Impacted Third Molars Research Articles

Changes in Mandibular Third Molar Angulation in High-anchorage Extraction vs Non-extraction Orthodontic Treatment: A Prospective Study

The study aimed to compare the prospective changes in mandibular third molar angulation in high anchorage cases treated with first premolar extractions vs non-extraction orthodontic treatment. The sample consisted of 56 nongrowing patients: Group I had 26 patients with a high anchorage requirement who underwent first premolar extractions and group II had 30 patients who underwent non-extraction treatment. Pretreatment, mid-treatment, and posttreatment panoramic radiographs were obtained for group I and pretreatment and posttreatment for group II. Angle between M2 (second molar)-horizontal reference plane (HRP), M3 (third molar)-HRP, and M2-M3 were measured bilaterally. Data were analyzed using Student t test and ANOVA test (p value < 0.05). Statistically significant increase was found between the pretreatment, mid-treatment, and posttreatment values of M2-M3 in group I (p value = 0.02 R and p value = 0.049 L) and between pretreatment to posttreatment values of M2-HRP in group II bilaterally (p value = 0.001). Significant increase was found in the M2-M3 angulations in group II on the right side (p value = 0.036). M3-HRP decreased in group I without reaching statistical significance. No statistically significant intergroup differences were found between the two groups in relation to M2-HRP, M3-HRP, and M2-M3 angulations. M2-M3 angulations increased significantly bilaterally in group I and on the right side in group II, indicating worsening of third molar angulation. M3-HRP worsened in group I without reaching statistical significance. Extraction therapy in high anchorage cases does not lead to an improvement in third molar angulation. The extraction of first premolars in high anchorage cases does not lead to an improvement in the angulation of mandibular third molars; moreover, the angulation worsened with extraction therapy. Prospective orthodontic patients need to be cautioned against any improvement in mesioangular impaction of mandibular third molars in high anchorage premolar extraction cases.

Impaction of mandibular third molars after orthodontic treatment by the edgewise method: a retrospective study.

This study aimed to determine the incidence of mandibular third molar (M3) impaction after orthodontic treatment by edgewise appliances, and identify possible determinant factors of M3 impaction. A retrospective cohort study was conducted with 1154 patients. Complete orthodontic records were analyzed pretreatment and posttreatment, considering the following variables: type of Angle malocclusion, treatment with or without extraction of first premolars, overbite, stage of dentition, M3 prior angulation and duration of orthodontic treatment. Impaction was determined after radiographic evidence of total closure of the root apex. The chi-square test and Poisson regression (p < 0.05) were used for statistical analysis with a hierarchical approach. Rate ratios (RR) and 95% confidence intervals (CI) were calculated. Mandibular M3 impaction incidence was 17%. Overbite equal to or greater than 4 mm (RR = 1.23, 95%CI: 1.11-1.26, p < 0.001), prior mesial angulation of M3 (RR = 0.59, 95%CI: 0.52-0.68, p < 0.001), non-extraction of first premolars (RR=1.06, 95%CI: 1.01-1.12, P=0.019) and orthodontic treatment time equal to or less than three years (RR = 0.94. 95%CI: 0.90-0.99, p < 0.014) were significantly associated with impacted M3. There was no correlation between the type of Angle malocclusion and the risk of impaction. In conclusion, the incidence of mandibular M3 impaction was considered low. The main pretreatment factors directly involved in impaction were mesioangulation of M3 and overbite equal to or greater than 4 mm. Orthodontic treatment with extraction of first premolars and treatment time greater than 3 years reduce the risk of impaction.

Does craniofacial morphology affect third molars impaction? Results from a population-based study in northeastern Germany.

