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Piezo-surgery Technique and Intramuscular Dexamethasone Injection to Reduce Postoperative Pain After Impacted Mandibular Third Molar Surgery

Phase 4
Completed
Conditions
Impacted Mandibular Third Molar Extraction
Interventions
Procedure: Conventional Rotatory instruments
Procedure: Piezosurgery
Registration Number
NCT04889781
Lead Sponsor
Central Military Healthcare - Oral and Maxillofacial Surgery Department
Brief Summary

The purpose of my study is to test the effect of using piezosurgery and dexamethasone injection in the surgical extraction of impacted mandibular third molars, on Postoperative Pain.

Detailed Description

Background: Third molar surgery is the most common procedure performed in oral and maxillofacial surgery practice.

This procedure is always associated with varying degrees of postoperative pain and swelling that may have a social impact. Traditionally, rotating instruments like burs have been used for osseous surgery.

Piezosurgery is a novel technique introduced to overcome the disadvantages associated with the conventional rotatory technique. Corticosteroids administration before or after the extraction of third molars is an efficient way to minimize postoperative pain due to their strong anti-inflammatory activity.

Many researchers conducted studies comparing the piezosurgery technique with conventional rotatory technique, regarding postoperative pain and working time, or studies comparing the conventional method with or without dexamethasone injection. Only one recent study (Nov 2018), conducted by Gümrükçü Z. et al. has compared Piezosurgery and dexamethasone injection in third molar surgery, but without evaluating the combined effect of these two techniques on postoperative pain.

Objectives: The objective of this study is to assess the effects of piezosurgery technique and intramuscular dexamethasone injection on postoperative pain in impacted third molar surgery.

Methods: The study design is a randomized controlled clinical trial: 80 patients with mandibular third molar impaction, indicated for surgical extraction should be treated randomly using either the piezosurgery or the conventional rotatory technique, and with or without intramuscular dexamethasone injection. Postoperative pain will be assessed using a visual analog scale (VAS) on days 1, 3, and seven postoperatively.

The differences in Post-operative pain within and between study groups (4 groups) will be tested using repeated measures of analysis of variance (ANOVA) or Friedman tests. Differences in working time among the three techniques will be assessed using a repeated measure of ANOVA. All statistical tests will be two-sided, and the significant level will be set at 0.05. All the analysis will be conducted using the Statistical Package for Social Sciences (SPSS) software version 22.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
80
Inclusion Criteria
  • Age from 15 to 30 years,
  • Having mandibular impacted third molars,
Exclusion Criteria
  • Heavy smokers (≥20 cigarettes),
  • Uncontrolled systemic conditions,
  • Infection of the surgery site,
  • Psychological problems,
  • History of allergy to dexamethasone, amoxicillin, or acetaminophen.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Rotatory Instruments without Dexamethasone injectionConventional Rotatory instrumentsSurgical extraction of Impacted Mandibular Third Molar using conventional rotatory instruments to perform osteotomy without Intramuscular Dexamethasone injection
Rotatory Instruments with Dexamethasone injectionDexamethasone injectionSurgical extraction of Impacted Mandibular Third Molar using conventional rotatory instruments to perform osteotomy with 8 mg Intramuscular Dexamethasone injection 30 min before surgery
Piezosurgery technique without Dexamethasone injectionPiezosurgerySurgical extraction of Impacted Mandibular Third Molar using the piezosurgery technique without Intramuscular Dexamethasone injection
Piezosurgery technique without Dexamethasone injectionConventional Rotatory instrumentsSurgical extraction of Impacted Mandibular Third Molar using the piezosurgery technique without Intramuscular Dexamethasone injection
Piezosurgery technique with Dexamethasone injectionPiezosurgerySurgical extraction of Impacted Mandibular Third Molar using the piezosurgery technique with 8 mg Intramuscular Dexamethasone injection 30 min before surgery
Piezosurgery technique with Dexamethasone injectionDexamethasone injectionSurgical extraction of Impacted Mandibular Third Molar using the piezosurgery technique with 8 mg Intramuscular Dexamethasone injection 30 min before surgery
Primary Outcome Measures
NameTimeMethod
Change of Postoperative Pain level From BaselineDays 1, 3, and 7 Post-op

Postoperative Pain level using Visual Analogue Scale (VAS): 100 mm in length ranging from 0 for " no pain" to 100 for "the worse imaginable pain

Working timePer-op

Surgery time from the start of the incision until the end of the suturing (min).

Secondary Outcome Measures
NameTimeMethod
Change oh The maximal mouth opening From BaselineAt Day 0 and Day 3

The maximal mouth opening, previously taken at Day 0 was measured at day three post-op, and expressed in millimeters (mm).

Trial Locations

Locations (1)

Central Military Hospital

🇱🇧

Beirut, Lebanon

Central Military Hospital
🇱🇧Beirut, Lebanon

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