Orthodontic Extraction Research Articles

Comparison of Pain Perception Between Local Infiltration and Inferior Alveolar Nerve Block Injection Techniques in Patients Undergoing Orthodontic Lower Premolar Extractions

Comparison of Pain Perception Between Local Infiltration and Inferior Alveolar Nerve Block Injection Techniques in Patients Undergoing Orthodontic Lower Premolar Extractions

The effect of roselle (Hibiscus sabdariffa l.) flower petal extract on smear layer removal of crown dentin

One of the initial stages carried out before making a restoration is the tooth preparation. The debris resulting from the preparation process of the tooth structure is called the smear layer. Dentin conditioner is needed to remove the smear layer so that the crown dentin surface is clean and the restoration can adhere well. Roselle (Hibiscus sabdariffa L.) are a herbal ingredient that has acidic properties found in its flower petals. This research was conducted to determine the effect of roselle flower petal extract on the removal of the smear layer on crown dentin. Eight human maxillary first premolars from orthodontic extraction patients were used as samples. This pre-experimental study was conducted with a test group consisted of control group conditioned with sterile distilled water and treatment group with 2,5%, 5%, and 10% of roselle flower petal extract. The research data was obtained through observing the results of scanning Electron Microscope (SEM). Roselle flower petal extracts 5% and 10% were able to clean the smear layer better than extracts with a concentration of 2.5% and the control group. This may be due to the acidic pH of the solution and demineralization process caused by the presence of citric acid and other organic acids in roselle flower petal extract.

Using a structured light scanner to evaluate 3-dimensional soft-tissue changes after extracting 4 premolars in young adult female patients

Facial esthetics have always received much attention in orthodontic treatment, especially in young adult female patients. Three-dimensional (3D) soft-tissue changes after orthodontic extraction have not been fully explained. This study evaluated the 3D morphologic changes after orthodontic extraction in young female patients using a structured light scanner. Forty-five adult female patients aged 20-25 years were enrolled in our study. The treatment group consisted of patients who received orthodontic treatment with 4 premolar extractions, and the control group was composed of young female volunteers who had not undergone any orthodontic treatment. To monitor the soft-tissue changes, 9 morphologic regions and 12 landmarks were identified for the 3D deviation analyses. The spatial deviations of landmarks and regions in the x, y, and z directions were constructed for quantitative analysis. Color map images were constructed to visualize soft-tissue displacement as a qualitative evaluation. The paired sample test was used to compare differences at the beginning of the experiment (T0) and after 24 months (T1) in both groups. An independent t test with Bonferroni correction was performed to compare differences between the treatment and control groups. A linear regression test was performed between incisor retraction and changes in the perioral tissues. Subtracting the effect of aging from the lip changes in the control group, the treatment group showed a statistically significant difference in the displacement of labrale superius (-1.37 mm), labrale inferius (-1.89 mm), the upper lip region (-0.98 mm), and the lower lip region (-1.36 mm) along the z-axis. No significant differences were found between the treatment and control groups in the temporal, parotideomasseteric, and buccal regions. Pearson correlation tests indicated a positive correlation between incisor tip retraction and changes in soft tissues (two-dimensional cephalometric analysis, 3D landmark measurements, and 3D regional measurements). The correlation coefficient ranged between 0.45 and 0.55. Three-dimensional soft-tissue changes were mainly concentrated in the upper and lower lip regions in adult female patients after the 4 premolars were extracted. For female patients aged 20-25 years with 4 extracted premolars, soft-tissue changes in the temporal, parotideomasseteric, and buccal regions were not clinically significant.