ObjectivesIt is still not clear why impaction of third molars occurs. Craniofacial morphology and facial parameters have been discussed to be strong predictors for third molar impaction. Thus, this study aimed to investigate the effect of craniofacial morphology on erupted or impacted third molars in a German population sample.Materials and methodsErupted and impacted third molars in 2,484 participants from the Study of Health in Pomerania were assessed by whole-body magnetic resonance imaging. Markers of facial morphology were determined in 619 individuals of those participants in whose 421 participants (16.7%) had at least one impacted third molar. Craniofacial morphology was estimated as linear measurements and was associated in a cross-sectional study design with impacted and erupted third molars by multinomial logistic regression models. Erupted third molars were used as reference outcome category and regression models were adjusted for age and sex.ResultsMaximum Cranial Width (Eurion-Eurion distance) was significantly associated with impacted third molars (RR: 1.079; 95% confidence interval 1.028–1.132). This association was even more pronounced in the mandible. Individuals with a lower total anterior facial height (Nasion-Menton distance) and a lower facial index also have an increased risk for impacted third molars in the mandible (RR 0.953; 95% confidence interval 0.913–0.996 and RR: 0.943; 95% confidence interval 0.894–0.995). No significant associations of third molar status with facial width (Zygion-Zygion distance), and sagittal cranial dimension (Nasion-Sella distance; Sella-Basion distance) were observed.ConclusionIndividuals with an increased maximal cranial width have a higher risk for impaction of third molars in the mandible and in the maxilla. Individuals with a lower anterior total anterior facial height and lower facial index also have an increased risk for third molars impaction in the mandible. These findings could help orthodontic dentists, oral surgeons and oral and maxillofacial surgeons in decision-making for third molars removal in their treatment. These findings highlight the necessity of an additional analysis of the maximal cranial width by the Eurion- Eurion distance.

Phenotypic heterogeneity of impacted third molar tooth: family case study

Tooth impaction is a pathological condition where a tooth fails to attain its normal functional position. The present study aims to highlight the phenotypic heterogeneity of impacted third molars in a Caucasian family, to investigate the characteristics of the dental phenotype, to evidence the diversity of dental phenotype, and to identify the inheritance mode of the condition. Detailed anamnesis, clinical examination, complementary tests (panoramic radiographs), family study and pedigree analysis. Phenotypic characteristics of impacted third molar tooth in our family case report was: Severe horizontal impaction of the mandibular right third molar, Angular impaction of the maxillary right third molar and angular impaction of the maxillary left third molar, Angular impaction of the mandibular left third molar and partial eruption of the maxillary right third molar, Horizontal impaction of the mandibular left third molar and Angular impaction of the mandibular left third molar. The inheritance mode of the impacted third molar tooth in the family case report was: from mother to both daughters’ transmission, from mother to both sons’ transmission, and from mother to daughter transmission. Family study and pedigree analysis are very important for illustrate the genetic basis of impacted teeth.

Risk of lingual nerve injuries in removal of mandibular third molars: a retrospective case-control study

BackgroundThrough the analysis of clinical data, we attempted to investigate the etiology and determine the risk of severe iatrogenic lingual nerve injuries in the removal of the mandibular third molar.MethodsA retrospective chart review was performed for patients who had undergone microsurgical repair of lingual nerve injuries. The following data were collected and analyzed: patient sex, age, nerve injury side, type of impaction (Winter’s classification, Pell and Gregory’s classification). Ratios for the respective lingual nerve injury group data were compared with the ratios of the respective data for the control group, which consisted of data collected from the literature. The data for the control group included previous patients that encountered various complications during the removal of the mandibular third molar.ResultsThe lingual nerve injury group consisted of 24 males and 58 females. The rate of female patients with iatrogenic lingual nerve injuries was significantly higher than the control groups. Ages ranged from 15 to 67 years, with a mean age of 36.5 years old. Lingual nerve injury was significantly higher in the patient versus the control groups in age. The lingual nerve injury was on the right side in 46 and on the left side in 36 patients. There was no significant difference for the injury side. The distoangular and horizontal ratios were the highest in our lingual nerve injury group. The distoangular impaction rate in our lingual nerve injury group was significantly higher than the rate for the control groups.ConclusionDistoangular impaction of the mandibular third molar in female patients in their 30s, 40s, and 50s may be a higher risk factor of severe lingual nerve injury in the removal of mandibular third molars.

Management of Unilaterally Impacted Permanent Mandibular First, Second and Third Molars

This case report describes the treatment of a teenage patient with simultaneous impaction of all three right mandibular permanent molars. The impacted first and second mandibular molars were surgically exposed and orthodontically erupted into good alignment and occlusion while the impacted third molar in the same quadrant was extracted. The unique clinical presentation, various treatment alternatives, the decision making process in finalizing the treatment plan and its clinical implementation are discussed.

Relationship between the Position of Impacted Third Molars and External Root Resorption of Adjacent Second Molars: A Retrospective CBCT Study.

