Effect of Submucosal Injection of Dexamethasone on Postoperative Discomfort After Third Molar Surgery: A Prospective Study

Aim The aim of this systematic review and meta-analysis was to compare, in the lower third molar surgery, the osteotomy techniques with rotary instruments and piezoelectric motors. Methods An electronic search was conducted using the following databases: Pubmed, Web of Science, and the Cochrane Oral Health Group Trials Register. Inclusion criteria were: studies in humans, randomized or nonrandomized, comparing the extraction of third molars that required osteotomy and/or odontosection with rotary instrument and osteotomy and/or odontosection with piezoelectric motor assistance. The analysis and inclusion of articles was performed by two reviewers independently. An evaluation of the quality of articles and data extraction was carried out. Results From a total of nine hundred seventy four (974) trials, eleven articles were included in the qualitative analysis, and seven were included in the quantitative analysis. Rotary instruments were faster than the piezoelectric surgery (95 % CI 0.34 to 1.16). The piezoelectric surgery showed better results when compared with roatry instruments when trismus was assessed in 2 (95 % CI 0.65 to 1.69), 3 (95 % CI 0.63 to 1.67) and 5 (95 % CI 0.03 to 2.26) days after surgery. Seven days after surgery, there were no differences between the techniques (95 % CI (-0.022) to (-1.49)). Conclusion The piezoelectric surgery was effective in reducing pain, swelling and trismus in third molar surgery, but the same requires greater surgical time than the rotary instruments.

Section: Discussionmentioning

confidence: 99%

Rotary Instrument or Piezoelectric for the Removal of Third Molars: a Meta-Analysis

Magesty

Galvão

Martins

et al. 2016

“…However, except for the use of steroids after third molar extraction [19,20], little has been published about potential benefits after orthognathic surgery.…”

Section: Discussionmentioning

confidence: 99%

Influence of Kinesiologic Tape on Post-operative Swelling After Orthognathic Surgery

Tozzi

Santagata

Sellitto

et al. 2015

Introduction Orthognathic surgery involves making several osteotomies that lead to varying degrees of post-operative swelling. The use of KT may be beneficial for postoperative treatment after head and neck surgery, accelerating drainage of tissue reaction or haemorrhages. The goal of this study was to find out if the application of KT prevents or improves swelling, pain and trismus after orthognathic surgery, improving patients' postoperative quality of life. Materials and Methods In this double-blinded, randomized, control trial, 24 patients in whom bimaxillary orthognathic surgery was indicated, were included. Before surgery each patient alternatively was randomly included in the study group (treated with K-Taping Ò and corticosteroid) or in the control group (treated with corticosteroid). In the present study a MakerBot Ò Digitizer 3D TM was used to assess accurate volume measurements. All swelling measurements were expressed as total 3-D area of the landmarks (cm 2 ) in T0 pre-operative, T1 fourth day after surgery. Results The differences T0-T1 are highly significant (p \ 0.01) between group 1 or study group (treated with K-taping Ò ) and group 2 (control group). Discussion The use of KT appears promising, because it is simple to carry out, less traumatic, economical, can be performed everywhere in the world, free from side effects on the body. Even when swelling persists, KT gives patients the impression of a minor swelling detracting them from their pain and morbidity. Further studies have to be performed to find out if KT can reduce or replace the need for additional medications such as the use of steroids.

“…NSAIDs have been reported to be effective in pain relief, while corticosteroids are effective in diminishing edema. Grossi et al [7] evaluated submucosal administration of 4 and 8 mg dexamethasone and showed a statistically significant reduction in facial edema on the second postoperative day in both dexamethasone doses compared with the control group, but no statistically significant differences were observed between the two dosage regimens. Vegas-Bustamante et al [15] showed that local injection of a single 40-mg dose of methylprednisolone into the masseter muscle on completion of the extraction of impacted lower third molars decreased swelling, trismus, and pain.…”

Section: Discussionmentioning

confidence: 99%

“…Measurement tools mentioned in the literature have included visual analog scales, trismus recordings, standardized stereo-radiographic or photographic measurements, computerized tomography, modified face bow devices, ultrasonography, facial plethysmographs, or various other means of taking direct facial measurements. In the present study, a modification of the tape-measure method as described by Schultze-Mosgau et al [6][7][8], two measurements were made between three reference points: the tragus, pogonion and corner of the mouth. The preoperative sum of the two measurements was considered as the baseline for that side.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pre-Emptive Analgesia with Ketamine for Relief of Postoperative Pain After Surgical Removal of Impacted Mandibular Third Molars

Hadhimane

Shankariah

Neswi

2015

Purpose In this study we assessed the clinical efficacy of sub-mucosal injection of ketamine at sub-anesthetic dose of 0.5 mg/kg on post-operative pain, swelling and trismus following surgical extraction of impacted mandibular third molars. Methods Forty bilaterally symmetrical impacted mandibular third molars in 20 patients who required surgical removal were included in the study. Within the same individual, one of the sites received a test medication whereas the other site was used as control. All patients received nerve blocks with local anesthetic (2 % lignocaine hydrochloride with 1:80,000 adrenaline); the Test group received sub-mucosal infiltration of 0.5 mg/kg of ketamine hydrochloride (without preservative) around the impacted mandibular third molar and along the incision line, while the Placebo group received normal saline infiltration, 10 min before placement of the incision. Results The pain scores on VAS at 30 min, 1, 4, 12 h and 1 day post-operatively was significantly lower in the Test group than in the Placebo group (p \ .05). With respect to facial swelling and mouth opening the Test group and Placebo group showed overall no statistically significant difference (p [ .05) on the 1st, 3rd and 7th post-operative days. Conclusion The sub-mucosal injection of 0.5 mg/kg ketamine administered before surgical removal of impacted mandibular third molars was found to be effective in significantly reducing post-operative pain for the first 24 h.