Evaluation of the need to prescribe opioid medication to control post-surgical pain of different periodontal/oral surgeries.

BACKGROUND: To determine the level of perceived pain after different types of periodontal/oral surgical procedures, and the differences in patients' selection of pain management, over the counter (OTC) versus opioid, based on procedure type. METHODS: Patients undergoing surgical procedures were asked to complete a pain questionnaire at four time points: 1) before surgery 2) first dose of analgesic at home, 3) 24 hours postoperatively, and 4) 72 hours postoperatively. The questionnaire consisted of numerical and descriptive scales to describe the perceived pain. RESULTS: A total of 198 patients completed the questionnaire. All surgical procedures were grouped into five major categories: bone augmentation procedures (11% BAP), teeth extractions (26% EXT), surgical implant placement (25% IP), mucogingival surgeries (21% MGS), and pocket elimination procedures (17%). IP surgery was associated with significantly less pain compared with MGS and EXT (P <0.05). There was a statistically significant difference for taking any medication based on type of surgical procedure at 24 hours (P <0.05). CONCLUSIONS: IP is associated with significantly lower perceived pain compared with EXT and MGS surgery. Analgesic consumption was generally parallel to pain perception. A considerable number of patients elected to control the post-surgical pain using OTC medication up to 72 hours. Periodontal/oral surgery procedures vary in the amount of perceived postoperative pain. Tailoring postoperative medications to the type of periodontal/oral surgery performed will help prevent overprescribing of opioids.

Sex-related differences in the distance of the mental foramen to the cementoenamel junction in adults: a study using cone beam computed tomography.

Injury to the contents of the mental foramen (MF) can be minimized by using cone beam computed tomography (CBCT) to determine the exact location of the MF prior to surgical procedures. In this retrospective study, variations in the vertical position of the MF between adult men and women older than 18 years were investigated using CBCT. The distance between the superior border of the MF and the most apical aspect of the cementoenamel junction (CEJ) of the mandibular second premolar was measured. Among the randomly accessed CBCT records of 200 patients, 176 MF-CEJ measurements met the inclusion criteria. There was a statistically significant difference (P < 0.001) between the sexes in the location of the MF. The distance in women was shorter by an average of 2.00 mm, irrespective of the side of the mandible. Additionally, a within-sex asymmetry between right and left sides was observed; the asymmetry was significantly greater in men than in women (P < 0.05). Clinicians should be cognizant of the influence of the patient's sex on the vertical position of the MF and the presence of asymmetry in the position of the MF between the right and left sides of the mandible within the sex groups.