Transdermal patches: Do they really works?—A comparative study of ketoprofen versus diclofenac analgesic patches in minor oral surgery

AbstractAim and objectivesA prospective split mouth study was done to compare the efficacy of transdermal ketoprofen versus diclofenac patch after therapeutic orthodontic tooth extraction based on four parameters – pain intensity (VAS), number of rescue analgesia intakes, local allergic reactions and patient tolerability for immediate and 3 consecutive postoperative days.Materials and methodsIn total, 33 (66 extraction sites) patients were divided into the ketoprofen patch group and the diclofenac patch group. A single ketoprofen patch (70 cm2 30 mg) was applied following extraction of premolars of the 1st and 4th quadrants and patients were recalled after 1 week for extractions of premolars of the 2nd and 3rd quadrants and diclofenac patch (50 cm2 100 mg) was applied on the deltoid region of the right arm, respectively. Patients were then evaluated under the above‐mentioned parameters.ResultsKetoprofen transdermal patch was found to be more effective in terms of controlling postoperative pain and the minimum number of rescue analgesia tablets taken as compared to diclofenac (statistically significant on 1st and 2nd day) though the former showed the incidence of a local allergic reaction (p‐value 0.002, 0.002 and 0.012), respectively, in few cases which were not seen in case of diclofenac.ConclusionOverall, both the transdermal patches are effective in terms of safety and providing analgesia, though more research are needed in proving the safeness and efficiency of these transdermal patches with large sample size.

A retrospective study of alveolar bone remodelling after anterior retraction in orthodontic tooth extraction cases with clear aligners and fixed appliances.

To evaluate alveolar bone dimensions and its relationship with tooth movement (retraction, intrusion and torque) during orthodontic treatment with fixed appliance and clear aligners. Thirty-two patients were included in this retrospective clinical study. Cone beam computed tomography (CBCT) was collected before and after treatment to measure the volume of dehiscence and fenestrations in the maxillary anterior region, anterior alveolar bone thickness and height and degree of tooth movement. Rank-sum tests were used to compare the differences in alveolar bone defect volumes between clear aligners and fixed appliance, multiple linear regression analysis was used for study evaluation, and kappa statistics were used to assess internal consistency and test-retest reliability. Post-operatively, most alveolar bone defects occurred on the labial side. The incidence of bone fenestration was 23.96% in the clear aligner group and 26.18% in the fixed appliance group, which was higher than the incidence of bone dehiscence (5.21%). The labial bone height decreased by 0.272 mm, and the palatal bone height increased by 0.617 mm for every 1 mm downward intrusion of the anterior tooth apex in the fixed appliance group. In the clear aligner group, there was no significant change in the labial bone height, and the palatal bone height decreased by 0.447 mm for every 1 mm of anterior tooth retraction coronally. In the fixed appliance group, anterior tooth intrusion and retraction may have led to alveolar bone resorption by its compression at the cervical level. This study provides a three-dimensional tooth movement evaluation method by using CBCT.

Comparative Evaluation of Transdermal Diclofenac and Oral Diclofenac in Management of Post - Operative Pain in Bilateral Premolar Orthodontic Extractions - A Comparative Interventional Study

Comparative Evaluation of Transdermal Diclofenac and Oral Diclofenac in Management of Post - Operative Pain in Bilateral Premolar Orthodontic Extractions - A Comparative Interventional Study

Evaluation of the relationship between incisor torque and profile aesthetics in patients having orthodontic extractions compared to non-extractions

ObjectiveThe aim of the present study was to evaluate the relationship between soft tissues aesthetics and incisor torque, as well as the effect of crowding, anchorage, and extraction pattern, in adult patients treated without extraction or with two or four extractions.Materials and methodsSeventy-seven subjects with permanent dentition were selected retrospectively. Among these, 24 patients were treated with four extractions, 24 with two extractions and 29 without extractions. Lateral cephalograms and photographies taken before (T0) and after (T1) treatment were retrieved. The amount of crowding and the type of anchorage were recorded, and a cephalometric analysis was performed. A one-way ANOVA was used to compare the variables within and between groups. Linear regressions were performed to evaluate the effect of different predictors on soft tissues variables at T1.ResultsThe statistical analysis showed no differences within and between groups for soft tissue aesthetics. A significant reduction of the angle obtained from the intersection of Frankfurt plane and mandibular plane was observed in the four-extractions group, and a significant proclination of the lower incisors was observed in the two-extraction group. Linear regressions revealed that the change in soft tissue profile aesthetics was affected by the type of anchorage and the two-extractions pattern.ConclusionsSimilar soft tissue aesthetics were observed after treatment in the three groups, despite the presence of some skeletal and dental differences.Clinical relevanceA well-controlled incisor torque helps to preserve soft tissues aesthetics. The type of anchorage could influence soft tissues.

