Clinical evaluation of single and repeated sessions of photobiomodulation with two different therapeutic wavelengths for reducing postoperative sequelae after impacted mandibular third molar surgery: a randomized, double-blind clinical study.

OBJECTIVE: The effects of the number of photobiomodulation (PBM) sessions on the postoperative inflammatory process remain controversial. The current literature comparing single and repeated PBM sessions is limited. This study aimed to compare the effects of single and repeated PBM sessions, applied at two different therapeutic wavelengths within the infrared spectrum, on postoperative inflammatory response after impacted third molar tooth extraction. METHODOLOGY: This randomized, double-blind clinical study included 40 patients with bilateral impacted mandibular third molars (80 teeth). The patients were divided into two groups each including 20 subjects (40 teeth) to receive either single-session laser at 810 nm (20 teeth) and 940 nm (20 teeth) immediately after the surgery or repeated laser sessions at 810 nm (20 teeth) and 940 nm (20 teeth) (immediately after the surgery and on postoperative Day 1). Lasers at 940 nm (power density 0.5 Watt/cm2, energy density 4 J/cm2 for a time until the cumulative energy on the device screen reaches 50 J from 0 J, in continuous mode, spot size 2.8 cm2) and at 810 nm (power density 0.14 Watt/cm2, energy density 4 J/cm2, for 30 seconds, in continuous mode, spot size 2.1 cm2) were applied intra- and extra-orally. Pain, swelling, and trismus were evaluated postoperatively. RESULTS: No significant differences were determined between the groups on the evaluated parameters (p>0.05). CONCLUSION: Within the study limitations, in PBM, the effects of 810 nm and 940 nm and those of single and repeated applications were similar regarding pain, swelling and trismus. Immediate postoperative PBM could be preferred to repeated applications performed by point application within a 24-hour period.

Clinical evaluation of single and repeated sessions of photobiomodulation with two different therapeutic wavelengths for reducing postoperative sequelae after impacted mandibular third molar surgery: a randomized, double-blind clinical study

Abstract The effects of the number of photobiomodulation (PBM) sessions on the postoperative inflammatory process remain controversial. The current literature comparing single and repeated PBM sessions is limited. Objective This study aimed to compare the effects of single and repeated PBM sessions, applied at two different therapeutic wavelengths within the infrared spectrum, on postoperative inflammatory response after impacted third molar tooth extraction. Methodology This randomized, double-blind clinical study included 40 patients with bilateral impacted mandibular third molars (80 teeth). The patients were divided into two groups each including 20 subjects (40 teeth) to receive either single-session laser at 810 nm (20 teeth) and 940 nm (20 teeth) immediately after the surgery or repeated laser sessions at 810 nm (20 teeth) and 940 nm (20 teeth) (immediately after the surgery and on postoperative Day 1). Lasers at 940 nm (power density 0.5 Watt/cm2, energy density 4 J/cm2 for a time until the cumulative energy on the device screen reaches 50 J from 0 J, in continuous mode, spot size 2.8 cm2) and at 810 nm (power density 0.14 Watt/cm2, energy density 4 J/cm2, for 30 seconds, in continuous mode, spot size 2.1 cm2) were applied intra- and extra-orally. Pain, swelling, and trismus were evaluated postoperatively. Results No significant differences were determined between the groups on the evaluated parameters (p>0.05). Conclusion Within the study limitations, in PBM, the effects of 810 nm and 940 nm and those of single and repeated applications were similar regarding pain, swelling and trismus. Immediate postoperative PBM could be preferred to repeated applications performed by point application within a 24-hour period.

Assessment of prevalence and volumetric estimation of possible Stafne bone concavities on cone beam computed tomography images.

OBJECTIVES: Our study aimed to determine the prevalence and volumetric estimates of Stafne bone cavities (SBC) on cone beam computed tomography (CBCT) images. METHODS: This retrospective study, which involved the CBCT images of 1141 men and 1260 women with an age range of 10-90 years, aimed to determine the prevalence of SBCs and to calculate their volumes using the semi-automatic segmentation method. RESULTS: A total of 15 SBCs were diagnosed in 14 patients. Among the detected SBCs, 7.14% were found in a female patient and 92.86% were found in 13 male patients. Of the total number of SBCs, 6.67% were anteriorly located and 93.33% were posteriorly located. Bilateral SBCs had a prevalence of 0.04%; unilateral posterior SBCs 0.54% and anterior SBCs 0.04%. The mean SBC volume was calculated as 338.05 mm3. CONCLUSIONS: The results of our study showed that SBC is a rare anomaly. In contrast to two-dimensional imaging techniques, CBCT allows a precise determination of SBCs' pattern of impact on adjacent bony structures, relationship with the mandibular canal and dimensions.

