclusion. LLLT may alleviate postoperative complications and improve early osteogenesis. It is a viable option for use in the treatment of osseous defects distal to mandibular second molars following extraction of impacted third molars.

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Section: Introductionmentioning

confidence: 99%

Effects of Low-Level Laser Therapy on Osseous Defects Distal to Mandibular Second Molar after Extraction of Impacted Third Molar

Chen

et al. 2022

Applied Bionics and Biomechanics

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“…The maxillary nerve block was not performed for maxillary third molar extractions to reduce the total dose of local anesthetic. Several studies have included maxillary third molar extraction when investigating postoperative pain after IMTM extraction [ 2 , 5 ]. However, maxillofacial pain might arrive in the early postoperative period because UGIANB targets only the inferior alveolar, lingual, and buccal nerves.…”

Section: Discussionmentioning

confidence: 99%

“…The worldwide prevalence of IMTMs is 25% [1]. The major complication of its extraction is postoperative pain, which can persist for more than a week despite analgesic therapy, and this pain induces negative impact of the patient's health and quality of daily life [2][3][4][5][6][7]. For this pain management, the intraoral inferior alveolar nerve block (IANB) is one of the most common techniques in dentistry [6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Mouth-Opener Technique for Ultrasound-Guided Inferior Alveolar Nerve Block: A Case Series of Extraction of Impacted Mandibular Third Molars

Oiwa,

Kumita,

Chaki

et al. 2023

Cureus

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Extraction of the impacted mandibular third molar (IMTM) is common in oral surgery, but its postoperative pain is severe. Ultrasound-guided inferior alveolar nerve block (UGIANB) is an analgesic technique in the mandibular nerve region. We describe UGIANB using a mouth opener and report the cases with a good postoperative course.Six patients underwent the extraction of bilateral IMTMs under general anesthesia. After surgery, we performed UGIANB and administered 5 mL of 0.375% levobupivacaine on each side. The postoperative numerical rating scale pain scores were 1 (0-2) and 2.5 (0-5) (mean (range)), postoperative day one and seven, respectively. The postoperative quality of recovery-40 scores were 188.5 (8.1) and 191.7 (7.6) (mean (SD)), postoperative day one and seven, respectively. No procedural complications were encountered.We performed UGIANB with a mouth opener on a patient with IMTM extraction and were able to provide safe and good analgesia.

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“…The procedure difficulty may range from pretty easy to extremely difficult, depending on its depth, angulation, and the resistance of the surrounding bone [ 9 ]. Surgical removal of these teeth is typically correlated with postoperative pain, facial swelling, and trismus while complications such as infection, dry socket, inferior alveolar nerve, or lingual nerve injuries are less common to occur [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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

2021

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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

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Cohort study of pain symptoms and management following impacted mandibular third molar extraction

Abstract: The results of this study suggest that bilateral impacted mandibular third molar extractions under intravenous sedation could be a recommended treatment option.

Cited by 6 publications

References 14 publications

Effects of Low-Level Laser Therapy on Osseous Defects Distal to Mandibular Second Molar after Extraction of Impacted Third Molar

Effects of Low-Level Laser Therapy on Osseous Defects Distal to Mandibular Second Molar after Extraction of Impacted Third Molar

Mouth-Opener Technique for Ultrasound-Guided Inferior Alveolar Nerve Block: A Case Series of Extraction of Impacted Mandibular Third Molars

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

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