RADIOGRAPHIC ASSESSMENT OF THE COURSE AND VISIBILITY OF THE MANDIBULAR CANAL BY PANORAMIC RADIOGRAPHY

Background and Objectives:  The mandibular canal is a canal inside the mandible that contains the inferior alveolar artery, the inferior alveolar nerve and the inferior alveolar vein. The anatomy and variations of the human mandible are very important for planning various surgical measures such as extraction of the third molar, dental implants and mandibular reconstruction. This study was conducted to determine the frequency of the different courses of the mandibular canal  and to investigate the visibility of the mandibular canal by panoramic radiography, among a sample of Yemeni adults. Subjects and Methods: A retrospective cross-sectional study was conducted in Sana'a city on a sample of Yemeni adults. The study consisted of panoramic radiographs of 928 patients; the number of males was 340 (36.6%) and 588 females (63.4%). The mandibular canal course, as shown in the panoramic radiographs, was classified into four types: elliptical, linear, turning curves and spoon-shaped. The visibility of this canal from the first to the third molar region was assessed through visual determination of whether the lower canal was clearly visible, possibly visible, or invisible. Results:   Elliptical curves were the most observed along the mandibular canal course at 62.2% of the total, followed by the linear curve (24.8%) while the lower rate curve spoon (7.9%) and the turning curve (5.2%). There were no statistically considerable differences between the distribution of the mandibular canal courses between males and females except in the spoon curve where the ratio was 10.8% in males versus 6.1% in females (p <0.05). The percentage of clearly visible mandibular canals was the highest among the spoon-shaped curves (49.9% in the first molar, 63% in the second, 78.1% in the third molar) and the lowest among the linear curves (10.9% in the first, 18.7% in the second and 33.5% in the third molar). On panoramic radiographs, the invisible mandibular canals are found in 198 (21.3%) of the examined sites in the first molar region, in 85 (11%) in the second molar region, and in only 6 (0.64%) in the third molar region. Conclusion:  It was observed that elliptical curves along the path of the mandibular canal were the most present, while a decrease in the ratio of the two types of spoon curve and turning curve was observed. It was found that spoon curve was significantly more common among males than females. It was also found that the visibility of  madibular canal is fewer in the first molar region than in the third molar region.                Peer Review History: Received: 21 September 2020; Revised: 8 October; Accepted: 29 October, Available online: 15 November 2020 Academic Editor: Dr. Sally A. El-Zahaby, Pharos University in Alexandria, Egypt, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Dr. Sunita Singh, Baylor College of Medicine, Houston, Texas, USA, [email protected] Dr. Ali Abdullah A. Al-Mehdar, Thamar University, Yemen,  [email protected] Similar Articles: BIOFILM FORMATION AND ANTIBIOTIC SUSCEPTIBILITY OF UROPATHOGENS IN PATIENTS WITH CATHETER ASSOCIATED URINARY TRACT INFECTIONS IN IBB CITY -YEME