Pre-eruptive intracoronal resorption in orthodontic patients: A retrospective analysis of 3,143 patients

ObjectivesThe aim of this retrospective study was to analyze the occurrence and characteristics of pre-eruptive intracoronal resorptions in a clinical orthodontic patient population. Materials and methodsPatients treated in an orthodontic department (University of Pécs, Pécs, Hungary) were included. Unerupted teeth on panoramic radiographs were analyzed for intracoronal radiolucent lesions. For each patient, the demographic data, jaw localization, number of unerupted teeth with pre-eruptive intracoronal resorption lesions, number of lesions per tooth, size and localization of pre-eruptive intracoronal resorption defects, affected tooth's surface, pulp involvement and ectopic position of the tooth with defects were recorded. ResultsIn the 3,143 patients investigated, 55 teeth in 49 patients showed pre-eruptive intracoronal resorption lesions (subject incidence: 1.56%). The incidence on unerupted teeth was 0.25%. Pre-eruptive intracoronal resorption was significantly more common in mandibles (43 mandibular vs. 12 maxillary lesions) with an odds ratio of 12.84 (95% Confidence Interval: 5.19–31.74) and no gender differences were found (p = 0.746). The occurrence of pre-eruptive intracoronal resorption was highest in the youngest (7–10 years) mixed dentition status group (p < 0.001). Most of the lesions (44 of 55, or 80.0%) were localized in the dentin, occupying two-third or less of the dentin thickness. Only 12.73% (7/55) of the lesions were not localized on the occlusal surface. Of the lesions, 89.1% (49/55) showed no obvious size increase over an average follow-up of 36.4 ± 8.1 months. ConclusionsPre-eruptive intracoronal resorption may occur mainly in the mixed dentition stage in orthodontic patients. Careful and attentive radiographic evaluations may facilitate early detection and follow-up of the lesions’ possible dimensional changes, especially when resorption influences orthodontic extraction therapy.

EFFICACY OF LOCALISED APPLICATION OF TRANEXEMIC ACID AND MEFENAMIC ACID TABLET POWDER IN EXTRACTION SOCKETS FOR CONTROL OF POST EXTRACTION BLEEDING AND PAIN:A SPLIT-MOUTH RANDOMIZED CONTROLLED CLINICAL TRIAL

Background: Post extraction bleeding and pain are two common complications in routine dental practice .There are no studies in which Tranexamic acid and Mefenamic acid combination powder is used locally to control post extraction bleeding and pain. Methodology: This study was conducted in 18 patients indicated for orthodontic extraction of mandibular first premolar and right side was the study side in which pre crushed TRANSET MF powder was placed and compared to the left side which was the control side .Post extraction bleeding immediately and 30 min post extraction was compared along with pain using VAS pain scale on 1,2,3,7 th day post extraction.. Results: There was statistically significant difference in time of post extraction bleeding between study side (less time) and the control side .There is statistically significant difference in pain scale less pain perceived in the study side than the control side. Conclusion: This study is the first one to evaluate the efficacy of crushed TRANSET MF Tablet Powder in post extraction sockets and has shown significant results in reducing post extraction pain and bleeding with no local and systemic side effects .Hence this will be a simple and cost effective technique that can reduce both post extraction bleeding and pain.

Evaluation of pharyngeal airway space after orthodontic extraction treatment in class II malocclusion integrating with the subjective sleep quality assessment

Orthodontic treatment with premolar extractions is typically used to relieve dental crowding and retract anterior teeth for lip profile improvement. The aim of the study is to compare the changes in regional pharyngeal airway space (PAS) after orthodontic treatment with Class II malocclusion and to identify the correlations between questionnaire results and PAS dimensions after orthodontic treatment. In this retrospective cohort study, 79 consecutive patients were divided into normodivergent nonextraction, normodivergent extraction, and hyperdivergent extraction groups. Serial lateral cephalograms were used to evaluate the patients’ PASs and hyoid bone positions. The Pittsburgh Sleep Quality Index and STOP-Bang questionnaire were used for sleep quality evaluation and obstructive sleep apnea (OSA) risk assessment, respectively, after treatment. The greatest airway reduction was observed in hyperdivergent extraction group. However, the changes in PAS and hyoid positions did not differ significantly among three groups. According to questionnaire results, all three groups had high sleep quality and low risk of OSA, with no significant intergroup differences. Moreover, pretreatment-to-posttreatment changes in PAS were not correlated with sleep quality or risk of OSA. Orthodontic retraction with premolar extractions nither exhibit significant reduction in airway dimensions nor increase their risk of OSA.