Can Photobiomodulation Therapy Be an Alternative to Methylprednisolone in Reducing Pain, Swelling, and Trismus After Removal of Impacted Third Molars?

Background and objective: Studies investigating an alternative to corticosteroids in terms of potential side effects after surgical removal of impacted third molars are still ongoing. Accordingly, the present randomized single-blind study aimed to compare the efficacy of photobiomodulation therapy (PBMT) and methylprednisolone on pain, edema, and trismus after surgical removal of impacted third molars. Methods: The study included 30 healthy patients with bilaterally impacted lower third molars. The side (right or left molar) that would be extracted at first and the treatment (PBMT or corticosteroid) that would be applied to this side were decided by tossing a coin. The time interval between two surgical operations was at least 3 weeks. In the laser group, immediately after the surgical procedure, PBMT was applied extraorally to the insertion point of the masseter muscle for 60 sec with an output power of 0.3 W and an energy density of 6 J/cm2 and then repeated on postoperative days 1 and 2. In the corticosteroid group, 40 mg/2 mL methylprednisolone sodium succinate was injected postoperatively into the masseter muscle with the intrabuccal approach. On postoperative day 1, methylprednisolone injection (20 mg/1 mL) was repeated. Pain was evaluated using the visual analog scale on postoperative days 1, 2, and 7. Edema (in mm) and trismus (in mm) were evaluated preoperatively and on postoperative days 2 and 7. Results: There were no significant differences between the PBMT and methylprednisolone administration in terms of postoperative pain, edema, and trismus. Conclusions: Within the limits of the present study, PBMT was considered an alternative and a useful method for controlling inflammatory complications following impacted wisdom tooth surgery as it exhibited similar clinical efficacy to that of methylprednisolone.

Clinical and histological evaluation of the efficacy of antimicrobial photodynamic therapy used in addition to antibiotic therapy in pericoronitis treatment.

BACKGROUND: Although antimicrobial efficacy of photodynamic therapy has been studied several times, there is no study investigating its efficacy on pericoronitis. This study aimed to determine whether antimicrobial photodynamic therapy combined with antibiotic therapy is clinically and histologically superior to antibiotic therapy alone in pericoronitis treatment. METHODS: Patients (n = 40) with pericoronitis were divided into two groups (20 patients for each) to receive either antibiotic + indocyanine green + 810 nm wavelength diode laser (antimicrobial photodynamic therapy group) or antibiotic alone. Initial biopsy samples were obtained from the affected tissue of the patients at their first presentation to the clinic before any intervention. The second biopsy samples were obtained on the 3rd day of treatment in both groups from the tissue part not biopsied before; tooth extraction was then performed. All tissue samples were histologically examined to assess inflammatory cell response. Patients' pain (using Visual Analogue Scale) and lymphadenopathy (presence or absence) were clinically evaluated in the first 3 days and on the 7th day of treatment. RESULTS: In the antimicrobial photodynamic therapy group, 100% improvement was achieved regarding pain and lymphadenopathy at the end of the 7th day. Comparison of the inflammatory cell scores of the 2nd biopsy samples between the antibiotic alone and antimicrobial photodynamic therapy groups revealed a significant difference in favor of antimicrobial photodynamic therapy group. CONCLUSIONS: Antimicrobial photodynamic therapy combined with antibiotic therapy for pericoronitis treatment was found to be more successful as compared with the antibiotic therapy alone regarding clinical and histological outcomes.

Comparison of Clinical Efficacies of Preoperatively Initiated Naproxen Sodium-Codeine Phosphate in Combination, Diclofenac Potassium, and Benzydamine Hydrochloride for Pain, Edema, and Trismus After Extraction of Impacted Lower Third Molar: A Randomized Double-Blind Study.

