Assessment of the Operative Course in Connection With Removal of Lower Third Molars

NCT ID: NCT00805298

Last Updated: 2012-10-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

154 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-08-31

Study Completion Date

2010-11-30

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The aim of this study is to compare postoperative complications after removal of lower third molars using two different types of anaesthetics and two different treatments against swelling and inflammation (methylprednisolone and placebo). The hypothesis is that a combination of a long-duration anaesthetic combined methylprednisolone will result in significantly less postoperative pain and inflammation.

Patients will have both lower third molars removed on two separate occasions. Each patient is randomly assigned to receive one type of local anaesthetic the first time and the other type the second time. Furthermore patients are randomised to receive either methylprednisolone or placebo the first time and the opposite treatment the second time.

During the week after surgery patients fill out a questionnaire with questions about level of pain and swelling at different times as well as the patients' perception of other postoperative complications. The patient is examined by a dentist on the 2nd and 7th day after surgery, where postoperative complications are recorded and thermographic images of the patient's face are taken to assess the degree of inflammation.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Background: After removal of lower third molars complications can occur, including pain, swelling, infection and sensory disturbances. As pain intensity has been shown to be worst during the first 4-8 hours post surgery, it might be relevant to use a local anaesthetic with long duration, e.g. bupivacaine, instead of the traditionally used lidocaine. Several studies have focussed on the effect of non-steroid anti-inflammatory drugs (such as glucocorticoids, e.g. methylprednisolone) to reduce postoperative swelling. However, no studies comparing the effect of bupivacaine combined with methylprednisolone and lidocaine combined with methylprednisolone have been conducted.

Aim: To compare postoperative complications after removal of lower third molars using 1) lidocaine, 2) lidocaine combined with methylprednisolone, 3) bupivacaine and 4) bupivacaine combined with methylprednisolone.

Methods: The study compares type end extension of postoperative complications after removal of lower third molars using four different combinations of local anaesthetics and anti-inflammatory treatment. The study is conducted as a double blinded, split mouth crossover trial, where each patient has both lower third molars removed at two different occasions.

Patients are randomised to receive one type of local anaesthetic the first time and the other type the second time. Furthermore patients are randomised to receive either methylprednisolone or placebo the first time and the opposite treatment the second time.

An objective assessment of postoperative swelling and inflammation is made by means of thermographic imaging of the operated side compared to the opposite side after the operation and at 2 and 7 days post surgery.

Each patient fills out a questionnaire, where the patients' perception of pain, swelling and other complications is registered. Furthermore, complications are recorded objectively by a dentist at the 2- and 7-day post-surgery visits

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Postoperative Pain Inflammation

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

third molar postoperative pain thermography postoperative inflammation methylprednisolone local anaesthetic postoperative pain after removal of lower third molars inflammation after removal of lower third molars

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

methylprednisolone

Group Type ACTIVE_COMPARATOR

methylprednisolone

Intervention Type DRUG

32 mg before surgery, 16 mg twice daily the day after surgery

placebo

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

two tablets before surgery, one tablet twice daily on the day after surgery

lidocaine

Group Type ACTIVE_COMPARATOR

xyloplyin adrenalin

Intervention Type DRUG

lidocaine local anaesthetic lidocaine 20 mg/ml, adrenalin 12,5 µg/ml maximum dosage 10 ml.

bupivacaine

Group Type ACTIVE_COMPARATOR

marcain adrenalin

Intervention Type DRUG

bupivacaine local anaesthetic bupivacaine 5 mg /ml, adrenaline 5 µg/ml maximum dosage 10 ml

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

methylprednisolone

32 mg before surgery, 16 mg twice daily the day after surgery

Intervention Type DRUG

placebo

two tablets before surgery, one tablet twice daily on the day after surgery

Intervention Type DRUG

xyloplyin adrenalin

lidocaine local anaesthetic lidocaine 20 mg/ml, adrenalin 12,5 µg/ml maximum dosage 10 ml.

