Assessment of the Operative Course in Connection With Removal of Lower Third Molars

Not Applicable

Completed

• Conditions: Postoperative Pain; Inflammation
• Interventions: Drug: methylprednisolone; Drug: placebo; Drug: xyloplyin adrenalin; Drug: marcain adrenalin

• Registration Number: NCT00805298
• Lead Sponsor: University of Aarhus

Brief Summary

The aim of this study is to compare postoperative complications after removal of lower third molars using two different types of anaesthetics and two different treatments against swelling and inflammation (methylprednisolone and placebo). The hypothesis is that a combination of a long-duration anaesthetic combined methylprednisolone will result in significantly less postoperative pain and inflammation.

Patients will have both lower third molars removed on two separate occasions. Each patient is randomly assigned to receive one type of local anaesthetic the first time and the other type the second time. Furthermore patients are randomised to receive either methylprednisolone or placebo the first time and the opposite treatment the second time.

During the week after surgery patients fill out a questionnaire with questions about level of pain and swelling at different times as well as the patients' perception of other postoperative complications. The patient is examined by a dentist on the 2nd and 7th day after surgery, where postoperative complications are recorded and thermographic images of the patient's face are taken to assess the degree of inflammation.

Detailed Description

Background: After removal of lower third molars complications can occur, including pain, swelling, infection and sensory disturbances. As pain intensity has been shown to be worst during the first 4-8 hours post surgery, it might be relevant to use a local anaesthetic with long duration, e.g. bupivacaine, instead of the traditionally used lidocaine. Several studies have focussed on the effect of non-steroid anti-inflammatory drugs (such as glucocorticoids, e.g. methylprednisolone) to reduce postoperative swelling. However, no studies comparing the effect of bupivacaine combined with methylprednisolone and lidocaine combined with methylprednisolone have been conducted.

Aim: To compare postoperative complications after removal of lower third molars using 1) lidocaine, 2) lidocaine combined with methylprednisolone, 3) bupivacaine and 4) bupivacaine combined with methylprednisolone.

Methods: The study compares type end extension of postoperative complications after removal of lower third molars using four different combinations of local anaesthetics and anti-inflammatory treatment. The study is conducted as a double blinded, split mouth crossover trial, where each patient has both lower third molars removed at two different occasions.

Patients are randomised to receive one type of local anaesthetic the first time and the other type the second time. Furthermore patients are randomised to receive either methylprednisolone or placebo the first time and the opposite treatment the second time.

An objective assessment of postoperative swelling and inflammation is made by means of thermographic imaging of the operated side compared to the opposite side after the operation and at 2 and 7 days post surgery.

Each patient fills out a questionnaire, where the patients' perception of pain, swelling and other complications is registered. Furthermore, complications are recorded objectively by a dentist at the 2- and 7-day post-surgery visits

Study Timeline

• Study Start: 2008-08
• Study First Submitted: 2008-12-08
• Study First Submitted QC: 2008-12-08
• Study First Posted: 2008-12-09
• Primary Completion: 2010-11
• Study Completion: 2010-11
• Status Verified: 2012-10
• Last Update Submitted: 2012-10-23
• Last Update Posted: 2012-10-24

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 154

Inclusion Criteria

• age ≥ 18 years
• two impacted or semi-impacted lower third molars with indication for removal
• signed informed consent

Exclusion Criteria

• allergy to study drugs or ingredients
• need for sedation
• pregnancy
• systemic disease besides asthma/hay fever

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
methylprednisolone	methylprednisolone	-
placebo	placebo	-
lidocaine	xyloplyin adrenalin	-
bupivacaine	marcain adrenalin	-

Primary Outcome Measures

Name	Time	Method
postoperative pain	within the first week after surgery
postoperative inflammation	within the first week after surgery

Secondary Outcome Measures

Name	Time	Method
use of analgesics	within one week after surgery
absence from work	within one week after surgery
trismus	within one week after surgery
alveolitis (dry socket)	within one week after surgery
sensory disturbance	within one week after surgery

Trial Locations

Locations (1)

School of Dentistry, Aarhus University; 🇩🇰 Aarhus, Denmark