Labial and Palatal Pressure Changes in Extraction Cases Before and After Maxillary Incisor Retraction: A Quasi-Experimental Study.

To evaluate the changes in lip and tongue pressure before and after incisor retraction in patients undergoing orthodontic treatment with premolar extraction and incisor retraction. A Quasi-experimental study Place and Duration of the Study: Orthodontic Department at Dow University of Health Sciences, Pakistan, from January 2018 to November 2019. The study included 64 patients who were divided into two groups, (32 patients of class I and 32 patients of class II malocclusion). The lip and tongue pressures were recorded before and after incisor retraction with the help of Flexiforce sensor. The collected data were statistically analysed using the SPSS V-24 software. Shapiro-Wilk test was used to test the normality of data. The mean difference between lip and tongue pressure before and after incisor retraction was analyzed by Wilcoxon Signed Ranks Test. The difference in soft tissue pressures between class I and class II treatment groups was carried out using the Mann Whitney test. The mean pressure on the labial surface of incisors was significantly reduced after premolar extraction and incisor retraction (p ≤0.001). On the other hand tongue pressure on the palatal side of incisors was enhanced after incisor retraction (p=0.008) Comparing the differences between Angle's class I and class II malocclusion in mean pressure changes before and after incisor retraction revealed that the difference was not statistically significant on labial (p=0.58) or palatal side (p=0.28) of maxillary incisors. Reduced lip pressure and increased tongue pressure were observed after incisor retraction, whereas no significant change was seen in between the class I and class II cases. This signifies that orthodontic extraction affects the pressure changes on incisors and teeth do not remain in balance equilibrium at rest. Lip pressure, Tongue pressure, Orthodontic treatment, Flexiforce resistive sensor, Extraction, neutral zone.

EBD spotlight: The diagnostic accuracy of artificial intelligence in orthodontic extraction decisions

EBD spotlight: The diagnostic accuracy of artificial intelligence in orthodontic extraction decisions

Treatment planning protocols with the Invisalign appliance: an exploratory survey.

To investigate the changes made by orthodontists to the initial digital treatment plan (DTP) regarding the Invisalign appliance provided by Align Technology until acceptance of the plan by the orthodontist. The DTPs of subjects who underwent treatment with the Invisalign appliance and satisfied inclusion criteria were assessed to determine the number of DTPs and changes regarding prescription of aligners, composite resin (CR) attachments, and interproximal reduction (IPR) between the initial DTP and the accepted plan. Statistical analyses were calculated via GraphPad Prism 9.0 (GraphPad Software Inc., La Jolla, Calif). Most of the 431 subjects who satisfied inclusion/exclusion criteria were female (72.85%). More DTPs were required for subjects who had orthodontic extractions (median [interquartile range; IQR]: 4 [3, 5]) compared with those who did not (median [IQR]: 3 [2, 4], P < .0001). The median (IQR) overall number of aligners prescribed in the accepted DTP (30 [20, 39]) was greater than the initial DTP (30 [22,41], P < .001). The number of teeth used for CR attachments increased from the initial to the accepted DTP (P < .001). More CR attachments were observed in extraction treatment DTPs with a prescribed 2-week aligner change protocol compared with nonextraction treatment (P < .0001). The number of contact points with prescribed IPR increased between initial and accepted DTPs (P < .0001). Significant changes regarding DTP protocols were observed between the initial and accepted DTPs and between nonextraction and extraction-based CAT.

