Page 77 - Demo

Alveolar iodine tampon packing reduces postoperative morbidity after third molar surgery754of bias. The only follow-up with the patients occurred 1 week postoperatively; thus, long-term complications could not be assessed. All the patients reported pain, swelling, problems with opening their mouth, mastication problems, and self-care interventions, such as taking the prescribed analgesics and applying cold packs. Pain, swelling, and functionality problems are the most important parameters of inflammation. Because of the lack of recall on days 3 or 4, the severity of the inflammation in these cases could not be determined. Another follow-up on the third or fourth postoperative day would be advantageous, as the problems peak at that time. In the present study, the changes in OHRQoL were assessed during the first 7 days after third molar surgery. Delayed onset infections are a rare complication that usually occur approximately 1 month after extraction.58 Possible long-term complications could not be evaluated because late infections can occur after surgery. Patients were instructed to call or visit the outpatient clinic in case of any late adverse events, such as swelling and pain. Only three patients returned after the 1-week visit; one patient after 2 weeks for reassurance that everything was uneventful and two other patients (one after surgical mandibular third molar extraction with an iodine tampon and one after surgical removal without a tampon) returned after 3 weeks with some pain, which resolved after rinsing out the healing socket. Blinding the patients for the intervention was not possible because the patients were able to taste the presence of the iodine-containing dressing in the extraction socket. The patients may have considered the placement of a dressing or the iodine-containing dressing to be a necessary part of any wound closure procedure; therefore, the patients’ perception of the therapeutic superiority of the iodine-containing dressing could have been affected by placebo effect bias. Another limitation is that we did not have information on how well or how often patients were able to use the Monoject® syringe. At the control visit, we reviewed the rinsing method but, as an earlier study demonstrated, a significant number of patients fail to use the syringe according to the instructions regardless of the education level of the patient.52 Placing a tampon avoids the need for local irrigation, and the alveolar packing reduces exposure of the postoperative bone, which may result in a reduction in pain and food impaction.