Effect of platelet-rich fibrin on frequency of alveolar osteitis following mandibular third molar surgery: a double-blinded randomized clinical trial.

PURPOSE: To evaluate the effectiveness of platelet-rich fibrin (PRF) in preventing the development of alveolar osteitis (AO). MATERIALS AND METHODS: In a double-blinded study, patients with bilateral impacted mandibular third molars underwent surgical extractions, with one socket receiving PRF and the other one serving as a control. The surgeon and patient were unaware of the study or control side. The predictor variable was the PRF application and was categorized as PRF and non-PRF. The outcome variable was the development of AO during the first postoperative week. Other study variables included age, gender, smoking status, irrigation volume, extraction difficulty, surgeon experience, and number of anesthetic cartridges. Data were analyzed using χ(2) and t tests, with the significance level set at a P value less than .05. RESULTS: Seventy-eight patients (mean age, 25 yr) underwent 156 impacted third molar surgeries. The overall frequency of AO was 14.74% for all surgeries. The frequency of AO in the PRF group was significantly lower than in the non-PRF group (odds ratio = 0.44; P < .05). CONCLUSION: Based on the results of the present study, PRF application may decrease the risk of AO development after mandibular third molar surgery.

Effect of menstrual cycle on frequency of alveolar osteitis in women undergoing surgical removal of mandibular third molar: a single-blind randomized clinical trial.

PURPOSE: To measure the association between the menstrual cycle and the frequency of alveolar osteitis (AO). MATERIALS AND METHODS: In a study with a single-blind design, patients with bilateral impacted third molar teeth underwent randomized surgical extraction: one tooth during the menstrual period and one during the middle of the cycle. The postoperative examiner was unaware of the menstrual cycle status of the patients. The predictor variable was the timing of the menstrual cycle and was grouped as mid-cycle and menstrual period. The outcome variable was AO, which was measured (without knowledge of the menstrual cycle timing) at 2 to 7 days postoperatively. Other study variables included oral contraceptive (OC) use, smoking status, irrigation used during surgery, extraction difficulty, surgeon experience, number of local anesthetic cartridges used, and patient age. Appropriate bi- and multivariate statistics were computed, and the level of statistical significance was set at P < .05. RESULTS: A total of 145 female patients, with a mean age of 24 years, underwent 290 third molar extractions. The overall frequency of AO was 23.45%. The frequency of AO was significantly greater in the middle of the cycle than during the menstrual period inboth the OC users and nonusers (P < .05). Although OC users revealed a significantly greater frequency of AO compared with nonusers (P < .05), no statistically significant differences were found between the 2 groups during the menstrual period (P > .05). CONCLUSIONS: According to the results of the present study, the menstrual cycle could be a determinant risk factor in the frequency of AO. We recommend that elective procedures be performed during the menstrual period in both OC users and nonusers to eliminate the effect of cycle-related hormonal changes on the development of AO.

Effectiveness of green tea mouthwash in postoperative pain control following surgical removal of impacted third molars: double blind randomized clinical trial.

BACKGROUND: Pain following surgical removal of impacted molars has remained an important concern among practitioners. Various protocols have been proposed to reduce postoperative pain. However, each one has special side effects and limitations. As green tea possesses anti-inflammatory and antibacterial properties, the aim of the current study was to evaluate the effectiveness of green tea mouthwash in controlling postoperative pain. MATERIALS AND METHODS: In a study with split-mouth and double blind design, 44 patients in need of bilateral removal of impacted third molars underwent randomized surgical extraction; following one surgery patients rinsed with a green tea mouthwash from the first to seventh postoperative day and after other extraction rinsed with placebo mouthwash in the same duration. Both patients and surgeon were blinded to the type of mouthwash. The predictor variable was type of mouthwash and primary outcome variable was postoperative pain measured by visual analogue scale (VAS) during first week after surgery. In addition, number of analgesics patients used after surgery recorded. To measure the effect of green tea mouthwash, repeated measures test with confidence interval of 95% was performed. RESULTS: Total of 43 patients with mean age of 24 years underwent total of 86 surgeries. VAS value had no statistically difference prior rinsing among groups (P-value > 0.05). However, the mean value of VAS following rinsing with green tea was statistically lower than placebo in postoperative days of 3-7 (P-value < 0.05). In addition, while rinsing with green tea, patients took significantly lower number of analgesics after surgery (P-value < 0.05). No side effects reported. CONCLUSION: Green tea mouthwash could be an appropriate and safe choice to control postoperative pain after third molar surgery.

Immediate Nonfunctional Loading of a Single Implant in the Posterior Maxillary Area: A Randomized Clinical Trial.

This study compared the clinical and radiographic outcomes of immediate nonfunctional loading of implants to conventional loading in the posterior maxilla. In this single-blind randomized clinical trial, a total of 39 implants were inserted and evaluated in 32 patients. Nineteen implants were in the control group, and 20 implants were placed in the test group. The test group received implants and immediate restoration within 72 hours after surgery; the control group was followed by a conventional loading protocol 4 months after surgery. Follow-up appointments were performed at 4, 6, and 12 months. Clinical assessment included measurement of implant stability through resonance frequency analysis (RFA), probing depth around the implant in four aspects, and survival rate. Radiographic assessment, including evaluation of crestal bone loss in the mesial and distal of the implants by parallel periapical radiography, was conducted. Twenty-nine implants were followed throughout the study period, completing the entire intended follow-up. No significant difference was seen between the test and control groups in terms of crestal bone loss at any interval either in mesial or distal aspects. Also, no significant difference was found between the two groups regarding implant stability. Probing depth did not show significant differences between groups at 6 and 12 months. Only one implant in the control group failed before prosthesis loading, and no failure was observed in the test group. Average of insertion torque in the control group and the test groups were 49 and 51 N/cm, respectively. This variable also showed no significant difference between the two groups. If appropriate primary stability is achieved, nonfunctional immediate loading of implants in the posterior maxilla may have similar results to conventional loading in this area. Using this protocol, the time of edentulousness could be minimized.