Piezo-surgery Technique and Intramuscular Dexamethasone Injection to Reduce Postoperative Pain After Impacted Mandibular Third Molar Surgery
Condition: Impacted Mandibular Third Molar Extraction
MeSH terms: Tooth, Impacted; Pain, Postoperative
Study type: Interventional
Phase: Phase 4

Summary: 
      The purpose of my study is to test the effect of using piezosurgery and dexamethasone
      injection in the surgical extraction of impacted mandibular third molars, on Postoperative
      Pain.
    

Detailed description: 
      Background: Third molar surgery is the most common procedure performed in oral and
      maxillofacial surgery practice.

      This procedure is always associated with varying degrees of postoperative pain and swelling
      that may have a social impact. Traditionally, rotating instruments like burs have been used
      for osseous surgery.

      Piezosurgery is a novel technique introduced to overcome the disadvantages associated with
      the conventional rotatory technique. Corticosteroids administration before or after the
      extraction of third molars is an efficient way to minimize postoperative pain due to their
      strong anti-inflammatory activity.

      Many researchers conducted studies comparing the piezosurgery technique with conventional
      rotatory technique, regarding postoperative pain and working time, or studies comparing the
      conventional method with or without dexamethasone injection. Only one recent study (Nov
      2018), conducted by Gümrükçü Z. et al. has compared Piezosurgery and dexamethasone injection
      in third molar surgery, but without evaluating the combined effect of these two techniques on
      postoperative pain.

      Objectives: The objective of this study is to assess the effects of piezosurgery technique
      and intramuscular dexamethasone injection on postoperative pain in impacted third molar
      surgery.

      Methods: The study design is a randomized controlled clinical trial: 80 patients with
      mandibular third molar impaction, indicated for surgical extraction should be treated
      randomly using either the piezosurgery or the conventional rotatory technique, and with or
      without intramuscular dexamethasone injection. Postoperative pain will be assessed using a
      visual analog scale (VAS) on days 1, 3, and seven postoperatively.

      The differences in Post-operative pain within and between study groups (4 groups) will be
      tested using repeated measures of analysis of variance (ANOVA) or Friedman tests. Differences
      in working time among the three techniques will be assessed using a repeated measure of
      ANOVA. All statistical tests will be two-sided, and the significant level will be set at
      0.05. All the analysis will be conducted using the Statistical Package for Social Sciences
      (SPSS) software version 22.
    

Intervention name(s): Dexamethasone injection; Piezosurgery; Conventional Rotatory instruments
Intervention type(s): Drug; Procedure; Procedure
Intervention description(s): Compare the effect of dexamethasone injection on reducing post-op pain after impacted third molar Surgery; Compare the effect of Piezosurgery device use on reducing post-op pain after impacted third molar Surgery; Surgical extraction using conventional rotatory instruments to perform osteotomy
Intervention MeSH terms: Dexamethasone; Dexamethasone acetate
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Impacted Mandibular Third molar surgery.; Pain; Dexamethasone; Piezosurgery