Page 64 - Demo

Chapter 462Study tampons and procedures.Given the crossover design, eligible patients were randomly assigned to the use of an iodine tampon or the Monoject® syringe. Patients were scheduled for surgery (tampon or no tampon) in two separate clinical sessions (one side at a time) at least 2 months apart.Randomization and the concealment of allocationThis study consisted of two trial conditions; first third molar removal with a tampon (tampon condition) followed by surgical removal without a tampon (Monoject® condition) or first third molar removal without a tampon (Monoject® condition) followed by surgical removal with a tampon (tampon condition). Prior to the first surgery, a surgical assistant allocated the patient to either trial condition using a computer random generator. After the allocation to a trial condition another surgical assistant assigned a side to either the experimental treatment or the control treatment side using again a computer random generator. The concealment of allocation was guaranteed through a sealed envelope. The operator received the envelope after the arrival of the patient in the surgery room and the envelope was opened by a surgical assistant after completion of the surgery. For the Monoject® condition (control condition), after surgery, the patients were provided a curved Monoject® syringe and oral and written instructions regarding the use of the syringe. They were instructed to start irrigating the wound 48 hours after surgery. They had to bring the tip to the distal side of the second molar in the wound and irrigate four times a day with a saline solution. For the tampon condition, a loosely administered 2 cm iodine tampon (Opraclean; Lohmann & Rauscher International GmbH &Co. KG, Rengsdorf, Germany) was placed in the socket for 1 week after removal of the impacted third mandibular molar. At the 1-week control visit, the tampon was removed. Postoperative instructionsAll patients were instructed to bite on gauze for 30 minutes. They were also instructed not to rinse or spit during the first 24 postoperative hours. Tooth brushing could be started the day after surgery. Ibuprofen 600 mg (Brufen, Abbot BV, Hoofddorp, the Netherlands) three times a day was prescribed