Is Therapeutic Elastic Bandage As Effective As Corticosteroids Following Third Molar Surgery?
Comparison Of The Effectiveness Of Submucosal Corticosteroid Injection And Elastic Therapeutic Bandage Applications On Pain, Swelling And Trismus After Surgical Removal Of Mandibular Third Molar Teeth
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
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Tokat, Turkey, 60100
- Tokat Gaziosmanpasa University, Faculty of Dentistry
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age between 18-65 years
- American Society of Anesthesiologists (ASA) Class 1 physiological status
- Consistent radiological and clinical data
- Volunteered to participate in the study
- Surgical difficulty score above 5 which was determined according to Pederson scale.
Exclusion Criteria:
- Being out of age range
- Analgesic or antibiotic therapy history in last 30 days due to symptoms of related third molar
- Smoking cigarette
- Any pathology associated with impacted third molar
- Active complaints on preoperative examination on the day of surgery
- Immunosuppressed or diagnosed with malignancy
- Diagnosed chronic diseases such as; Diabetes mellitus (DM), hypertension, cerebrovascular event, psychiatric diseases, coagulopathies
- Autoimmune diseases
- If total operation time exceeds 45 minutes
- Patients who could not attend regular follow-up visits
- Allergy to the medications prescribed or utilized in study protocol
- Inconsistent clinical and radiological data
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Active Comparator: Postoperative NSAID Prescription
Patients in this arm received common postoperative prescriptions following removal of their impacted third molars for seven days; twice a day 500 mg amoxicillin+125 mg clavulanic acid, twice a day 25 mg dexketoprofen trometamol and three times a day 1.5 mg/ml clorhexidine gluconate+1.2
mg/ml benzydamine hydrochloride containing 200 ml mouthwash.
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Patients were instructed to record the number of drugs they used until the second and seventh postoperative days.
Other Names:
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Active Comparator: Preoperative Submucosal Corticosteroid Injection
Patients in this arm were administered 8mg/2ml dexamethasone 21-phosphate preoperatively after local anesthesia were obtained.
Injection site was the depth of buccal sulcus near operation site.
For the patients in this arm 25 mg dexketoprofen trometamol was excluded from postoperative prescription in order not to affect the anti-inflammatory effects of corticosteroid.
Instead of NSAID, three times a day 500 mg paracetamol was prescribed.
The patients were advised not to exceed maximal dosage of 3000 mg (6 tablets) in a day.
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Injections were administered in the immediate preoperative period as a single shot.
Other Names:
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Active Comparator: Postoperative Therapeutic Elastic Bandage Application
In this arm the therapeutic elastic bandage applications were immediately performed after removal of mandibular third molars.
The distance between tragus-lateral commissura line and supraclavicular lymph nodes was measured and the tapes were then cut into 5 tails.
The base of the tape was placed on supraclavicular lymph nodes and tails were placed on the site to cover parotid, submandibular, submental and superficial cervical lymph nodes.
The tapes were removed on postoperative second day.
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The bands' lengths were individually measured and divided into five equal parts up to 2/3 of their lengths to obtain fan-type shape.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Preoperative Pain Intensity
Time Frame: On the day of surgery preoperatively
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The patients were asked to mark their pain intensities on a Numerical Rating Scale in which '0' means no pain, '5' means moderate pain and '10' means worst imaginable pain on the day of surgery preoperatively.
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On the day of surgery preoperatively
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Change From Baseline Maximal Mouth Opening on Postoperative Follow Up Visits
Time Frame: Preoperatively on the day of surgery, postoperative second and seventh days.
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All patients' maximal mouth opening were measured and recorded as the distance between upper and lower right central incisors.
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Preoperatively on the day of surgery, postoperative second and seventh days.
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Change From Baseline Facial Measurements on Postoperative Follow Up Visits
Time Frame: Preoperatively on the day of surgery, postoperative second and seventh days.
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Measurements were performed on the ipsilateral site between tragus and lateral commissura, lateral canthus and angle of mandible with a flexible ruler.
The obtained values' average amounts were calculated and recorded for each patient.
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Preoperatively on the day of surgery, postoperative second and seventh days.
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Oral Analgesic Consumption-1
Time Frame: Postoperative Second Day
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The patients were asked to record the amounts of consumed analgesic tablets (tablets per day) until first follow up visit.
