Effect of a Single Dose of Deflazacort on Postoperative Pain, Swelling, and Trismus after Impacted Lower Third Molar Surgery: Randomised Clinical Trial.

Background and Objectives: The aim of this study was to investigate the efficacy of a single preoperative dose of deflazacort on pain, swelling, and trismus after impacted lower third molar surgery. Materials and Methods: This randomised, prospective, double-blind, split-mouth clinical study included 26 healthy individuals with bilaterally impacted lower third molars. Group 1 was given a placebo (single-dose vitamin C tablet), and group 2 was given a single 30 mg dose of deflazacort 1 h prior to surgery. Pain was evaluated using the visual analogue scale for 1 week postoperatively. Oedema (in mm) and trismus (in mm) were evaluated preoperatively and on postoperative days 2 and 7. The Mann-Whitney U test was applied for group analyses. p values < 0.05 were considered statistically significant. Results: Postoperative pain scores were significantly lower in the deflazacort group at the 6th and 12th hours after surgery (p < 0.05). There were no significant differences in trismus between the groups at any time point (p > 0.05). There was less oedema in the deflazacort group on postoperative days 2 and 7, without any statistically significant difference (p > 0.05). Conclusions: A single preoperative dose of 30 mg deflazacort was found to be clinically effective in reducing pain and oedema after extraction of impacted lower third molars.

Effect of combined boric acid and chlorhexidine mouthwashes on postoperative complications and periodontal healing after impacted third molar surgery: a-double blind randomized study.

OBJECTIVES: This study aimed to evaluate the effects of different concentrations of boric acid (BA) combined with chlorhexidine (CHX) mouthwash on postoperative complications and periodontal healing following impacted third molar surgery. MATERIALS AND METHODS: A total of 80 patients were randomly divided into eight groups. The patients in the study groups received different concentrations of BA ranging from 0.1% to 2.5% combined with CHX or 2% BA mouthwash alone. The control group received CHX mouthwash alone. The scores of self-reported pain and jaw dysfunction, trismus, edema, number of analgesics used, and periodontal parameters were compared between the groups. RESULTS: 2.5% BA + CHX group had significantly lower pain and facial swelling values during the follow-up period. 2% BA + CHX group reported significantly lower jaw dysfunction scores on the fourth and fifth postoperative days. The control group showed significantly higher values for pain, jaw dysfunction, and facial swelling than other groups. No significant differences were found between the groups regarding trismus, analgesic use, and periodontal variables. CONCLUSIONS: The combination of higher concentrations of BA with CHX was more effective in reducing pain, jaw dysfunction, and swelling following impacted third molar surgery than CHX mouthwash alone. CLINICAL RELEVANCE: The combination of BA and CHX showed better results than the gold standard CHX mouthwash in reducing postoperative complications related to surgical removal of impacted third molars without any adverse effects. This new combination can be an effective alternative to traditional mouthwashes after impacted third molar surgery to ensure oral hygiene.

Effect of St. John's wort oil and olive oil on the postoperative complications after third molar surgery: randomized, double-blind clinical trial.

OBJECTIVES: This multicenter study aimed to evaluate the effects of St. John's wort oil and virgin olive oil on the postoperative complications and compare this with chlorhexidine gluconate plus benzydamine hydrochloride mouthwash after the removal of impacted third molar. METHODS: A total of 90 patients in need of impacted third molar surgery were included in this study. All included patients were randomly divided into 3 groups. The patients in group 1 received St. John's wort oil; the patients in group 2 received virgin olive oil, and those in group 3 received mouthwash containing chlorhexidine gluconate plus benzydamine hydrochloride. The self-reported pain and difficulty during jaw function, trismus, facial swelling, number of analgesics used during first postoperative week, and postoperative periodontal condition including plaque accumulation, bleeding on probing, and periodontal pocket depth were compared between the groups. RESULTS: No significant differences were found regarding the study variables. CONCLUSIONS: The data of the present study supports that the use of essential oils provides efficient alternative to the gold standard chlorhexidine gluconate mouthwash in reducing postoperative complications and improving healing process without adverse effects after surgical removal of impacted third molars. CLINICAL RELEVANCE: The use of essential oils showed similar results as the chlorhexidine gluconate mouthwash regarding swelling, mouth opening, pain, need for rescue medication, infectious complications (i.e., alveolar osteitis), and periodontal healing. Therefore, essential oils can be an alternative to routine mouthwashes to ensure oral hygiene after impacted third molar surgery.