Effect of orthodontic treatment on the periapical radiolucency of endodontically treated teeth: a CBCT analysis

BackgroundThis study aimed to evaluate periapical radiolucency of endodontically treated teeth before and after orthodontic treatment using cone-beam computed tomography (CBCT).MethodsPatients who underwent orthodontic treatment at Wonkwang University Daejeon Dental Hospital between January 2009 and June 2022 were included based on the following criteria: root canal treatment, and availability of CBCT images taken before and after orthodontic treatment with an interval of > 1 year between both scans. Patients with primary teeth or orthodontic tooth extractions were excluded. The size of the periapical radiolucency (SPR) of the endodontically treated tooth was evaluated using CBCT. Pre-orthodontic treatment CBCT images and the latest post-orthodontic treatment CBCT images were analyzed. The selected teeth were further categorized based on the orthodontic duration, CBCT interval, the patient sex and age, the tooth type and position (maxilla or mandible), and quality of root canal obturation. Statistical analyses were performed to evaluate changes in SPR using the paired t-test and multiple regression analysis.ResultsIn total, 115 teeth (37 anterior teeth, 22 premolars and 56 molars) from 61 patients (age, 14–54 years) were included, with 39 teeth from male patients and 76 teeth from female patients. The age was ranged between 14 and 54 years old, and mean age was 25.87 years old. The mean CBCT interval and orthodontic treatment period were 43.32 months and 36.84 months, respectively. Seventy-five teeth showed good obturation quality, 80 were not used as anchors during orthodontic treatment, and 71 were maxillary. The SPR size increased after orthodontic treatment for 56 teeth and decreased for 59 cases. The average change in SPR was -0.102 mm and the difference was not significant. Significant decrease of SPR were observed between female patients (p = 0.036) and maxillary teeth (p = 0.040).ConclusionOrthodontic treatment had no significant impact on the changes in the SPR in endodontically treated teeth in most categories. However, there was a significant difference among females and the maxillary teeth. In both categories, the size of radiolucency decreased significantly.

Changes in the Vertical Dimension After Orthodontic Treatment in Response to Different Premolar Extraction Patterns.

Premolar extractions in orthodontics can relieve dental crowding and affect incisor inclination. The aim of this retrospective study was to compare changes to the facial vertical dimension after orthodontic treatment with different premolar extraction patterns and non-extraction treatment. This was a retrospective cohort study. The pre-and post-treatment records of patients with at least 5.0mm of dental arch crowding were accessed. Patients were divided into three groups: Group A, patients who had four first premolars extracted during their orthodontic treatment; Group B, patients who had four second premolars extracted during their orthodontic treatment; and Group C, patients with no extractions during orthodontic treatment. The pre-and post-treatment skeletal vertical dimension measured through the mandibular plane angle, as well as the incisor angulations/positions, were measured on lateral cephalograms and compared between groups. Descriptive statistics were computed and statistical significance was set at p<0.05. A one-way ANOVA test was conducted between groups to assess for statistically significant differences in changes to the mandibular plane angle and incisor positions/angulations. Post-hoc statistical analyses were performed between groups for parameters showing significant differences. One-hundred twenty-one patients were included (47 males and 74 females) with ages ranging from 9 years old to 26 years old. Mean upper dental crowding ranged from 6.0 to 7.3mm and mean lower crowding ranged from 5.9-7.4mm across groups. There were no significant differences in mean age, mean treatment length, or mean dental arch crowding in each arch across groups. There were no significant differences in changes to the mandibular plane angle across all three groups regardless of the extraction pattern or non-extraction during orthodontic treatment. The upper and lower incisors were significantly retracted in groups A and B and significantly protracted in group C post-treatment. The upper incisors retroclined significantly more in Group A than Group Band proclined significantly in Group C. No differences in the vertical dimension and the mandibular plane angle were observed when extracting first versus second premolars and in non-extraction treatment. Significant changes to the incisor inclinations/position were observed depending on the extraction/non-extraction pattern executed. Different premolar extraction patterns during orthodontic treatment do not influence changes to the vertical dimension. Clinicians should make extraction decisions based on desired outcomes for incisors rather than controlling the vertical dimension.

Treatment Effectiveness of Clear Aligners in Correcting Complicated and Severe Malocclusion Cases Compared to Fixed Orthodontic Appliances: A Systematic Review.