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Postoperative Second Day
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Postoperative Pain Intensity-1
Time Frame: Postoperative Second Day
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The patients were asked to mark their pain intensities on a Numerical Rating Scale in which '0' means no pain, '5' means moderate pain and '10' means worst imaginable pain.
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Postoperative Second Day
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Postoperative Pain Intensity-2
Time Frame: Postoperative Seventh Day
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The patients were asked to mark their pain intensities on a Numerical Rating Scale in which '0' means no pain, '5' means moderate pain and '10' means worst imaginable pain.
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Postoperative Seventh Day
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Oral Analgesic Consumption-2
Time Frame: Postoperative Seventh Day
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The patients were asked to record the amounts of consumed analgesic tablets (tablets per day) between first and last follow up visits.
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Postoperative Seventh Day
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Wound Healing Scores
Time Frame: Postoperative second and seventh days.
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Extraction wound healing rates were evaluated by Landry's healing index.
The index scores were classified as; 1. Very poor, 2. Poor, 3. Good, 4. Very Good and 5. Excellent.
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Postoperative second and seventh days.
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Oral Health Impact Profile
Time Frame: Preoperatively on the day of surgery, postoperative second and seventh days.
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Oral health-related quality of life was followed up with Oral Health Impaction Profile-14 questionnaire (Turkish Version).
The investigators aimed to detect the alterations in quality of life due to surgical intervention and the other treatment modalities.
The obtainable scores vary between 0-56 points.
Lower scores indicate better postoperative physical and psychological conditions.
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Preoperatively on the day of surgery, postoperative second and seventh days.
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Postoperative Symptom Severity Evaluation
Time Frame: Postoperative seventh day.
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Postoperative inflammatory symptoms were evaluated with the postoperative symptom severity scale at the end of the follow-up period individually.
The scale scores vary between 0%-100%.
The higher scores indicate that the individual experienced severe symptoms.
The investigators aimed to detect the severity of symptoms from the point of the patient's view.
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Postoperative seventh day.
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Nihat Akbulut, Assoc. Dr., Tokat Gaziosmanpasa University
Publications and helpful links
General Publications
- Ristow O, Hohlweg-Majert B, Sturzenbaum SR, Kehl V, Koerdt S, Hahnefeld L, Pautke C. Therapeutic elastic tape reduces morbidity after wisdom teeth removal--a clinical trial. Clin Oral Investig. 2014 May;18(4):1205-1212. doi: 10.1007/s00784-013-1067-3. Epub 2013 Aug 21.
- Alcantara CE, Falci SG, Oliveira-Ferreira F, Santos CR, Pinheiro ML. Pre-emptive effect of dexamethasone and methylprednisolone on pain, swelling, and trismus after third molar surgery: a split-mouth randomized triple-blind clinical trial. Int J Oral Maxillofac Surg. 2014 Jan;43(1):93-8. doi: 10.1016/j.ijom.2013.05.016. Epub 2013 Jun 28.
- Deo SP. Single-Dose of Submucosal Injection of Dexamethasone Affects the Post Operative Quality of Life After Third Molar Surgery. J Maxillofac Oral Surg. 2016 Sep;15(3):367-375. doi: 10.1007/s12663-015-0846-6. Epub 2015 Dec 7.
- Erdil A, Akbulut N, Altan A, Demirsoy MS. Comparison of the effect of therapeutic elastic bandage, submucosal dexamethasone, or dexketoprofen trometamol on inflammatory symptoms and quality of life following third molar surgery: a randomized clinical trial. Clin Oral Investig. 2021 Apr;25(4):1849-1857. doi: 10.1007/s00784-020-03487-y. Epub 2020 Aug 15.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Nervous System Diseases
- Neurologic Manifestations
- Neuromuscular Manifestations
- Spasm
- Trismus
- Physiological Effects of Drugs
- Autonomic Agents
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Anti-Inflammatory Agents, Non-Steroidal
- Analgesics, Non-Narcotic
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Antineoplastic Agents
- Antiemetics
- Gastrointestinal Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Dexamethasone
- Dexamethasone 21-phosphate
- Dexketoprofen trometamol
Other Study ID Numbers
Other Study ID Numbers
- 19-KAEK-100
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- Study Protocol
- Statistical Analysis Plan (SAP)
- Clinical Study Report (CSR)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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