Complications of Third Molar Surgery

In this study, a dual-responsive multifunctional band-aid comprising a force-induced shrinkage layer and a drug-treated layer has been developed, characterized by its on-demand drug release. Evaluated through the pig skin the force-induced shrinkage layer facilitates active wound closure by forming stable adhesion to the skin. Afterward, the layer could provide mechanical force simulating the embryonic skin in response to temperature changes. Concomitantly, confronting the increased levels of reactive oxygen species (ROS) at the wound site, the drug-treated layer made of an ROS-responsive hydrogel, promptly releases zinc oxide (ZnO) and catalase (CAT) to exert antibacterial and anti-inflammatory stress effects, ultimately accelerating the healing process of chronic wounds. More important, this versatile hydrogel-based band-aid demonstrates remarkable efficacy in both bacteria-infected rat wounds and rat tooth extraction wounds. Overall, the versatility of this approach presents a comprehensive and convenient strategy for the treatment of clinical chronic wounds.

ChatGPT (OpenAI) is a large language model. This model uses artificial intelligence and machine learning techniques to generate humanlike language and responses, even to complex questions. The authors aimed to assess the reliability of responses provided via ChatGPT and evaluate its trustworthiness as a means of obtaining information about third-molar surgery.

The authors assessed the 10 most frequently asked questions about mandibular third-molar extraction. A validated questionnaire (Chatbot Usability Questionnaire) was used and 2 oral and maxillofacial surgeons compared the answers provided with the literature.

Most of the responses (90.63%) provided via the ChatGPT platform were considered safe and accurate and followed what was stated in the English-language literature.

The ChatGPT platform offers accurate and scientifically backed answers to inquiries about third-molar surgical extraction, making it a dependable and easy-to-use resource for both patients and the general public. However, the platform should provide references with the responses to validate the information.

Patients worldwide are exposed to reliable information sources. Oral surgeons and health care providers should always advise patients to be aware of the information source and that the ChatGPT platform offers a reliable solution.

We aimed to analyze the incidence of postoperative complications after the removal of impacted mandibular third molars using a dental straight, low-speed handpiece.

This single-center retrospective descriptive study was conducted from January 2018 to December 2021. Inclusion criteria for the enrolled patients were complete medical records, no history of systemic disease, and received surgical removal of impacted mandibular third molars using a straight, low-speed handpiece.

A total of 1050 patients underwent mandibular third molar removal with a straight, low-speed handpiece under local anesthesia. Most complications occurred in cases involving horizontal angulation (15.4%) and those categorized as level B (13.3%) and class II (13.9%) impactions. The difficulty index indicated moderate difficulty in most cases (55.3%), with the most and least common postoperative complications being pain (5.7%) and paresthesia (1.5%), respectively.

Most complications reported in this study were minor, transient, and within the ranges reported in the literature. No major complications, such as emphysema, were reported, while paresthesia was the least frequently reported complication. Thus, third molar removal using a straight, low-speed handpiece was associated with few complications and might be used as one of the safe procedures.

Preserving stable tooth-periodontal tissue integration is vital for maintaining alveolar bone stability under physiological conditions. However, tooth extraction compromises this integration and impedes socket healing. Therefore, it becomes crucial to provide early stage coverage of the socket to promote optimal healing. Drawing inspiration from the periodontium, we have developed a quaternized methacryloyl chitosan/dopamine-grafted oxidized sodium alginate hydrogel, termed the quaternized methacryloyl chitosan/dopamine-grafted oxidized sodium alginate hydrogel (QDL hydrogel). Through blue-light-induced cross-linking, the QDL hydrogel serves as a comprehensive wound dressing for socket healing. The QDL hydrogel exhibits remarkable efficacy in closing irregular tooth extraction wounds. Its favorable mechanical properties, flexible formability, and strong adhesion are achieved through modifications of chitosan and sodium alginate derived from biomass sources. Moreover, the QDL hydrogel demonstrates a superior hemostatic ability, facilitating swift blood clot formation. Additionally, the inherent antibacterial properties of the QDL hydrogel effectively inhibit oral microorganisms. Furthermore, the QDL hydrogel promotes angiogenesis, which facilitates the nutrient supply for subsequent tissue regeneration. Notably, the hydrogel accelerates socket healing by upregulating the expression of genes associated with wound healing. In conclusion, the periodontium-mimicking multifunctional hydrogel exhibits significant potential as a clinical tooth extraction wound dressing.

Common side effects of third molar (M3) operations including pain, edema, and trismus have an adverse effect on patient quality of life. Injectable platelet-rich fibrin (i-PRF) may ameliorate some of the side effects of the operation.

The primary purpose of this study is to measure and compare differences in pain, swelling, trismus, and quality of life between i-PRF side and a control side of subjects undergoing M3 removal.

This study is a single-center, split-mouth, randomized prospective clinical trial conducted at Ordu University Faculty of Dentistry. Patients who presented between March and August 2022 for the extraction of impacted third molars due to various reasons were included in the study. The exclusion criteria were local conditions and systematic comorbidities. Additionally, patients with differences that could cause bias between the sides were excluded from the study.

The predictor variable is treatment i-PRF or control.

The outcome variables of interest are the pain level and analgesic consumption values on the Visual Analog Scale, the distance between determined reference points, maximum mouth opening, and the Postoperative Symptom Severity scale data. A Postoperative Symptom Severity scale was created using questions commonly employed in the clinical evaluation of patients following the extraction of third molars. This scale was further divided into subscales corresponding to the 7 primary adverse effects identified in a prior study.

Covariate variables, sex, age, and operation times.

The normality of the distribution of the study data was assessed using the Kolmogorov-Smirnov test. Depending on whether the data exhibited a normal distribution or not, the data were analyzed using either the paired t-test or the Wilcoxon test. A P value < .05 was considered statistically significant.

The study included 35 patients with a mean age of 19.97 ± 2.07 years. The i-PRF side significant success in postoperative edema measurements. There was a statistically significant difference observed between the control side and the i-PRF side on the second day (control: 9.74 ± 0.57 mm, i-PRF: 9.46 ± 0.51 mm) and seventh day (control: 9.33 ± 0.59 mm, i-PRF: 9.12 ± 0.50 mm) in lateral canthus-angulus measurements (P: .01 and P: .04, respectively). Additionally, on the second day, there was a statistically significant difference in tragus-commisura measurements (control: 11.53 ± 0.62 mm, i-PRF: 11.31 ± 0.58 mm) with a P value of .02. There was no significant difference observed between the sides in terms of postoperative pain (P > .05). However, analgesic consumption in the i-PRF side was significantly lower at the sixth hour (control: 1.8 ± 0.58 dose, i-PRF: 1.14 ± 0.35 dose), 24th hour (control: 1.77 ± 0.54 dose, i-PRF: 1.14 ± 0.35 dose), and second day (control: 1.8 ± 0.47 dose, i-PRF: 1.4 ± 0.73 dose) postoperatively (P: .000, P: .000, and P: .012). Mouth opening was significantly lower in the i-PRF side on the second day (control: 27.88 ± 6.48 mm, i-PRF: 25.51 ± 5.56 mm) (P: .025). However, i-PRF had no significant effect on postoperative quality of life (P > .05).

According to the study results, i-PRF had a limited effect on the management of postoperative pain, but i-PRF was effective in reducing postoperative edema. Further studies with larger patient sides are now needed to yield more detailed findings on the subject.