Background and objectives: Impacted third molars (ITM) are the most commonly-impacted teeth. There is a risk for ITM to cause a number of pathological conditions, and external root resorption (ERR) of adjacent teeth is one of the most prevalent. Retaining or prophylactic extraction of ITM is a polemic topic. External root resorption of adjacent teeth is one of possible indications for prophylactic removal of ITM. The aim of this study was to assess the relationship between external root resorption (ERR) on the distal aspect of second molars’ roots and positional parameters of ITM. Methods: Cone beam computed tomography scans of 109 patients (41 males, 68 females; mean age 26.4 ± 7.9 years) with 254 ITM (131 in the maxilla and 123 in the mandible) were retrospectively analyzed. Positional parameters of ITM (mesio-distal position, angulation, impaction depth, and available eruption space) were evaluated. The presence, location, and depth of ERR of adjacent second molars were assessed. Results: Analysis showed a relationship between ITM impaction depth, mesial inclination angle, and the presence of ERR. Mesial inclination angle of more than 13.6° increased the odds of ERR occurrence by 5.439 (95% CI, 2.97–9.98). ITM presence at the level of ½ of roots of the adjacent second molar or more apically increased the odds of ERR occurrence by 2.218 (95% CI, 1.215–4.048). No significant correlation was detected between the occurrence of ERR and patient age, gender, or the available eruption space in the mandible. Depth of ERR did not depend on its location. Conclusions: Incidence of ERR in second molars is significantly associated with mesial inclination and a deep position of ITM.

External Root Resorption and Caries of Mandibular Second Molar in Association with Third Molar Impaction Status

Impaction status of a mandibular third molar (M3) leads to some pathological conditions. Objective: Thisretrospective study was conducted to compare the effect of erupted (e-M3) and impacted mandibular third molars(i-M3) on caries in the adjacent second molar and external root resorption (ERR). Methods: We used cone beamcomputed tomography (CBCT) images of 200 patients with a mean age of 28.19 ± 8.3 years who had an e-M3on one side of the mandible and an i-M3 on the other side of the mandible. All the images were evaluated for theexistence of caries and ERR. Results: Caries was detected in 32.5% of cases of i-M3 and in 21% of cases of e-M3(p = 0.01). ERR was present in 18.5% of cases of i-M3 and no resorption was observed in cases of e-M3 (p = 0.00).Conclusions: Caries and ERR in cases of i-M3 can be reliably identified via CBCT scan. Among patients withcaries in the i-M3 group, the degree of caries was significantly lower on the other side of the mandible. Instead ofprophylactic removal of e-M3, periodic clinical and radiologic examinations are advised.

Is Panoramic Imaging Equivalent to Cone-Beam Computed Tomography for Classifying Impacted Lower Third Molars?

Preoperative recognition of the relative position of the mandibular third molars may contribute to more reliable treatment planning, avoiding injuries and decreasing surgical and recovery times. The research questions for this study were as follows: 1) Is panoramic radiography (PR) equivalent to cone-beam computed tomography (CBCT) in determining the degree of mandibular third molar impaction? 2) For PR, is the external oblique ridge a more reliable reference to determine the degree of mandibular third molar impaction? This retrospective case-series study assessed whether the imaging modalities (primary predictor variable) are equivalent in determining the degree of impaction of third molars (primary outcome variable) according to the parameters of the Pell and Gregory classification. Two oral and maxillofacial radiologists evaluated PR and CBCT images presenting at least 1 mandibular third molar. The degrees of impaction related to the ascending ramus and related to the external oblique ridge (secondary outcome variables) also were assessed. The agreement rates between PR and CBCT were presented, and the imaging modalities were compared by the McNemar-Bowker test (α=.05). A total of 173 patients were included (66 male and 107 female patients). Among these patients, 313 mandibular third molars were assessed. In relation to the occlusal plane, the agreement rate between PR and CBCT was 82.1% for Pell and Gregory class A, 90.5% for class B, and 65.6% for class C (P=.116). The overall agreement rate between the classifications in relation to the mandibular ramus on PR and CBCT ranged from 66.8% (considering the ascending ramus, P<.001) to 76.4% (considering the external oblique ridge, P<.001). PR performs similarly to CBCT in the classification of impaction in relation to the occlusal plane. However, PR shows a tendency to underestimate the space for accommodation of the third molar compared with CBCT. Furthermore, the external oblique ridge is not a reliable alternative landmark on PR.

