Abstract
Postoperative pain is one of the main complications following impacted mandibular third molar (IMTM) surgery. The aim of this study was to assess the effect of the local application of bupivacaine on reducing early postoperative pain following IMTM surgery. A prospective, single-blinded, randomized controlled study was conducted on 40 patients who had undergone the surgical removal of an IMTM under local anesthesia. In the study group (n = 20), absorbable gelatin sponge (AGS) soaked in 3 mL of 0.5% plain bupivacaine hydrochloride was locally applied in the post-extraction socket. In the control group (n = 20), AGS soaked in 3 mL of normal saline was used. Pain intensity was assessed using a pain numerical rating scale (NRS) 4 and 12 h postoperatively. The variables were compared between the 2 groups and probability values <0.05 were considered statistically significant. The pain scores in the study group were significantly lower than those recorded in the control group at 4 h postoperatively (p = 0.003), whereas the difference in the pain scores between the 2 groups 12 h after surgery was not statistically significant (p = 0.443). The local application of bupivacaine is effective in reducing postoperative pain 4 h after the surgical extraction of IMTMs without any significant complications.
Highlights
The impaction of third molars is a common problem worldwide
The local application of bupivacaine is effective in reducing postoperative pain 4 h after the surgical extraction of impacted mandibular third molar (IMTM) without any significant complications
This study evaluated the efficacy of absorbable gelatin sponge (AGS) soaked in plain bupivacaine or normal saline, applied in the postextraction socket, in reducing the early postoperative pain associated with IMTM surgery
Summary
The impaction of third molars is a common problem worldwide. Its prevalence has been estimated to range from about 3% to about 68%, with an average rate of 24.4%; it has significant geographic variation.[1]. Postoperative pain is the most common complication following dental surgery,[3] and the patient’s experience depends on the degree of surgical trauma, the need for bone removal and the periosteal extension. It is undoubtedly the most common symptom and can continue even 1 week after surgery, despite analgesic treatment, leading to increased morbidity and detrimental effects on the patient’s well-being and quality of life.[6,7] Inadequate management of early postoperative pain has been related to a wide range of negative outcomes, including delayed recovery and even an increased risk of developing chronic pain.[8,9]. Postoperative pain is one of the main complications following impacted mandibular third molar (IMTM) surgery
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