An evaluation of effects of platelet-rich-fibrin on postoperative morbidities after lower third molar surgery.

OBJECTIVES: The aim of the present study was to assess whether the use of platelet-rich fibrin (PRF) decreased the pain, swelling, and trismus levels of postoperative third molar surgery. MATERIALS AND METHODS: In a double-blinded, split-mouth randomized study, thirty patients (6 male/24 female, mean age 20.32 years) with bilateral symmetric impacted third molars were enrolled in this study to receive surgery. The PRF mass was randomly placed in one of the extraction sockets, whereas the other socket was left without treatment. The outcome variables were pain, maximum mouth opening (trismus), swelling (edema), and the presence of dry socket which were measured using a 10-point visual analog scale, manual calipers, and 3dMD facial imaging system which was used for the 1st time in the third molar surgery. RESULTS: Statistical analyses revealed that there were no significant differences between the control and study groups regarding postoperative pain, swelling, and trismus (P > 0.05). CONCLUSION: The results of this study suggest that PRF was not observed to have a positive effect on postoperative discomfort, so even though, PRF is presumed to have positive effects on healing and recovery processes.

The efficacy of hyaluronic acid in postextraction sockets of impacted third molars: A pilot study.

OBJECTIVE: This study aims to evaluate the effectiveness of local hyaluronic acid (HA) administration to surgically remove impacted third molar sockets and measure pain, swelling, and trismus. MATERIALS AND METHODS: The study included a total of 25 healthy patients aged 18-29 years with asymptomatic bilaterally impacted lower third molars. All cases have been performed under local anesthesia. In the study group, 0.8% HA (Gengigel®) was applied in the postextraction sockets of the right third molars and in the control group nothing was applied to the extraction sockets of the left third molars. Postoperative pain, trismus, and swelling were evaluated on the 1st, 3rd, and 7th postoperative days. RESULTS: No difference was determined between groups in facial swelling and maximum mouth opening. However, the amount of pain significantly reduced in HA groups according to visual analog scale (P = 0.001). CONCLUSION: The results of this study showed that HA can produce an analgesic action in postextraction sockets after surgical removal of impacted teeth and therefore it has a clinical benefit to reduce usage of nonsteroidal anti-inflammatory drugs after dentoalveolar surgery.

How could multimedia information about dental implant surgery effects patients' anxiety level?

BACKGROUND: To evaluate the effects of different patient education techniques on patients' anxiety levels before and after dental implant surgery. MATERIAL AND METHODS: Sixty patients were randomized into three groups; each contained 20 patients; [group 1, basic information given verbally, with details of operation and recovery; group 2 (study group), basic information given verbally with details of operative procedures and recovery, and by watching a movie on single implant surgery]; and a control group [basic information given verbally "but it was devoid of the details of the operative procedures and recovery"]. Anxiety levels were assessed using the Spielberger's State-Trait Anxiety Inventory (STAI) and Modified Dental Anxiety Scale (MDAS). Pain was assessed with a visual analog scale (VAS). RESULTS: The most significant changes were observed in the movie group (P < 0.05). Patients who were more anxious also used more analgesic medication. Linear regression analysis showed that female patients had higher levels of anxiety (P < 0.05). CONCLUSIONS: Preoperative multimedia information increases anxiety level.

Comparison of a new flap design with the routinely used triangular flap design in third molar surgery.

The aim of this study is to introduce a new flap design in the surgical removal of impacted mandibular third molars - a lingually based triangular flap - and to compare this flap design with the routinely used triangular flap. This randomized, prospective, split-mouth study involved 22 patients with impacted bilateral mandibular third molars that were symmetrically positioned, mesially angulated, and retained in bone. The impacted teeth were removed in two sessions, using two different flap designs: the new alternative flap and the traditional triangular flap. Postoperative complications (pain, swelling, trismus, alveolar osteitis, and wound dehiscence) were recorded on days 2, 7, 14, and 21. The data obtained were analysed using the χ(2) test, the Mann-Whitney U-test, and Pearson's correlation. In terms of the severity of postoperative facial swelling and trismus, there were no statistically significant differences between the flap designs (P>0.05). The alternative flap exhibited higher pain scores at 12h post-surgery (P<0.05). In addition, the alternative flap group exhibited less wound dehiscence, although this was not statistically significant. Moreover, all wound dehiscence in this group occurred on sound bone. In conclusion, these results show that this new flap design is preferable to the routinely used flap for impacted third molar surgery.