This systematic review aimed to critically assess the available evidence regarding the effectiveness and efficiency of clear aligners in the comprehensive treatment of complex cases accompanied by premolars extraction. An electronic literature search by two reviewers was independently done on 27 February 2023 in the following databases without time and language limitations: Pubmed®, Scoups®, Google Scholar, Cochrane Library database, Web of Science™, and Proquest Database Open. Randomized controlled trials (RCTs) of any type, non-randomized clinical trials (CCT), cohort studies, and prospective, retrospective, and cross-sectional studies were reviewed. The risk of bias in included studies was assessed using the Risk of Bias (RoB 2.0) tool for randomized trials and the Risk of Bias in Non-randomized Studies (ROBINS-I) tool for non-randomized studies. After carefully searching the literature, six trials were included in this systematic review, three RCTs, two retrospective cohort studies, and one CCT. Two hundred eighty-three patients were included (186 females, 97 males). Three studies found that there were no differences between the clear aligners and fixed appliances when evaluations were done using the American Board of Orthodontists Objective Grading System (ABO-OGS) or the Peer Assessment Rating (PAR) index. Two studies found that there were some differences between predicted and achieved tooth movements when clear aligners were used in premolars extraction cases. Based on the included studies, the duration of treatment was shorter with fixed appliances than the clear aligners when applied to orthodontic extraction cases. Both clear aligners and fixed appliances were found effective in the orthodontic treatment of premolar extraction-based cases. Fixed appliances have the advantage of achieving better buccolingual inclination and occlusal contacts in a shorter treatment duration. Treatment with clear aligners might be associated with differences between predicted and achieved tooth movements. Therefore, the characteristics of these techniques should be considered when making a treatment decision.

Efficacy of Sodium Bicarbonate-Buffered Local Anesthetic Solution in Cases Requiring Bilateral Maxillary Premolar Orthodontic Extraction: A Comparative Split-Mouth Study.

Aims and objectives This study was carried out to evaluate the efficacy of 8.4% sodium bicarbonate-buffered local anesthetic solution and conventional local anesthetic in patients requiring bilateral maxillary orthodontic extractions in terms of pain on injection, onset of action, and duration of action. Methods 102 patients requiring bilateral maxillary orthodontic extractions were included in the study. Buffered local anesthetic was administered on one side while conventional local anesthesia (LA) was administered on the other side. Pain on injection was measured using a visual analogue scale, while onset of action was measured by probing the buccal mucosa after 30 seconds of administration and duration of action was measured by the time after which the patient experienced pain or took a rescue analgesic. The data was statistically analyzed to determine the significance. Results The pain during injection was found to be lesser at sites where buffered local anesthetic was administered (mean visual analogue scale (VAS) score = 2.4) as compared to conventional local anesthetic(mean VAS score = 3.9). The onset of action was faster with buffered local anesthetic(mean value = 62.3 seconds) as compared to conventional local anesthetic (mean value = 157.16 seconds). Lastly, the duration of action was found to be longer for buffered local anesthetic group (mean value = 225.65 minutes) as compared to conventional local anesthetic (mean value = 187 minutes). Conclusion 8.4% sodium bicarbonate-buffered local anesthetic was found to be more efficient than conventional local anesthetic in terms of reduction in pain on injection as well as faster onset and longer duration of action.

Efficacy of Transdermal Ketoprofen Patch in Comparison to Transdermal Diclofenac Patch in Postoperative Analgesia for Orthodontic Extractions: A Randomized Split-Mouth Study.