PURPOSE: The aim of this study was to compare the clinical efficacies of naproxen sodium-codeine phosphate in combination, benzydamine hydrochloride, and diclofenac potassium for pain, edema, and trismus after lower third molar extraction. MATERIALS AND METHODS: Ninety healthy volunteers in whom impacted third molar extraction was indicated were randomly distributed into 3 groups. One hour before the tooth-extraction process, patients were administered one of the following drugs: naproxen sodium, 550 mg, and codeine phosphate, 30 mg, in a tablet; diclofenac potassium, 50 mg, in a coated pill; or benzydamine hydrochloride, 50 mg, in a coated pill. Pain assessment was conducted via a visual analog scale; edema assessment, by measuring the distances between predetermined facial landmarks; and trismus assessment, by measuring interincisal distance. Regarding rescue analgesics (paracetamol, 500 mg), the number and time of use by patients were recorded. RESULTS: Naproxen sodium-codeine phosphate was more effective for pain, edema, and trismus than diclofenac potassium and benzydamine hydrochloride (P < .05). Benzydamine hydrochloride yielded similar clinical responses to diclofenac potassium (P > .05). No drug-related side effects were observed. CONCLUSIONS: Naproxen sodium-codeine phosphate constitutes the drug of choice after the extraction of a patient's impacted lower third molar. Benzydamine hydrochloride has similar efficacy to diclofenac potassium, and it can be used as a nonsteroidal anti-inflammatory analgesic drug.

Malpositioned canine treatment with autotransplantation and laser.

Children and young adults often have tooth loss due to congenital tooth deficiency, trauma, or caries. Autotransplantation has many benefits. The transplanted tooth can be moved orthodontically, maintains alveolar bone growth potential during eruption, and functional periodontal ligament function also permits tooth eruption, allows the defected areas to be filled with the bones; gingival contour is much more successful than the one obtained with prosthesis. In this paper, treatment steps and follow-up results of autotransplantation case supported with biostimulation are mentioned. A 14-year-old female patient was admitted to the clinic with a complaint of decayed tooth 53 and malposed tooth 13. Mobile primary tooth was pulled out, and the socket was shaped with surgical drills. By performing transplantation of ectopic canine, splint was applied with steel wire and composite. Diode laser was used to provide deep disinfection of canals. The patient underwent low-dose laser therapy for biostimulation immediately after these procedures. We did not encounter any ankylosis, root resorption, periodontal, or functional problems in our evaluation with computed tomography after 3 years follow-up of the patient.

Soft Tissue Schwannomas of the Hard Palate and the Mandibular Mentum.

Schwannomas are benign, slow growing, encapsulated tumours that originate from the Schwann cells. Intraoral schwannomas are rare, and most of these tumours involve the tongue. They are rarely located in the hard palate or in the facial soft tissue. Herein, we present the clinical and histological features as well as the prognoses of two male patients with schwannoma, one of which was localized to the hard palate and the other to the facial soft tissue around the mandibular mentum and caused swelling.

Effectiveness of Single Session of Low-Level Laser Therapy with a 940 nm Wavelength Diode Laser on Pain, Swelling, and Trismus After Impacted Third Molar Surgery.

INTRODUCTION: In low-level laser therapy (LLLT), applications are generally performed in repetitive sessions using wavelengths of around 800 nm, at which the depth of penetration of laser is greater. The present study aimed to investigate the effects of LLLT with a 940 nm diode laser, which was performed extraorally on all the primarily and secondarily affected areas immediately after surgery in a single session, on pain, swelling, and trismus that occurred after impacted tooth extraction. MATERIALS AND METHODS: Thirty-five outpatients with similarly impacted lower third molars on both sides were selected. The teeth of patients were removed in two separate operations. Postoperatively, the patients received laser therapy with energy of 4 J/cm(2) on one side and no laser energy was applied to the other side (placebo side). Swelling, trismus, and subjective assessment of pain on a visual analog scale were evaluated and compared between the laser-treated and placebo sides. RESULTS: There was no statistically significant difference in pain, swelling, or trismus between the sides (Mann-Whitney U test p > 0.05). However, according to the clinical outcomes, swelling and trismus were less in the laser-treated side than in the placebo side. CONCLUSIONS: A single-session LLLT that would be applied with a diode laser immediately after impacted tooth extraction might help patients to be less affected by postoperative trismus and swelling.

Comparison of the Effects of Daily Single-Dose Use of Flurbiprofen, Diclofenac Sodium, and Tenoxicam on Postoperative Pain, Swelling, and Trismus: A Randomized Double-Blind Study.

