Page 73 - Demo

Alveolar iodine tampon packing reduces postoperative morbidity after third molar surgery714The use of a tampon in the extraction socket is a form of surgical drainage. Other types of surgical drainage in third molar surgery are the use of a tube and a rubber drain. A recent meta-analysis of 10 randomized clinical trials found that surgical drainage after impacted mandibular third molar surgery results in less facial swelling and a better mouth opening during both the early stage (2-3 postoperative days) and late stage (5-7 postoperative days).33 Postoperative pain was significantly less in the drainage group during the early stage, but there were no significant differences in the late stage. In the review, the tube drain had better results in terms of facial swelling and trismus compared to the rubber or gauze drain. However, the rubber drain was more effective regarding pain than the tube and gauze drains.33 The advantage of the gauze drain compared to the rubber or tube drain is that its removal is easy, and no sutures are needed to fix the drain. Also, the medication impregnated in the gauze can have a positive effect on the postoperative sequela. Our results are in agreement with the different impregnated gauze studies, in which reduced pain, swelling, and trismus was seen after the use of a tampon at the surgical extraction site.30,31,47 Assessing the effect of chlortetracycline ointment gauze, Akota et al. found a reduction in postoperative AO but failed to find beneficial effects on pain, swelling, and trismus.29 Pain was less in the no-drain group on the day of surgery and first 2 postoperative days, but the mean pain intensity was not significantly different compared to the control group, which is in contrast with the findings of the present study. However, from the third day onwards, the pain was less in the drain group. Egbor and Saheeb evaluated the effect of whitehead varnish dressing in the extraction socket on postoperative pain, swelling, and trismus.32 They found reduced swelling and trismus in the dressing group but no significant postoperative pain reduction. Although the difference in mean pain score was not significant between the study groups, the mean pain score was consistently lower in the dressing group. However, in that study, patients also received oral doses of 500 mg amoxicillin and 200 mg metronidazole every 8 h for 5 days. Therefore, it is unclear if the reduction in postoperative sequela was not influenced by the antibiotic administration. Cerqueira et al. found that a drain helped control swelling, but found no effect on pain or trismus.40 The pain was more severe in the non-drain group at 72 h and 7 days postoperatively, but at 24 h the pain was more severe in the drain group. The Cerqueira study could not be compared with the present study