Introduction Non-steroidal anti-inflammatory drugs (NSAIDs) are the most prescribed analgesics for controlling post-exodontia pain, administered by various routes. The transdermal route possesses the advantages of providing sustained release of the drug, being non-invasive, bypassing first-pass metabolism, and eliminating gastrointestinal adverse effects. This study compared the analgesic efficacy of diclofenac 200 mg and ketoprofen 30 mg transdermal patches for post-orthodontic exodontia pain. Materials and methods Thirty patients who underwent orthodontic bilateral maxillary and/or mandibular premolar extractions under local anaesthesia were included in the study. Each patient received single transdermal diclofenac 200 mg patch and single transdermal ketoprofen 30 mg patch on the outer, ipsilateral upper arm immediately post-extraction in the two appointments in random order. The pain score was recorded every second hourly for the first 24 hours postoperatively using a visual analog scale (VAS). The requirement of rescue analgesics at various time points and the total number of rescue analgesics taken in the first 24 hours postoperatively were noted. Any allergic reaction to the transdermal patches was also recorded. Results The analgesic efficacy of the two transdermal patches at any given time point in 24 hours by Mann-Whitney U test showed no statistically significant (p<0.05) difference. An overall intragroup statistically significant difference (p<0.05), by Wilcoxon matched pairs test, was found by comparison of VAS pain scores at different time points to that at 0-2 hours after application of transdermal ketoprofen and diclofenac patches, respectively. The mean maximum pain intensity was slightly lower for ketoprofen (2.33) than diclofenac (2.60) transdermal patch. Patients consumed the rescue analgesic within the first 12 hours postoperatively, with the mean value of the total number of rescue analgesics taken with ketoprofen transdermal patch (0.23) slightly lower than diclofenac transdermal patch (0.27) application. Conclusion Ketoprofen and diclofenac transdermal patches provide similar analgesia post orthodontic extraction. The patients required rescue analgesics only during the initial hours of the postoperative follow-up period.

Efficacy of Localised Application of Tranexemic Acid and Mefenamic Acid Tablet Powder in Extraction Sockets for Control of Post Extraction Bleeding and Pain in Dental Practise

Background: Post extraction bleeding and pain are two common complications in routine dental practice .There are no studies in which Tranexamic acid and Mefenamic acid combination powder is used locally to control post extraction bleeding and pain.&#x0D; Methodology: This study was conducted in 18 patients indicated for orthodontic extraction of mandibular first premolar and right side was the study side in which pre crushed TRANSET MF powder was placed and compared to the left side which was the control side .Post extraction bleeding immediately and 30 min post extraction was compared along with pain using VAS pain scale on 1,2,3,7 th day post extraction.&#x0D; Results: There was statistically significant difference in time of post extraction bleeding between study side (less time) and the control side .There is statistically significant difference in pain scale; less pain perceived in the study side than the control side.&#x0D; Conclusion: This study is the first one to evaluate the efficacy of crushed TRANSET MF Tablet Powder in post extraction sockets and has shown significant results in reducing post extraction pain and bleeding with no local and systemic side effects .Hence this will be a simple and cost effective technique that can reduce both post extraction bleeding and pain.

Effect of orthodontic extraction of mandibular premolars on third molar angulation after treatment with fixed appliances : Across-sectional study.

Orthodontic treatment involving premolar extractions might improve the angulation of lower third molars, which are the teeth most often impacted. This study analyzes the impact of first/second lower premolar extraction during orthodontic therapy on the angulation of mandibular third molars. A total of 120patients treated non-extraction (n = 40), with extraction of first (n = 40), or second lower premolars (n = 40) were included. The mesiodistal angulation of lower third molars relative to the adjacent tooth and their developmental stage were evaluated from posttreatment orthopantomograms. Between-group differences were statistically evaluated at asignificance level of 0.05. The orthopantomograms of 120patients (51% female) with amedian age of 15.2years at the time of debonding were evaluated after amean treatment duration time of 2.9years. No difference (P > 0.05) was seen between the average angulation of the lower third molars of the right (mean = 24.4°, standard deviation [SD] 13.6°) and the left side (mean = 23.6°, SD 14.1°). No differences in the angulation of the lower third molar were found between the non-extraction and extraction groups for the right (P = 0.44) or the left side (P = 0.22). Likewise, no differences were found when comparing the first and second premolars for the right (P = 0.26) or the left side (P = 0.10). Premolar extraction was associated with an advanced root development stage of the right third molar (odds ratio 7.1; 95% confidence interval 1.1-48.1; P = 0.04), with no differences between extraction of the first or second premolar (P = 0.10). Orthodontic treatment involving premolars extractions might be associated with asmall acceleration in root development, but not with the angulation, of lower third molars.