The Effect of Age of Titanium Dental Implants on Implant Survival and Marginal Bone Resorption: A 5-Year Retrospective Follow-Up Study.

It has been demonstrated that the osteoconductivity, hydrophilicity, and biological capacity of titanium decreases over time, and this phenomenon was described as the biological aging of titanium. The aim of this study was to evaluate whether the age of sand-blasted and acid-etched (SLA) titanium dental implants (duration from the production date until the date of dental implant surgery) affects marginal bone resorption and implant survival. This nonrandom convenience-sample retrospective pilot study was carried out in 200 implants of 64 patients. Radiographic measurements were performed on intraoral periapical radiographs. Implants were divided into 2 age groups; group 1 = 0-3 months and group 2 = 36-41 months. A P value < .05 was considered statistically significant. Of the implants, 41% (n = 82) were between 0 and 3 months old, and 59% (n = 118) were between 36 and 41 months old. All (n = 200) of the implants survived and maintained their function. The mean mesial marginal resorption measurement was 0.60 ± 0.65 mm, and the mean distal marginal resorption was 0.77 ± 1.07 mm. There was no statistically significant difference between the amount of mesial and distal marginal bone resorption according to implant age (P > .05). In SLA surface titanium implants with adequate initial primary stability and a 3-month osseointegration period before loading, biological aging of titanium did not affect implant survival and marginal bone resorption.

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.

Analgesic efficacy of naproxen-codeine, naproxen+dexamethasone, and naproxen on myofascial pain: A randomized double-blind controlled trial.

OBJECTIVE: To assess the effects of naproxen sodium-codeine phosphate, naproxen sodium-dexamethasone, and naproxen sodium on myofascial pain. METHODS: This randomized, double-blind prospective clinical study was conducted with patients who applied with the complaint of pain in the temporomandibular region. A total of 169 patients were randomly divided into four groups and received the following treatments: Group A: naproxen sodium 550 mg; Group B: naproxen sodium 550 mg + codeine phosphate 30 mg; Group C: naproxen sodium 550 mg + single-dose dexamethasone 8 mg, and Group D: paracetamol 500 mg. RESULTS: Of the patients, 132 were female, and 37 were male, with a mean age of 27.04 ± 10.56 (18-69 years). Analgesic efficiency of the naproxen sodium-codeine phosphate group was the most effective at the 2nd week and 4th week (p < 0.05). CONCLUSION: Naproxen sodium-codeine phosphate might be preferred as an analgesic in similar cases with severe myofascial pain.

Evaluation of the efficacy of topical rifamycin application on postoperative complications after lower impacted wisdom teeth surgery.

PURPOSE: This study aimed to evaluate the efficacy of a single-dose topical rifamycin application on postoperative complications after impacted lower third molar surgery. MATERIALS AND METHODS: This prospective, controlled clinical study consisted of individuals with bilaterally impacted lower third molars that would be extracted for orthodontic reasons. The extraction sockets were irrigated with 3 ml/250 mg of rifamycin solution in Group 1, while in Group 2 (control group) the extraction sockets were irrigated with 20 ml of physiological saline. Pain intensity was measured daily for 7 days by using visual analog scale. Trismus and edema were evaluated preoperatively and on the postoperative days 2 and 7 by calculating the proportional changes in maximum mouth opening and mean distance between reference points of the face, respectively. Paired samples t-test, Wilcoxon signed rank test and Chi-square test were used to analyze the study variables. RESULTS: 35 patients (19 female, 16 male) were included in the study. The mean age of all participants was 22.19±4.98. Alveolitis was observed in 8 patients, (6 in the control group, 2 in the rifamycin group). There was no statistically significant difference between groups in terms of trismus and swelling measurements on the 2nd and 7th postoperative days (p>0.05). VAS scores were significantly low in rifamycin group on postoperative days 1 and 4 (p<0.05). CONCLUSION: Within the limits of the present study, topical rifamycin application reduced the incidence of alveolitis, prevented infection, and provided analgesic effect after surgical removal of impacted third molars.

