Kinesio taping (KT) is used after mandibular third-molar surgery, yet its benefits and time course remain uncertain. We evaluated whether KT reduces pain, swelling, and trismus versus no tape. PRISMA-2020–conform systematic review and meta-analysis (PROSPERO CRD420251072421). Seven databases (PubMed, Embase.com, Scopus, Web of Science Core Collection, CENTRAL, ScienceDirect, Cochrane Library) plus grey literature were searched from inception to 19 May 2025. Eligible studies were adult randomized trials (parallel or split-mouth) under local anaesthesia; KT (≥10% stretch) was applied within 1 h of closure. Outcomes were pain on VAS immediately and days 2–7; swelling; maximum inter-incisal opening; rescue-analgesic intake; skin reactions; and global improvement. Effects were pooled as mean differences (MD) or Hedges g standardized mean differences (SMD) using REML random-effects with inverse-variance weighting and Hartung–Knapp; heterogeneity used I². Risk of bias used RoB-2. Publication bias used a 24-h funnel plot, Egger’s test (α=0.10), and trim-and-fill. Sensitivity analyses were leave-one-out. Certainty used GRADE. Thirteen randomized trials (2019–2025; n=646) were included; overall risk of bias was high. Pain favoured KT early: SMD −0.88 (95% CI −1.11 to −0.65) at 24 h and −0.91 (−1.33 to −0.50) at 48 h; at day 4 the reduction was uniform (I²=0%) with MD −1.94 (−2.56 to −1.32). By day 7, pain was small and uncertain: SMD −0.66 (−1.48 to 0.15; I²=93%). Swelling showed a small week-one benefit: SMD −0.42 (−0.75 to −0.09; I²=46%). Trismus improved mid-week in single studies (day-4 MD 13.60 mm [10.46 to 16.74]; day-5 MD 5.00 mm [2.56 to 7.44]); pooled day-7 SMD 0.42 (−0.19 to 1.02; I²=83%). Egger’s tests were non-significant except trismus at 2 days (p=0.0003); trim-and-fill imputed zero studies. Early pain findings were robust to leave-one-out. GRADE rated day-7 pain, swelling, and trismus as very low certainty. KT yields large early analgesia, a small week-one swelling reduction, and mid-week opening gains chiefly from single studies; interpretation is limited by high bias risk, heterogeneity, variable measurement, and ≤7-day follow-up. KT may be offered as an adjunct for early symptom control after third-molar extraction; by day 7 effects are small and uncertain.

Predictive factors in tomographic imaging for inferior alveolar nerve injury during third-molar surgery: A systematic review and meta-analysis.

AIM: This study aims to develop and externally validate machine-learning models that effectively predict the risk and severity of postoperative symptoms one week following mandibular third molar extractions. METHODS: This retrospective cohort study included 321 patients (18–35 years old) who underwent lower third-molar surgery. Demographics, Pell–Gregory vertical (PGV) and Pell-Gregory level (PGL) classifications, surgical variables, and day-7 pain visual analogue scale (VAS) were recorded for all participants. The data were randomly divided into training (70%) and validation (30%) datasets. Five machine-learning algorithms—Gradient Boosting Machine (GBM), Extreme Gradient Boosting (XGBoost), Random Forest (RF), Decision Tree (DT), and Neural Network (NNET)—were developed using nested cross-validation. Model performance was assessed through area under the receiver operating characteristic (AUROC) values, Brier scores, and calibration slopes, with a nomogram constructed from the best-performing model. RESULTS: GBM achieved the highest discrimination on the validation dataset with an AUROC of 0.687 (95% CI, 0.624–0.744), followed by the Neural Network (AUROC = 0.677). The GBM model yielded a calibration slope of 0.98 and a Brier score of 0.225, indicating excellent predictive accuracy. However, the top six predictors were found to be operative time, mouth opening, PGV, PGL, smoking, and preoperative symptoms. The GBM model, which underlies the nomogram, achieved an area under the curve (AUC) value of 0.666, indicating its discrimination capability. Additionally, the calibration curve confirmed the model's accuracy, and the decision curve analysis (DCA) suggested that the nomogram provides clinically promising potential for effective risk stratification. CONCLUSIONS: A GBM-based nomogram provides moderate yet clinically useful discrimination for healthy adults aged 18–35 years at risk for severe early symptoms after third-molar extraction. However, this approach requires external validation in older or medically complex patients before it is recommended for clinical predictions.