MANDIBULAR IMPACTED THIRD MOLAR;

Objectives: To compare the difference in mean trismus by giving two doses of Dexamethasone after surgical extraction of impacted mandibular third molar. Study Design: Randomized controlled clinical trial. Period: 1st Jan 2016 to 30thJune 2017. Setting: Out Patient Department of Oral &amp; maxillofacial Surgery, Nishtar Institute of Dentistry Multan. Methodology: Data was entered on SPSS version 23 and mean ± SD were calculated for quantitative variables like age and mouth opening in mm. Similarly frequency and percentage of qualitative variables were calculated and presented like gender and incidence of trismus. P value ≤ 0.05 was considered as significant. Results: There were 60 patients in total. Males were 31 (51.7%) while females were 29 (48.3%) (Graph-1). Mean age of the patients was 37.25 + 9.04 years ranging from a minimum of 20 to a maximum of 50 years. When students t-test was applied to compare the means of two groups, in group A the mean trismus was found to be 25.77 + 3.58 mm while in group B the mean trismus was found to be 35.53 + 5.11 mm. The t-value was found to be 8.56 and df 58. The p-value was found to be &lt; 0.0001 which was clinically significant. Conclusion: The dosage of 8 mg of dexamethasone was statistically more significant in the reduction of trismus as compare to 4mg (p-value =0.000). So it is recommended that Dexamethasone with dosage of 8mg should be used to control postoperative trismus after surgical extraction of mandibular impacted third molar.

Epidermal Growth Factor Receptor (EGFR) Expression and Incidence of Cystic Changes in Asymptomatic Dental Follicles in Smoking Patients

Background: Smoking is a well-known predisposing factor for pathological changes in oral tissues. Epithelial proliferation due to smoking is caused by the increased expression and activation of epidermal growth factor receptor (EGFR), which is a protooncogen. Aims: The objective of this study was to evaluate Epidermal Growth Factor Receptor (EGFR) expression and intensity and the incidence of histologically diagnosed cystic changes in asymptomatic impacted lower third molar (ILTM) follicles of smoking and non-smoking patients. Materials and Methods: A hundred dental follicles obtained from asymptomatic ILTMs were examined histopathologically and immunohistochemically using antibody against EGFR. After initial microscopic analyses, 18 specimens were excluded from the study because of lack of epithelium. The final EGFR expression intensity score of samples was determined by multiplying the percentage of positively stained cells by the staining intensity. Results: Cystic changes were detected with microscopic evaluation. In the smoking group, the relation between EGFR scores and cystic changes were found statistically significant (p<0.05). The relation of age and EGFR scores that showed cystic changes in the smoking group was also found statistically significant (p<0.05). Conclusion: Asymptomatic ILTMs of the smoker patients may be suspected for the higher possibility of cystic changes compared with the nonsmokers. Smoking may be considered as a factor for the decision of removal of an asymptomatic ILTM. Key Words: EGF Receptor, cystic changes, dental follicles, smoking

Relationship of Mandibular Third Molar to Mandibular Anterior Crowding

Abstract Introduction The impact of third molars in occurrence of secondary mandibular incisor crowding has been a disputable subject and is reviewed in the dental literature for many years. The relationships between lower third molar angulation, eruption level, and eruption space to lower anterior crowding are not completely understood. Aim To evaluate the relation between the third molar angulations, eruption space, eruption level, and mandibular anterior crowding. Materials and Methods Pretreatment plaster study models (mandibular dental arches) and orthopantomograph of 40 individuals, aged between 12 and 22 years, were part of the study. The whole sample was divided into two groups based on the Little's index of irregularity: group I—control group (n = 20) composed of patients with index 0 to 3 mm, and group II—study group (n = 20) composed of patients with index &gt; 3 mm. Calculations were made for the third molar eruption depth, eruption space, and angulation. Statistical Analysis Mean values were compared for selected dimensions between the control and study groups with Student's t-test. Results Statistically significant differences for Ganss ratio in right side between the control and study groups with a p-value of 0.049 were observed. Statistically insignificant difference was seen between the control and study groups for other parameters. Eruption level B was found for maximum molars in the study group, 95% on right and 85% on left side. Conclusion It was inferred that no strong relation exists between the third molar eruption level, space, and angulations to mandibular anterior crowding.