The relationship between frontal sinus dimensions and skeletal malocclusion.

Purpose: The aim of this retrospective research is to compare frontal sinus dimensions in skeletal Class I, skeletal Class II, and skeletal Class III individuals and to evaluate the relationship of these dimensions with anterior skull base length and some cephalometric values. Materials and methods: In this research, we used lateral cephalometric radiographs of 60 people aged 17 to 25. In individuals with skeletal Class I malocclusion, skeletal Class II malocclusion due to mandibular insufficiency, and skeletal Class III malocclusion due to mandibular excess, measurements of frontal sinus length and height as well as S-N, Co-A and Co- Gn lengths, ANB0, FMA0, SN-GoGn0 angles values were performed. The length between the highest point and the lowest point of the frontal sinus was calculated as the height of the frontal sinus, and the length between the most anterior and the most posterior points of the frontal sinus was calculated as the length of the frontal sinus. Results: The frontal sinus length and height were found to be higher in skeletal Class III individuals than in skeletal Class I and skeletal Class II individuals, however, there was no significant difference between skeletal Class I and Class II individuals. Conclusion: The increase in frontal sinus height and length correlated positively with the decrease in the ANB angle and the increase in the SN and Co-Gn lengths. The dimensions of the frontal sinus may be an indicator for the remaining mandibular growth potential.

Temporary Mental Nerve Paresthesia Originating from Periapical Infection.

Many systemic and local factors can cause paresthesia, and it is rarely caused by infections of dental origin. This report presents a case of mental nerve paresthesia caused by endodontic infection of a mandibular left second premolar. Resolution of the paresthesia began two weeks after conventional root canal treatment associated with antibiotic therapy and was completed in eight weeks. One year follow-up radiograph indicated complete healing of the radiolucent periapical lesion. The tooth was asymptomatic and functional.

Evaluation of the analgesic efficacies of Dexketoprofen Trometamol and Dexketoprofen Trometamol + Thiocolchicoside combinations in the impacted third molar surgery: Randomised clinical trial

Background: Postoperative pain is one of the most common complications. The aim of this study is to evaluate the analgesic efficacies of dexketoprofen trometamol and two different dosages of dexketoprofen trometamol + thiocolchicoside combination in the impacted third molar tooth operation. Material and Methods: This randomized, double-blind study included 75 patients who did not have any disease. Patients were assigned to 3 groups. Group 1 received 25 mg dexketoprofen trometamol + 4 mg thiocholchicoside, Group 2 received 25 mg dexketoprofen trometamol +8 mg thiocholchicoside, and Group 3 received 25 mg dexketoprofen trometamol. In each group, the analgesic medication was administered twice a day, starting 1 hour before the operation. The level of pain was assessed with VAS. Results: Patient age varied from 18 to 36 years. Of all patients, 59.2% (n=42) were female and 40.8% (n=29) were male. Drug side effects were observed in 28.17% (n=20) of the patients. Mean 24th hour VAS score was lower in dexketoprofen trometamol + 8 mg thiocolchicoside group compared to dexketoprofen trometamol group (p<0.05). There was no statistically significant difference between the three groups regarding drug side effects (p>0.05). Conclusions: Dexketoprofen trometamol + 8 mg thiocolchicoside combination has higher analgesic efficacy compared to dexketoprofen trometamol. More studies are needed to interpret the analgesic and anti-inflammatory effects of thiocholchicoside + dexketoprofen trometamol combination

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