Postoperative pain, swelling, and transient trismus commonly follow impacted mandibular third-molar surgery. Hyaluronic acid (HA) can modulate early inflammation and support soft-tissue repair, while polynucleotides (PN) may further enhance fibroblast activity. This study evaluated whether an intrasocket PN-HA gel improves early postoperative outcomes versus standard care. Single-center, retrospective split-mouth study in adults undergoing bilateral removal of partially impacted mandibular third molars. One socket received PN-HA gel (Regenfast © , 5mL) before suturing (TG), the contralateral socket received no adjunct (CG). Outcomes: pain (VAS 0-10) at 12 hours and daily for 7 days; maximum interincisal distance on 2, 5, and 7 postoperative days (POD); facial swelling from standardized 3D facial scans at baseline, POD2, POD5, and POD7. Parametric analyses used paired tests and one-way ANOVA with Tukey post hoc; Pearson correlations assessed relations among pain, swelling, and mouth opening. Eighteen patients completed follow-up without complications. Operative time was comparable between allocations. Pain peaked at approximately 12 hours and was lower on test sides during the early window, with differences diminishing by POD5-7. Swelling increases were smaller on test sides at POD2 and POD5 and converged by POD7. MID recovered faster on test sides at POD2 and POD5, approaching baseline in both groups by POD7. Correlations reflected expected dynamics: higher pain was associated with greater swelling and reduced mouth opening, most pronounced around the inflammatory peak. Intrasocket PN-HA gel reduced early pain and swelling and hastened mouth-opening recovery (greatest at 48-72h, converging by 1week), indicating clinical utility for reducing short-term morbidity after third-molar surgery.

To evaluate whether Er: YAG surgery and Nd: YAG-based low-level laser therapy (LLLT), combined with medical collagen, improve early postoperative outcomes after extraction of impacted mandibular third molars.Adults undergoing surgical removal of mesioangular or horizontal impacted mandibular third molars were randomized equally (1:1:1:1) to blank control (BCG), collagen only (COL), lasers only (LAS), or collagen plus lasers (COL + LAS). Primary endpoints were pain (VAS; spontaneous and swallowing; POD1/3/7), swelling (POD1/3/7), trismus (POD1/3/7), and early mucosal healing (POD3/7). Secondary endpoints were bleeding (30min post-extraction only), cutaneous induration/ecchymosis (POD7), alveolar osteitis (POD3/7), and local cytokines (IL-1β, IL-6, TNF-α; POD3/7).In 120 patients, COL + LAS was superior: less pain, swelling, and trismus at POD1/3 and higher early mucosal-healing rates at POD3/7 than BCG, COL, or LAS; by POD7, between-group differences in pain, swelling, and trismus were minimal. All active arms reduced 30-min bleeding versus BCG. At POD7, cutaneous induration was lowest with COL + LAS (ecchymosis not significant). Cytokines declined overall; IL-1β and TNF-α were lowest with COL + LAS at POD3/7, whereas IL-6 decreased similarly across active arms.Er: YAG surgery plus Nd: YAG-based LLLT with medical collagen improved short-term recovery after impacted mandibular third-molar surgery.

ABSTRACT Surgery for impacted mandibular third molars is one of the most common interventions and is associated with the risk of inferior alveolar nerve (IAN) injury. Coronectomy emerges as a conservative alternative, consisting of removing the tooth crown while preserving the root fragments, with the aim of reducing neurosensory complications. This technique has been increasingly studied due to its ability to minimize iatrogenic injuries, especially in cases where radiographic proximity between the root and mandibular canal indicates a high risk. The objective of this article is to review the recent literature on coronectomy, highlighting its indications, contraindications, clinical outcomes, and main complications, as well as to evaluate evidence related to root migration, infection, fragment exposure, and the need for reintervention. In this study, it was observed that coronectomy has a lower incidence of paresthesia compared to complete extraction, with factors such as age, bone density, and surgeon experience determining the success of the procedure. Standardized surgical protocols, clinical and radiographic monitoring, and the use of cone-beam computed tomography increase the safety and predictability of results. Despite possible complications, the technique demonstrates significant benefits for the patient’s quality of life and neurosensory function. The conclusion indicates that coronectomy is a safe and effective option for selected cases, provided it is performed with adequate planning, strict indication criteria, and systematic follow-up, constituting a conservative and evidence-based approach for preserving the IAN. Keywords: Coronectomy; third molar; nerves; injury; third molar surgery; postoperative complications.