KNOWLEDGE AND PERCEPTION OF MOLAR INCISOR HYPOMINERALIZATION AMONG DENTAL PRACTITIONERS IN SANA’A CITY- YEMEN

Background: Molar incisor hypomineralization (MIH) has been recognized as a global dental disorder and concern about this pathology is growing among clinicians around the world. Objectives: This study aimed to investigate the knowledge and perception of Yemeni dental practitioners in the city of Sana'a in relation to diagnosis, etiological factors and management of MIH. Materials and Methods: A questionnaire modified from similar previous studies was distributed to 311 Yemeni dentists providing oral health care in Sana'a city. The survey consists of two parts, the first is the demographic-occupational variables that was collected for the participants and the second part included questions related to perception of the diagnosis, possible etiological factors, severity of the condition and management, and the participants ’willingness for advance training in relation to MIH. Results: The overall response rate is (90%). The majority of respondents came across MIH in their practices (GDPs= 83.2%, SDPs= 90%).Yellow / brown demarcation is feasible as a common clinical symptom. The composite resin was the most used restorative material. The genetic factor was the most specific etiological factor. Most GDPs were significantly uncertain in the diagnosis of MIH compared to SDPs (P = 0.003). Most of the respondents (72.5%) had a low level of knowledge regarding MIH. Participants support the need to assess MIH occurrence and conduct clinical training. Conclusion: Molar incisor hypomineralization (MIH) is a common dental problem faced by dental practitioners in Sana'a City who have required clinical training regarding diagnosis, etiological factors and MIH management.                                Peer Review History: Received: 8 September 2020; Revised: 7 October; Accepted: 20 October, Available online: 15 November 2020 Academic Editor: Dr. Sally A. El-Zahaby, Pharos University in Alexandria, Egypt, [email protected] Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Dr. Mohamed Awad AbdAlaziz Mousnad, International University of Africa (IUA) and Sudan, [email protected] Antonio José de Jesus Evangelista, Federal University of Ceará, UFC, Brazil,  [email protected] Similar Articles: PREVALENCE OF STAPHYLOCOCCUS AUREUS IN DENTAL INFECTIONS AND THE OCCURRENCE OF MRSA IN ISOLATES CAUSES FOR EXTRACTION OF PERMANENT TEETH IN GENERAL DENTAL PRACTICES IN YEMEN SERO-PREVALENCE OF HEPATITIS C VIRUS AMONG DENTAL CLINIC WORKERS IN SANA’A CITY- YEMEN AND THE RISK FACTORS CONTRIBUTING FOR ITS INFECTION PREVALENCE AND CAUSES OF TRAUMATIC DENTAL INJURIES TO ANTERIOR TEETH AMONG PRIMARY SCHOOL CHILDREN IN SANA'A CITY, YEMEN ETIOLOGY AND RISK FACTORS OF STOMATITIS AMONG YEMENI DENTURE WEARER

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

CLINICAL FEATURES, AGE AND SEX DISTRIBUTIONS, RISK FACTORS AND THE TYPE OF BACTERIA ISOLATED IN PERIODONTITIS PATIENTS IN SANA'A, YEMEN

Background: Periodontitis is an inflammation caused by plaque in the surrounding dental structures. It is a major factor in adult tooth loss. There is lack of information on associated clinical features, risk factors and microbial etiology of periodontitis in Sana’a, Yemen. Aim: The study focused on associated clinical features, risk factors and the separation and classification of bacteria in periodontitis and associated risk factors amongst patients attending dental clinics is Sana’a city.&nbsp; Methods: First, 296 patients were admitted to the dental clinic at the Republican University Hospital and private dental clinics in Sana'a during a period of nearly one year, which began in December 2019 AD and ended in November 2020 AD, when they were diagnosed with dental diseases, then 49 of them were selected who are suffering from periodontitis, of whom 22 are males and 27 are females. Sterile paper points were used for the sample collection. Standard culture and biochemical techniques were used for the isolation and identification. Structured questionnaires were used to record clinical features, demographic variables and other risk factors of periodontitis. Results: A total of 130 microorganisms were isolated from 49 patients with periodontitis. Male patients accounted for 14.4% and females 18.9% of the all 296 patients who attended our clinics.&nbsp; There was no important association between sex and periodontitis occurrence while there was significant association the younger age groups (45.4% in &lt;26 years of age). The most common signs and symptoms were swollen or puffy gums (91.9%), bleed easily gums (96%), halitosis (96%), painful chewing (87.8%), pus between teeth and gums (71.4%), loose teeth or loss of teeth (44.9%), gingival recession (83.7%), spitting out blood when brushing or flossing teeth (79.6%), and tender gums (93.9%). Conclusion: This study is new in Sana'a city. The clinical features of preiodentitis in Yemen and the risk factors are similar to those reported in the literature elsewhere, but the isolated bacteria differ in frequency from those reported elsewhere, as some upper respiratory tract pathogens such as Streptococcus pyogenes are commonly isolated in this study. Knowledge of the clinical features, bacterial causes of gum disease, and risk factors is the key to successful periodontal therapy. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Peer Review History: Received 8 January 2021; Revised 5 February; Accepted 25 February, Available online 15 March 2021 Academic Editor: Essam Mohamed Eissa, Beni-Suef University, Egypt, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.&nbsp; Received file:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.5/10 Reviewer(s) detail: Dr. Tamer Elhabibi, Suez Canal University, Egypt,&nbsp;[email protected] Dr. Rawaa Souhil Al-Kayali, Aleppo University, Syria,&nbsp;[email protected] Rola Jadallah,&nbsp;Arab American University, Palestine,&nbsp;[email protected] Prof. Dr. Gorkem Dulger, Duzce University, Turkey, [email protected] Similar Articles: RISK FACTORS OF PERIODONTAL DISEASES AMONG YEMENI YOUNG DENTAL PATIENTS KNOWLEDGE AND PERCEPTION OF MOLAR INCISOR HYPOMINERALIZATION AMONG DENTAL PRACTITIONERS IN SANA’A CITY- YEMEN PREVALENCE OF STAPHYLOCOCCUS AUREUS IN DENTAL INFECTIONS AND THE OCCURRENCE OF MRSA IN ISOLATES ASSOCIATION BETWEEN THE STREPTOCOCCUS MUTANS BIOFILM FORMATION AND DENTAL CARIES EXPERIENCE AND ANTIBIOTICS RESISTANCE IN ADULT FEMALE

