Effectiveness of Drainage in Mandibular Third Molar Surgery: A Systematic Review and Meta-Analysis

Liu, Shaopeng; You, Zhu; Ma, Chuan; Wang, Ye; Zhao, Hongxia

doi:10.1016/j.joms.2018.03.004

Cited by 14 publications

(21 citation statements)

References 29 publications

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“…In the novel approach, a partial-thickness flap is removed and the wound heals through open follow-up care; sutures are absent. Indeed, a recent study highlighted that surgical drainage has a positive effect on postoperative reactions after the removal of Ms3 [27,28], and in a pioneering work, Pajarola and Sailer [29] concluded that an open wound healing method after surgical removal of Ms3 is advocated. Lastly, the possible clinical feasibility of using the FSA is also validated by a considerable reduction in surgery time, which improves the patient's comfort.…”

Section: Discussionmentioning

confidence: 99%

Flapless Surgical Approach to Extract Impacted Inferior Third Molars: A Retrospective Clinical Study

Materni

Angelis

Tullio

et al. 2021

JCM

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This study aimed to compare a flapless surgical approach (FSA) with a traditional envelope flap (traditional approach (TA)). Every patient was treated with two approaches: TA and FSA. The primary outcome variables were both the discomfort during the post-operative convalescence and the correct final recovery of the impacted area. The secondary outcome variable was the average duration of the surgery. Post-operative pain and oedema were recorded. The measurements of soft tissue interface toward the distobuccal edge of the second molar were taken by periodontal probe before surgery (baseline) and 8 weeks after surgery. Statistical software was used to evaluate the data; a p-value < 0.05 was considered statistically significant. Twenty-four teeth of 12 patients (six Caucasian males and six Caucasian females, aged 23 ± 4 (17–30) years) with both lower impacted third molars (Ms3) were analysed. Considering an alpha error 0.05 that sample size allows power from 0.80 to 0.90, depending on the variable evaluated. Concerning attached gingiva, oedema and pain, the linear mixed model resulted in a statistically significant difference between the TA and FSA (p = 0.003; p < 0.01; and p = 0.018, respectively). Conversely, the model did not show a difference (p = 0.322) if pocket probing depth was considered. The FSA procedure was faster (p < 0.05) than the TA procedure (17 min and 8 s (± 6 s) vs. 28 min and 6 s (± 4 s), respectively). The results suggest that the FSA could be a suitable option for improving the surgical removal of lower Ms3. However, additional randomized controlled trial studies are necessary to confirm the reliability of our procedure and to verify its suitability in more complex Ms3 classifications.

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Section: Discussionmentioning

confidence: 99%

Flapless Surgical Approach to Extract Impacted Inferior Third Molars: A Retrospective Clinical Study

Materni

Angelis

Tullio

et al. 2021

JCM

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“…Wound healing by secondary intention and administration of an alveolar iodine-containing tampon in the postoperative extraction socket is a form of surgical drainage. Over the past three decades, multiple studies have examined the administration of various foreign agents in a post-extraction socket [14][15][16][17] and have evaluated how these agents impact the degrees of pain, swelling, trismus, and chewing problems. Additionally, several prior studies have evaluated the effects of surgical drainage on wound healing, postoperative sequelae, and pain.…”

Section: Discussionmentioning

confidence: 99%

“…Different studies have reported a beneficial effect of a locally applied gauze drain after the surgical removal of a mandibular third molar on alveolar osteitis, pain, and swelling [14][15][16][17]. In a recent cross-over design study of our research group, we found that insertion of an iodinecontaining tampon into the extraction alveolus had a positive effect on oral health-related quality of life (OHRQoL), pain, trismus, and several self-care behaviors during the first postoperative week after surgical removal of a mandibular third molar [8].…”

Section: Introductionmentioning

confidence: 99%

Alveolar iodine tampon packing after impacted third molar surgery improves oral health–related quality of life and postoperative sequela: a randomized study

Lindeboom

Tuk

Möllenkamp

et al. 2020

Oral Maxillofac Surg

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Objective The aim of this study was to evaluate the effect of an iodine tampon on postoperative discomfort after surgical removal of a mandibular third molar. Material and methods Patients were randomly assigned to two groups: one group received an alveolar iodine-containing tampon in the extraction socket (N = 44), and the other group used a disposable syringe (Monoject®) to rinse the wound (N = 43). Postoperative discomfort was assessed with the Oral Health Impact Profile-14 (OHIP-14) questionnaire, Pain Intensity Numerical Rating Scale (PI-NRS), and questions about self-care and discomfort. Results This study included 87 patients (52 women and 35 men) with an average age of 26.47 years (SD, 6.36). The mean OHIP-14 sum scores were significantly lower in the iodine tampon group compared with the Monoject® syringe group. Mean PI-NRS scores significantly differed between the iodine tampon group (3.33; SE, 0.27) and Monoject® syringe group (4.46; SE, 0.27) (F (1, 85) = 8.16, p < 0.01), with no interaction effect between time and PI-NRS (F (6, 510) = 1.26, p = 0.28). Patients in the iodine tampon group reported less postoperative discomfort. Conclusions Insertion of an iodine-containing tampon in the postoperative socket reduced the pain and impact on oral healthrelated quality of life during the first postoperative week and positively influenced postoperative sequelae.

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“…Third molar removal is often related to pain, swelling, and trismus, and how to minimize the postoperative discomfort remains controversial. A meta‐analysis by Liu, You, Ma, Wang, and Zhao (2018) evaluated the effectiveness of surgical drainage for managing postoperative pain, facial swelling, and trismus 2–3 days (early stage) and 5–7 days (late stage) after lower third molar removal. They concluded that the pain during the early stage could be reduced by surgical drainage, but not in the late stage.…”

Section: Complicationsmentioning

confidence: 99%

“…For facial swelling, tube drainage showed better results than rubber and gauze drainage. In terms of pain, the rubber drain resulted in a better outcome than tube and gauze drains that have to be sutured to the mucosa (Liu et al, 2018).…”

Section: Complicationsmentioning

confidence: 99%

Comprehensive review of lower third molar management: A guide for improved informed consent

et al. 2020

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Lower third molar removal is the most commonly performed dental surgical procedure. Nevertheless, it is difficult to ensure that all the informed consent forms given to patients are based on the best evidence as many newer publications could change the conclusions of previous research. Therefore, the goal of this review article is to cover existing meta‐analyses, randomized control trials, and related articles in order to collect data for improved and more current informed consent.

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Effectiveness of Drainage in Mandibular Third Molar Surgery: A Systematic Review and Meta-Analysis

Cited by 14 publications

References 29 publications

Flapless Surgical Approach to Extract Impacted Inferior Third Molars: A Retrospective Clinical Study

Flapless Surgical Approach to Extract Impacted Inferior Third Molars: A Retrospective Clinical Study

Alveolar iodine tampon packing after impacted third molar surgery improves oral health–related quality of life and postoperative sequela: a randomized study

Comprehensive review of lower third molar management: A guide for improved informed consent

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