BackgroundAnxiety during oral surgery adversely affects patients’ compliance with treatment and patient–doctor cooperation. Therefore, various treatment protocols have been developed to reduce anxiety. This study aimed to evaluate the effects of music and white noise on patients’ anxiety and pain during surgery for impacted third molars. MethodsAccording to the Consolidated Standards of Reporting Trials statement, this single-blind, randomized, controlled trial with parallel groups involved 66 patients who met the eligibility criteria and were randomly assigned to one of three groups. Group 1 listened to preselected songs played against a pre-prepared standard “white noise” through noise-isolating headphones that block ambient noise during the procedure. Group 2 listened only to music through noise-isolating headphones during the procedure. Group 3 listened to natural ambient noise during the procedure. All surgical procedures were performed in a standard operating room. All patients completed the State-Trait Anxiety Inventory-State (STAI-S) form and indicated their anxiety on a Visual Analog Scale (VAS) preoperatively and postoperatively. They also indicated the pressure/pain level they felt during the procedure on a VAS. The primary predictor variable was the music and white noise intervention. The primary outcome variables were the STAI-S and VAS scores. Sex was included as a covariate.ResultsAnxiety VAS scores were significantly lower postoperatively than preoperatively in Groups 1 (p < 0.001), 2 (p < 0.001), and 3 (p = 0.002). Similarly, STAI-S scores were significantly lower postoperatively than preoperatively in Groups 1 (p < 0.001), 2 (p < 0.001), and 3 (p = 0.012). The change in STAI-S scores (p = 0.053) did not differ significantly between groups.ConclusionAlthough not statistically significant, listening to music alone or with white noise reduced the anxiety experienced by patients during the procedure and increased their comfort. As a simple, inexpensive, and non-invasive method, listening to self-selected music in the preoperative and perioperative periods could benefit patients.

PROPHYLACTIC ANTIBIOTIC USE IN LOWER THIRD MOLAR SURGERY MAY REDUCE DRY SOCKET AND INFECTIONS, BUT EVIDENCE REMAINS WEAK.

Aromatherapy on Anxiety, Pain, and Quality of Life Following Surgery of Mandibular Third Molars: A Randomized, Double-Blind Clinical Trial.

Impacted third molar extraction is a common surgical procedure performed by oral and maxillofacial surgeons, often requiring effective wound closure techniques. Conventional sutures have been widely used; however, knotless sutures have emerged as an alternative method, potentially offering faster wound closure and reduced post-operative complications. This study evaluates the effectiveness of knotless sutures as a wound closure agent compared to conventional sutures in impacted third-molar surgeries in the Pakistani population. Objective: To compare the outcomes of knotless sutures versus conventional sutures regarding wound closure time and post-operative swelling in impacted third-molar surgeries. Methods: A randomized controlled trial was conducted at the Department of Oral &amp; Maxillofacial Surgery, Dr. Ishrat Ul Ebad Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan. 72 patients undergoing impacted third molar extraction were randomly allocated into Group A (knotless sutures) and Group B (conventional sutures), with 36 patients in each group. Primary outcomes included wound closure time (measured in minutes) and post-operative swelling (measured in millimeters) at 1-hour and 72-hour intervals. Data were analyzed using SPSS version 23, and statistical significance was set at p≤0.05. Results: The mean age of participants was 26.14 ± 4.66 years in Group A and 24.50 ± 4.39 years in Group B. Mean wound closure time in Group A was significantly lower (2.78 ± 0.90 minutes) compared to Group B (4.47 ± 1.30 minutes, p=0.0001). Swelling at 1 hour post-operatively was significantly lower in Group A (42.69 ± 4.82 mm) than in Group B (46.22 ± 4.46 mm, p=0.002). Similarly, at 72 hours, swelling was lower in Group A (34.75 ± 4.80 mm) compared to Group B (40.80 ± 6.56 mm, p=0.0001). Conclusion: Knotless sutures improved wound closure efficiency and reduced post-operative swelling compared to conventional sutures in impacted third-molar surgeries. These findings support adopting knotless suturing techniques in oral surgical procedures to enhance clinical outcomes and patient comfort.