CLINICAL EFFECTS OF PLATELETS RICH FIBRIN (PRF) FOLLOWING SURGICAL EXTRACTION OF IMPACTED LOWER THIRD MOLARS AMONG A SAMPLE OF YEMENI ADULTS

Background and aims: Third molar surgery is one of the most frequent procedures in oral and maxillofacial surgery. Pain, trismus, and swelling are the majority symptoms that have an impact on patients' quality of life. Haemorrhage, alveolitis and infections are general complications. Several endeavors have been through to decrease the possibility of complications and make better patients' quality of life, such as the administration of platelet-rich plasma (PRP) or the administration of platelet-rich fibrin (PRF).  The aim of this study is to determine the clinical consequences of PRF subsequent to surgical extraction of impacted lower third molars among a sample of Yemeni adults by evaluate the PRF effect on postoperative complications of pain, swelling, and mouth opening and to compare the difference in the healing process between the PRF surgery site and the control site. Methods: The prospective study consisted of 36 patients who obtainable for subtraction of an impacted bilateral mandibular molar. Subsequent to extraction, plugs were filled up with PRF or without PRF in the study (18 patients) and comparative control (18 patients) groups, respectively. Postoperative edema was calculated using a flexible tape measure by estimating the distance between several facial features on the 2nd to the 7th postoperative days. Postoperative pain was assessed using a line-type visual analog scale (VAS) and a verbal scale (VRS); and trismus by caliper scales. Epi-Info version 7.0 was used for data analysis. Results: There were statistical significant variations concerning the PRF group and the control group in regard to pain intensity, number of analgesics tablets used and the interincisal distance, as the p value were 0.001, 0.0001 and 0.001 respectively. Conclusion: The PRF helps in reducing the post-surgical pain, edema and trismus. As well as accelerate healing process after the application to the socket of surgically extracted lower third molar.                         Peer Review History: Received: 11 November 2022; Revised: 14 December; Accepted: 6 January 2023, Available online: 15 January 2023 Academic Editor: Prof. Dr. Gorkem Dulger, Duzce University, Turkey, [email protected] Received file:                             Reviewer's Comments: Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, [email protected] Dr. Tamer Elhabibi, Suez Canal University, Egypt, [email protected] Similar Articles: HISTOLOGIC AND RADIOGRAPHIC STUDY OF PATHOLOGIC CHANGE IN COMPLETE IMPACTED THIRD MOLARS DENTAL FOLLICLES KNOWLEDGE AND PERCEPTION OF MOLAR INCISOR HYPOMINERALIZATION AMONG DENTAL PRACTITIONERS IN SANA’A CITY- YEME