PURPOSE: The aim of the present study was to compare the effects of daily single-dose use of flurbiprofen, diclofenac sodium, and tenoxicam on pain, swelling, and trismus that occur after surgical extraction of impacted wisdom teeth using local anesthesia. MATERIALS AND METHODS: The present study included 3 groups with 30 patients in each group. Those volunteering to participate in this double-blind randomized study (n = 90) were selected from a patient population with an indication for extraction of impacted wisdom teeth. Group 1 patients received 200 mg flurbiprofen, group 2 patients received 100 mg diclofenac sodium, and group 3 patients received 20 mg tenoxicam. All doses were once a day, starting preoperatively. Pain was evaluated postoperatively at 1, 2, 3, 6, 8, and 24 hours and at 2 and 7 days using a visual analog scale (VAS). For comparison with the preoperative measurements, the patients were invited to postoperative follow-up visits 2 and 7 days after extraction to evaluate for swelling and trismus. The statistical analysis was performed using descriptive statistics in SAS, version 9.4 (SAS Institute, Cary, NC), software. Statistical analysis of the pain, swelling, and trismus data was performed using the Kruskal-Wallis, Dunn, and Wilcoxon-Mann-Whitney U tests. The statistical level of significance was accepted at P = .05 and power of 0.80. RESULTS: Clinically, tenoxicam showed better analgesic and anti-inflammatory efficacy compared with diclofenac sodium and, in particular, flurbiprofen. Although the VAS scores in the evaluation of pain showed statistically significant differences at 2 days, no statistically significant difference was found for swelling and trismus. CONCLUSIONS: Our study evaluated the analgesic and anti-inflammatory effects with a daily single dose of flurbiprofen, diclofenac sodium, and tenoxicam. Daily 20 mg tenoxicam can be accepted as an adequate and safe option for patients after a surgical procedure.

Changes in the surface of bone and acid-etched and sandblasted implants following implantation and removal.

OBJECTIVE: The aim of this study was to determine whether there are any changes in the surface of bone or implant structures following the removal of a screwed dental implant. MATERIALS AND METHODS: For this, six individual samples of acid-etched and sandblasted implants from three different manufacturers' implant systems were used. They were screwed in a D1 bovine bone, and they were removed after primary stabilization. The bone and implant surfaces are evaluated with scanning electron microscope. RESULTS: Through examination of the surfaces of the bone prior to implantation and of the used and unused implant surfaces, it was found that inhomogeneity in the implant surface can cause microcracking in the bone. CONCLUSIONS: This is attributed to the stress induced during the implantation of self-tapping implants and suggests that a tap drill may be required in some instances to protect the implant surface.

Removal of epulis fissuratum by Er,Cr:YSGG laser in comparison with the conventional method.

OBJECTIVE: The present study aimed to compare clinical outcomes during the recovery period after soft tissue surgery performed by an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser with those after surgery with the conventional method, in which a scalpel was used. METHODS: A total of 44 epulis fissuratum removal surgeries were performed in 30 healthy volunteers using either an Er,Cr:YSGG laser (laser group) or a scalpel (conventional group), with the same number of lesions in each group. Both groups were controlled postoperatively on days 2, 7, 14, and 30. The visual analog scale (VAS) pain scores of the patients and healing, erythema, and suppuration in the surgical area were recorded with scores between 0 and 3. Total wound surface was measured by a ruler according to the Bates-Jensen Wound Assessment Tool. RESULTS: The results of the present study demonstrated that there were no significant differences between the conventional group using analgesic and the laser group in terms of the VAS scores (p = 0.744) and edema (p = 0.206). Evaluation of wound surface revealed healing without any problem as of the 2nd day at a rate of 82% in the laser group and 59% in the conventional group. CONCLUSIONS: In conclusion, Er,Cr:YSGG laser was superior to scalpel regarding clinical outcomes, and led to a difference in the use of analgesic and local anesthetic.

Comparison of the efficacy of low doses of methylprednisolone, acetaminophen, and dexketoprofen trometamol on the swelling developed after the removal of impacted third molar

BACKGROUND: The aim of the present study was to compare the efficacy of low doses of methylprednisolone, acetaminophen and dexketoprofen trometamol, which are among the drug groups used in our clinic, on postoperative swelling developing after removal of impacted third molar. MATERIAL AND METHODS: The three group of patients received either 40 mg methylprednisolone or 300 mg acetaminophen or 12.5 mg dexketoprofen trometamol one hour before the procedure, according to the patient groups. The patients in the methylprednisolone group were injected with methylprednisolone at a dose of 20 mg 24 hour after the procedure and prescribed 300 mg acetaminophen as rescue analgesic. During the postoperative period, the doses that were given before the procedure were continued 3 times a day for 2 days in the acetaminophen and dexketoprofen trometamol groups. Maximal swelling was assessed preoperatively and at the postoperative 48 hours by ultrasound images. RESULTS: Swelling was 34% lower in the methylprednisolone than in the other groups; however, no statistically significant difference was found between the groups. The acetaminophen and dexketoprofen trometamol groups exhibited clinical results close to each other. CONCLUSIONS: Combination of low doses of methylprednisolone and acetaminophen provide a safe and adequate clinical success on swelling

Comparison of the efficacy of low doses of methylprednisolone, acetaminophen, and dexketoprofen trometamol on the swelling developed after the removal of impacted third molar.