Objectives:The aim of this work is to evaluate the possibility that the three-dimensional (3D) reconstruction of a cone beam computed tomography (CBCT) scan may facilitate the technical planning of the surgical extraction of third molars, whose roots are located in proximity of or in contact with the inferior alveolar nerve.Materials and Methods:This article describes the planning process and the extraction of a lower third molar with the inferior alveolar nerve (IAN) entrapped through its roots using the 3D reconstruction of a CBCT scan.Results:After-surgery clinical examinations showed normal healing of the surgical wound and no neurological symptoms.Conclusions:The 3D reprocessing of a CBCT allows the construction of a computer-aided design model to investigate the spatial relationships between the wisdom tooth and the IAN. This method makes it possible to reconstruct a virtual model to preview the tooth and its spatial relationships, simplifying the mental processes of reworking and analyzing the existing relationships in the area, an important aid, especially in cases that are difficult to diagnose with a first-level examination. Indeed, it helps in reducing the risk of intra-operative injury to the nerve during extraction procedures.

The use of ozone in medicine and dentistry is well-supported in the scientific literature, particularly for its antibacterial, antiviral, anti-inflammatory, and anti-edema effects. These benefits are achieved through reductions in pro-inflammatory substances, stimulation of neoangiogenesis, and enhanced production of antioxidant enzymes. Additionally, ozone is pain-relieving by inactivating algogenic mediators and inducing endorphin release. Although ozone application devices are standard in conventional medicine, they are less so in dentistry and often have reduced performance. This study aims to evaluate the effectiveness of a specific ozone therapy device in managing postoperative pain and promoting healing in patients undergoing impacted third-molar extractions. Materials and methods: Patients scheduled for the extraction of impacted third molars were enrolled in a randomized split-mouth study to receive either ozone therapy or conventional antibiotic treatment. The Visual Analog Scale (VAS) assessed pain intensity and healing progress. Results: Patients treated with ozone therapy reported significantly lower pain levels and demonstrated qualitatively improved healing compared to the control group, with statistical significance. Conclusions: The study supports the use of ozone therapy in routine dental surgical practice, highlighting its favorable cost/benefit profile. Ozone therapy can be beneficial for impacted third-molar surgeries and broader applications in oral surgery. Keywords: Ozone therapy in dentistry, OZONE DTA equipment, Third molar extraction and soft tissue healing.

The use of ozone in medicine and dentistry is well-supported in the scientific literature, particularly for its antibacterial, antiviral, anti-inflammatory, and anti-edema effects. These benefits are achieved through reductions in pro-inflammatory substances, stimulation of neoangiogenesis, and enhanced production of antioxidant enzymes. Additionally, ozone is pain-relieving by inactivating algogenic mediators and inducing endorphin release. Although ozone application devices are standard in conventional medicine, they are less so in dentistry and often have reduced performance. This study aims to evaluate the effectiveness of a specific ozone therapy device in managing postoperative pain and promoting healing in patients undergoing impacted third-molar extractions. Materials and methods: Patients scheduled for the extraction of impacted third molars were enrolled in a randomized split-mouth study to receive either ozone therapy or conventional antibiotic treatment. The Visual Analog Scale (VAS) assessed pain intensity and healing progress. Results: Patients treated with ozone therapy reported significantly lower pain levels and demonstrated qualitatively improved healing compared to the control group, with statistical significance. Conclusions: The study supports the use of ozone therapy in routine dental surgical practice, highlighting its favorable cost/benefit profile. Ozone therapy can be beneficial for impacted third-molar surgeries and broader applications in oral surgery. Keywords: Ozone therapy in dentistry, OZONE DTA equipment, Third molar extraction and soft tissue healing.

repair are examined, highlighting the importance of the blood clot and its adverse effects, from its malformation to its loss. The study covers risk factors, diagnosis, symptoms and prevention of these complications, emphasizing that infections can manifest up to 30 days after surgery. Although uncommon, these infections are seen as the main reason for delayed healing after surgery. The classification of third molar removal surgery as contamination is debated in relation to the incidence of infections, highlighting the importance of care and operative technique compared to the prophylactic administration of antibiotics. Specific guidelines are demonstrated for patients with compromised immune systems. The content develops prevention strategies, including decontamination, use of sterile materials, drug therapy, cleaning and debridement of surgical wounds in order to treat and prevent such infections. It stresses that the use of antibiotics is not justified by the absence of biosafety precautions and emphasizes the essentiality of maintaining the aseptic chain for successful treatment. This research aims to contribute to a more in-depth understanding of post-operative complications in third molar extractions, providing a preventative and effective approach to dental surgery.