Correlation of Impaction of Mandibular Third Molars with Sagittal Dimension of Face

Correlation of Impaction of Mandibular Third Molars with Sagittal Dimension of Face

Mesioangular impacted lower third molars: angulation before and after orthodontic treatment with premolar extraction

Impaction of the lower third molars is due to the lack of space in the retromolar pad. Extraction of premolars in orthodontic treatment helps the uprighting of mesioangular impacted third molars so that they can erupt normally. The aim of this study was to measure changes in angulation during orthodontic treatment of mesioangular impacted lower third molars. This retrospective, cross-sectional analytical study used 25 samples of panoramic radiographs from patients aged 10–21 years before and after orthodontic treatment. Angulation was measured using the long axis of the lower second molars as the reference plane. The Wilcoxon test and paired t-test (p < 0.05) showed no significant changes in lower third molar angulation on both sides (p > 0.05). Radiographs showed a tendency for an increase in angulation, although the change was not statistically significant (p > 0.05). These increases occurred most frequently in the adult group (17–21 years old). It can be concluded that the extraction of premolars in orthodontic treatment did not significantly affect the angulation of impacted third molars.

Position of Impacted Mandibular Third Molar in different Skeletal Facial Types

Introduction: Variation in growth pattern in different facial forms affect the space available for tooth eruption, therefore the mandibular third molar impaction has correlation with different skeletal facial types.Objective: To determine the position of impacted mandibular third molar in different skeletal facial types in Nepalese samples.Materials &amp; Method: This cross sectional study was carried out on pre-treatment lateral cephalogram and orthopantomogram records of 207 orthodontic patients visiting Kantipur Dental College and Hospital. Age range of the sample was 16-33 years. Various facial forms were determined with the help of mandibular plane angle (SN-GoGn); for which Nemoceph software was used. Beta angle was used to determine the angle of impaction of mandibular third molar. Impaction pattern was classified as per Pell &amp; Gregory and Winter’s system. SPSS version 20 was used for statistical analysis.Result: Overall rate of mandibular third molar impaction was 63.77% (11.11% unilateral and 52.66% bilateral impaction). The most common type of impaction bilaterally was mesioangular based on Winter’s classification, Class II Position B based on Pell &amp; Gregory’s classification. Higher rate of mandibular third molar impaction was found in dolichofacial type of face (49.2%).Conclusion: Decreased mandibular third molar impactions are seen in brachyfacial type compared to mesofacial and dolichofacial types

Impaction of lower third molars and their association with age: radiological perspectives

BackgroundThird molars are the most commonly impacted teeth, and their extraction is the most commonly performed procedure in oral and maxillofacial surgery. The aim of the present study is to describe the pattern of mandibular third molar impaction and to define the most appropriate age for prophylactic extraction of mandibular third molar teeth.MethodsA total of 1198 orthopantomographs (OPGs) with 1810 impacted lower third molars were reviewed by two authors. The pattern of eruption in relation to patient’s age was examined using standard radiographic points and angles. Statistical analysis was performed using SPSS for Windows release 16.0 (SPSS Inc., Chicago, IL, USA).ResultsIn patients older than 20 years, vertical pattern of impaction was the most common (21.4%); while in young patients; horizontal impaction was more common (21.3%). Furthermore, there was a constant pattern of increase in Pell-Gregory ramus class 1 with increasing age, as the prevalence of class 1 was 0% at age 18 years compared to 54.9% at the age of 26 years.ConclusionFrequency of vertical impaction of lower third molars was seen more at an older age (> 20 years) in this study, with an increase in the retromolar space. Late extraction of mandibular third molar teeth (i.e. after the age of 20) is therefore recommended when prophylactic extraction is considered.