BACKGROUND: The aim of the present study was to compare the efficacy of low doses of methylprednisolone, acetaminophen and dexketoprofen trometamol, which are among the drug groups used in our clinic, on postoperative swelling developing after removal of impacted third molar. MATERIAL AND METHODS: The three group of patients received either 40 mg methylprednisolone or 300 mg acetaminophen or 12.5 mg dexketoprofen trometamol one hour before the procedure, according to the patient groups. The patients in the methylprednisolone group were injected with methylprednisolone at a dose of 20 mg 24 hour after the procedure and prescribed 300 mg acetaminophen as rescue analgesic. During the postoperative period, the doses that were given before the procedure were continued 3 times a day for 2 days in the acetaminophen and dexketoprofen trometamol groups. Maximal swelling was assessed preoperatively and at the postoperative 48 hours by ultrasound images. RESULTS: Swelling was 34% lower in the methylprednisolone than in the other groups; however, no statistically significant difference was found between the groups. The acetaminophen and dexketoprofen trometamol groups exhibited clinical results close to each other. CONCLUSIONS: Combination of low doses of methylprednisolone and acetaminophen provide a safe and adequate clinical success on swelling.

Angiolymphoid hyperplasia with eosinophilia in the angle region of the mandible.

Angiolymphoid hyperplasia with eosinophilia (ALHE), also called epithelioid hemangioma, is a rare benign vascular lesion usually affecting the muscular arteries of the head and neck in female patients. Here, we report a 30-year-old male patient who presented with painless swelling in the angle region of the mandible. The diagnosis of the specimen, which was surgically removed under local anesthesia, was made as ALHE. The patient has remained uneventful for 3 years.

Effect of low-dose dexketoprofen trometamol and paracetamol on postoperative complications after impacted third molar surgery on healthy volunteers: A pilot study

OBJECTIVES: The aim of the present study was to investigate the analgesic and anti-inflammatory effects of dexketoprofen trometamol (DT) and paracetamol on deep acute somatic pain and inflammation in patients undergoing impacted third molar surgery. This study was planned to present benefits that we could obtain with low burden of drug. Study DESIGN: Effects of drugs, which were administered preemptively before the procedure, on pain, mouthopening limitation, and swelling were assessed by visual analogue scale (VAS), magnetic resonance imaging (MRI), and mouth-opening measurement. Following surgery, time intervals when the patients first need to receive the drug were measured. RESULTS: The VAS scores of the patients were lower in the side treated with DT than that in the paracetamol treated side. There was no significant difference between the groups in terms of mouth-opening limitation. MRI recordings revealed that swelling was lower in the side treated with paracetamol than DT treated side. CONCLUSIONS: Administration of the drugs before surgery contributed to the postoperative patient comfort. The analgesic activity of 12.5 mg dose of DT was similar to, even better than, the analgesic activity of 500 mg dose of paracetamol; however, DT had insufficient anti-inflammatory efficacy

Effect of low-dose dexketoprofen trometamol and paracetamol on postoperative complications after impacted third molar surgery on healthy volunteers: A pilot study.

OBJECTIVES: The aim of the present study was to investigate the analgesic and anti-inflammatory effects of dexketoprofen trometamol (DT) and paracetamol on deep acute somatic pain and inflammation in patients undergoing impacted third molar surgery. This study was planned to present benefits that we could obtain with low burden of drug. STUDY DESIGN: Effects of drugs, which were administered preemptively before the procedure, on pain, mouth-opening limitation, and swelling were assessed by visual analogue scale (VAS), magnetic resonance imaging (MRI), and mouth-opening measurement. Following surgery, time intervals when the patients first need to receive the drug were measured. RESULTS: The VAS scores of the patients were lower in the side treated with DT than that in the paracetamol treated side. There was no significant difference between the groups in terms of mouth-opening limitation. MRI recordings revealed that swelling was lower in the side treated with paracetamol than DT treated side. CONCLUSIONS: Administration of the drugs before surgery contributed to the postoperative patient comfort. The analgesic activity of 12.5 mg dose of DT was similar to, even better than, the analgesic activity of 500 mg dose of paracetamol; however, DT had insufficient anti-inflammatory efficacy.