Preemptive analgesia is an analgesic intervention to influence postoperative pain sensation. Control of postoperative pain is a major challenge for any surgeon. Adequate control of postoperative pain continues to be a challenge for modern medicine. The advent of artificial intelligence (AI) in all spheres of life, including medicine, has created the technical ability to process a variety of types and characteristics of data related to many diseases. The application of artificial neural networks in medical science has made it possible to obtain an independent, objective assessment as a consequence of the application of preemptive analgesia. The data analysis by our original model, compared with the routinely used statistical methods, show the presence of a tendency for a positive effect of preemptive analgesia. In order to obtain an efficient self-learning neural network, it is necessary to use large arrays of properly selected data that fulfill the role of input parameters for the neural network. The results obtained from the original model used are comparable to the traditionally used statistical methods. This model objectifies to a certain extent the preemptive analgesia in the surgery of third mandibular molars.

Aim: To examine whether there is a correlation between blood pressure, heart rate, and pain with the level of preoperative and postoperative anxiety in surgery of impacted third molars under local anesthesia. Subjects and Methods: In the study, which included adult patients of both sexes with an indication for surgical extraction of impacted third molars, research parameters were measured as follows: 1st measurement (day of examination) - blood pressure, heart rate, preoperative anxiety with Spielberger’s State-Trait Anxiety Inventory (STAI); 2nd measurement (immediately before the intervention) - blood pressure, heart rate, preoperative anxiety with STAI; 3rd measurement (day after intervention) - blood pressure, heart rate, postoperative anxiety with STAI, postoperative pain with visual analog scale. Results: The values of preoperative and postoperative anxiety and the measured parameters of blood pressure, heart rate, and postoperative pain were statistically significantly positively correlated with each other during all measurements. Conclusion: In order to increase the satisfaction of both the patient and the ordinarius, and to prevent possible complications in this type of oral surgical intervention, it would be useful to consider adequate therapy in order to prevent the development of anxiety, considering the confirmed correlation with the measured parameters.

Effectiveness of wearing glasses with green lenses on dental anxiety for third-molar surgery: A randomized clinical trial

Is ChatGPT a reliable source of scientific information regarding third-molar surgery?

PREEMPTIVE INTRAVENOUS IBUPROFEN AND LOCAL KETAMINE IMPROVE POSTOPERATIVE ANALGESIA FOLLOWING THIRD MOLAR SURGERY: A DOUBLE-BLIND, RANDOMIZED, PLACEBO-CONTROLLED CLINICAL STUDY

Background Third-molar surgeries are very commonly done by oral and maxillofacial surgeons. Pain and swelling that is associated with this procedure is a frequent reason for the patient's discomfort and apprehension. There is a need to look for a drug that can substantially reduce postoperative swelling amongst the patients. Pain, swelling, and trismus are common complications that are encountered after third molar surgery. These complications have a major impact on the quality of life of patients undergoing minor surgical procedures. Aim The aim of this study was to compare the effectiveness of coumarin and trypsin/chymotrypsinin the reduction of postoperative sequelae for mandibular third molar surgeries. Materials and methods The research was carried out at Saveetha Dental College and Hospital in the Department of Oral and Maxillofacial Surgery. The study consisted of 50 individuals, 25 individuals received tablets of coumarin, and 25 individuals received tablets containing a combination of trypsin/chymotrypsin postoperatively. Patients were evaluated postoperatively for pain and swelling. Postoperative pain was measured on days one, three, and seven after surgery using a visual analog scale.The postoperative swelling was measured on postoperative days three and day seven via a four-point technique.Data were analyzed using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States). P-values less than 0.05 were considered statistically significant. The independent samples t-test was used to compare the outcomes between the two groups. Results It was found that study participants in the trypsin/chymotrypsin group reported statistically significantlyless pain postoperatively than participants receiving coumarin (p=0.001). There was more reduction in swelling postoperatively in patients who were given trypsin/chymotrypsin as compared to the participants who were given coumarin, and the results were statistically significant. Conclusion Based on the data obtained, it can be inferred that the trypsin/chymotrypsin combination was more effective in reducing postoperative sequelae like pain and swelling than coumarin in the mandibular third molar surgeries.