Clinical evaluation of two dexamethasone regimens in the extractions of impacted third molars—a randomized clinical trial

The aim of the present study was to compare two therapeutic protocols of dexamethasone for the prevention of postoperative swelling, pain, and other complications after the extraction of impacted third molars, in a prospective, randomized, crossover, double-blinded clinical trial. Fifty patients with symmetrical impaction of third molars were randomly assigned to two different protocols of dexamethasone for each side. Patients underwent two sessions performed at a 21-day interval. In group 1, patients took 8mg of dexamethasone orally 1h before the procedure, and in group 2, 4mg dexamethasone orally 1h before and 24h after the procedure. Surgery duration, volume of local anesthetics, surgical technique, and rescue medication were standardized. Postoperative pain was evaluated using a visual analog scale (VAS) at predefined times: before operation; immediately after; 1, 2, 4, and 12h; and 1, 2, 3, and 7days after operation. The patients were also instructed to take notes of the number of rescue medication tablets taken. Edema and mouth opening were clinically evaluated before surgery and in the postoperative period (second and seventh postoperative days). There were no significant differences between groups for VAS scales (p = 0.5048), but the use of rescue medication was significantly lower in group 1 (p = 0.006). None statistically significant differences (p > 0.05) were observed between groups in any of the time points for all measurements of edema. However, the mouth opening limitation (DIINC) was bigger (p = 0.0069) for group 1 at 2days. Pre-emptive use of different dexamethasone regimens had a beneficial effect against pain, edema, and mouth opening limitation, especially when administered at an 8mg concentration, which suggests that this protocol may also be efficient for more invasive surgery.

The potential of heart rate variability for exploring dental anxiety in mandibular third molar surgery

An objective method to recognize patient psychology using heart rate variability (HRV) has recently been developed and is increasingly being used in medical practice. This study compared the potential of this new method with the use of conventional surveys measuring anxiety levels in patients undergoing impacted third molar (ITM) surgery. Patient anxiety was examined before treatment in 64 adults who required ITM surgery, using two methods: measurement of HRV and conventional questionnaire surveys (state section of the State–Trait Anxiety Inventory (STAI-S) and Dental Fear Survey (DFS)). Both methods were assessed for their respective abilities to determine the impact of personal background, the amount of information provided, and the surgical procedure on patient psychology. Questionnaires and HRV yielded the same finding: dental experience was the single background factor that correlated with patient anxiety; the other factors remain unclear. The STAI-S showed a significant relationship between the information provided to the patient and their anxiety level, while the DFS and HRV did not. In addition, HRV demonstrated its ability to assess the effects of the surgical procedure on patient psychology. HRV demonstrated great potential as an objective method for evaluating patient stress, especially for providing real-time information on the patient’s status.

Prevalence of dentigerous cysts due to impaction of mandibular third molar teeth

Dentigerous cyst is an odontogenic cyst that surrounds the crown of an impacted tooth, caused by fluid accumulation between the reduced enamel epithelium and the enamel surface, usually associated with mandibular third molars. The purpose of this study was to find out the prevalence of dentigerous cyst caused by impaction of mandibular third molar at the oral and maxillofacial surgery department of Hasan Sadikin hospital Bandung. This study was a descriptive survey study. Samples were taken from the data of patient’s medical record from July 2006 until June 2011. The result of this study showed the number of oromaxillofacial cyst cases in the period was as much as 316 (0.78%). Dentigerous cyst was the most common odontogenic cyst (48,64%). Dentigerous cyst most commonly caused by impaction of the mandibular third molar (13,89%). The amount of male and female patients with dentigerous cyst was the same (50% each). The most age group that suffered dentigerous cyst due to impaction of the mandibular third molars was the age group of 41-50 years (40%). The most chosen therapy was enucleation (100%). From the results of this study can be concluded that dentigerous cyst due to impaction of mandibular third molars was the most common case, with the same frequency found in both male and female, the most age group of impacted was the age group of 41-50 years old, and the most chosen therapy was enucleation.

Efficacy of NSAID (Lornoxicam) After Impacted Third-Molar Surgery With/Without Conscious Sedation: A Double-Blind Randomized Clinical Study

Aim: Pain and swelling following surgery for impacted third molars can be controlled by various methods. This study compared the analgesic and anti-inflammatory efficacy and tolerability of lornoxicam, aspirin and a placebo with and without conscious sedation in impacted mandibular third-molar surgery. Materials and Methods: 60 patients undergoing third-molar surgery were divided into 2 groups of conscious sedation and routine local anesthesia (n=30). Both groups were divided into three subgroups (n=10) that received either Lornoxicam, aspirin, or a placebo postoperatively. Results: In both the conscious sedation and local anesthesia groups, swelling reduction was significantly greater with Lornoxicam compared to aspirin and placebo (pConclusion: Conscious sedation resulted less pain and swelling. Moreover, Lornoxicam was found to be an effective analgesic and anti-inflammatory agent for use in conjunction with oral surgery.