Trigeminal neurosensory deficit and patient reported outcome measures: the effect on quality of life

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The Efficacy and Clinical Safety of Various Analgesic Combinations for Post-Operative Pain after Third Molar Surgery: A Systematic Review and Meta-Analysis.

Objectives To run a systematic review and meta-analysis of randomized clinical trials aiming to answer the clinical question "which analgesic combination and dosage is potentially the most effective and safe for acute post-operative pain control after third molar surgery?". Materials and Methods A systematic search of computer databases and journals was performed. The search and the evaluations of articles were performed by 2 independent reviewers in 3 rounds. Randomized clinical trials related to analgesic combinations for acute post-operative pain control after lower third molar surgery that matched the selection criteria were evaluated to enter in the final review. Results Fourteen studies with 3521 subjects, with 10 groups (17 dosages) of analgesic combinations were included in the final review. The analgesic efficacy were presented by the objective pain measurements including sum of pain intensity at 6 hours (SPID6) and total pain relief at 6 hours (TOTPAR6). The SPID6 scores and TOTPAR6 scores of the reported analgesic combinations were ranged from 1.46 to 6.44 and 3.24 - 10.3, respectively. Ibuprofen 400mg with oxycodone HCL 5mg had superior efficacy (SPID6: 6.44, TOTPAR6: 9.31). Nausea was the most common adverse effect, with prevalence ranging from 0-55%. Ibuprofen 200mg with caffeine 100mg or 200mg had a reasonable analgesic effect with fewer side effects. Conclusion This systematic review and meta-analysis may help clinicians in their choices of prescribing an analgesic combination for acute post-operative pain control after lower third molar surgery. It was found in this systematic review Ibuprofen 400mg combined with oxycodone HCL 5mg has superior analgesic efficacy when compared to the other analgesic combinations included in this study.published_or_final_versio

Trigeminal Neurosensory Deficit and Patient Reported Outcome Measures: The Effect on Life Satisfaction and Depression Symptoms

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Coronectomy of the lower third molar is safe within the first 3 years

PURPOSE: There is no long-term evaluation on the safety of coronectomy of the lower third molar. The aim of this study was to investigate the 3-year morbidity of coronectomy of the lower third molars and to monitor the behavior and migration pattern of the retained roots after coronectomy. MATERIALS AND METHODS: This was a prospective cohort study. Patients with lower third molars with specific radiographic sign(s) showing proximity of the roots to the inferior alveolar nerve who underwent coronectomy in a previous randomized clinical trial were reviewed postoperatively in the first week and the third, sixth, 12th, 24th, and 36th months. The morbidities of infection, pain, root eruption, reoperation to remove the root, and the development of any pathology were recorded. The pattern of any root migration was analyzed. RESULTS: Ninety-eight patients (35 men and 63 women; mean age, 25.7 yrs; standard deviation, 7.9 yrs) with 135 coronectomies completed the 36-month review. None presented with infection or pain from the postoperative third month onward. Root eruption causing sensitivity occurred in 3% (4/135) of the sample and the erupted roots were removed. None of the reoperated cases presented with a postoperative inferior alveolar nerve deficit. No pathology developed in any of the retained roots after coronectomy. Root migration was noted in most cases in the first 12 months, and all roots stopped migrating from the 24th month onward. The mean root migration at 36 months was 2.8 mm (standard deviation, 1.4 mm). CONCLUSIONS: This study confirms that retained roots after coronectomy in the lower third molars produce no complications in terms of infection, pain, or the development of pathologies within the first 3 years. Root eruption can occur in a very small percentage of patients and may require reoperation to remove the root.link_to_subscribed_fulltex

Root migration and morbidities after coronectomy of lower third molar: a 5 year prospective study

Dr Mike Leung wins research prize in Xia

The Effect of Trigeminal Neurosensory Deficit on Quality of Life

Session: Oral and Maxillofacial SurgeryObjectives: To investigate the effect of persistent neurosensory disturbance of the lingual nerve (LN) or inferior alveolar nerve (IAN) on quality of life (QoL). Methods: Patients with persistent neurosensory deficit of LN or IAN after lower third molar surgery (for 12 months or more) were the study group. Health-related QoL was assessed using the 36-item Short Form Health Survey (SF-36), oral health-related QoL using the 14-item Short Form Oral Health Impact Profile (OHIP-14). The control group was an age and gender matched sample of other oral surgery patients. Differences in SF-36 scores and OHIP-14 scores between the groups were compared. Results: Thirty-six subjects (18 cases and 18 controls) were recruited. Patients with neurosensory deficits had poorer Mental-Health Component Scores (MCS) (p=0.01), Role-physical (p=0.01), General Health (p=0.02), Social Functioning (p<0.01) and Role-emotion (p<0.01). The OHIP-14 scores were also significantly worse in this patients with neurosensory deficits compared with the control group (p<0.01). There were no statistical differences in various parameters of the QoL within the neurosensory deficit group with respect to gender, nerves involved, or presence of hyperaesthesia / pain at the affected areas. Conclusions: Patients with persistent LN or IAN deficit after lower third molar surgery have poorer health-related QoL and poorer oral health-related QoL than those without such deficits