Intervention Type DRUG

marcain adrenalin

bupivacaine local anaesthetic bupivacaine 5 mg /ml, adrenaline 5 µg/ml maximum dosage 10 ml

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

medrol

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* age ≥ 18 years
* two impacted or semi-impacted lower third molars with indication for removal
* signed informed consent

Exclusion Criteria

* allergy to study drugs or ingredients
* need for sedation
* pregnancy
* systemic disease besides asthma/hay fever
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Tandlaegeforeningen, Calcin fonden

UNKNOWN

Sponsor Role collaborator

University of Aarhus

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Jennifer H Christensen, DDS

Role: PRINCIPAL_INVESTIGATOR

University of Aarhus

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

School of Dentistry, Aarhus University

Aarhus, , Denmark

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Denmark

References

Explore related publications, articles, or registry entries linked to this study.

Beirne OR, Hollander B. The effect of methylprednisolone on pain, trismus, and swelling after removal of third molars. Oral Surg Oral Med Oral Pathol. 1986 Feb;61(2):134-8. doi: 10.1016/0030-4220(86)90173-8.

Reference Type BACKGROUND
PMID: 3457335 (View on PubMed)

Bouloux GF, Punnia-Moorthy A. Bupivacaine versus lidocaine for third molar surgery: a double-blind, randomized, crossover study. J Oral Maxillofac Surg. 1999 May;57(5):510-4; discussion 515. doi: 10.1016/s0278-2391(99)90063-0.

Reference Type BACKGROUND
PMID: 10319823 (View on PubMed)

Bruce RA, Frederickson GC, Small GS. Age of patients and morbidity associated with mandibular third molar surgery. J Am Dent Assoc. 1980 Aug;101(2):240-5. doi: 10.14219/jada.archive.1980.0183.

Reference Type BACKGROUND
PMID: 6931159 (View on PubMed)

Bystedt H, Nordenram A. Effect of methylprednisolone on complications after removal of impacted mandibular third molars. Swed Dent J. 1985;9(2):65-9.

Reference Type BACKGROUND
PMID: 3859943 (View on PubMed)

Campbell WI, Kendrick RW, Ramsay-Baggs P, McCaughey W. The effect of pre-operative administration of bupivacaine compared with its postoperative use. Anaesthesia. 1997 Dec;52(12):1212-6.

Reference Type BACKGROUND
PMID: 9485979 (View on PubMed)

Chiapasco M, De Cicco L, Marrone G. Side effects and complications associated with third molar surgery. Oral Surg Oral Med Oral Pathol. 1993 Oct;76(4):412-20. doi: 10.1016/0030-4220(93)90005-o.

Reference Type BACKGROUND
PMID: 8233418 (View on PubMed)

de Boer MP, Raghoebar GM, Stegenga B, Schoen PJ, Boering G. Complications after mandibular third molar extraction. Quintessence Int. 1995 Nov;26(11):779-84.

Reference Type BACKGROUND
PMID: 8628837 (View on PubMed)

Esen E, Tasar F, Akhan O. Determination of the anti-inflammatory effects of methylprednisolone on the sequelae of third molar surgery. J Oral Maxillofac Surg. 1999 Oct;57(10):1201-6; discussion 1206-8. doi: 10.1016/s0278-2391(99)90486-x.

Reference Type BACKGROUND
PMID: 10513866 (View on PubMed)

Holland CS. The influence of methylprednisolone on post-operative swelling following oral surgery. Br J Oral Maxillofac Surg. 1987 Aug;25(4):293-9. doi: 10.1016/0266-4356(87)90068-4.

Reference Type BACKGROUND
PMID: 3304412 (View on PubMed)

Leone M, Richard O, Antonini F, Rousseau S, Chabaane W, Guyot L, Martin C. Comparison of methylprednisolone and ketoprofen after multiple third molar extraction: a randomized controlled study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Jan;103(1):e7-9. doi: 10.1016/j.tripleo.2006.07.005. Epub 2006 Oct 6.

Reference Type BACKGROUND
PMID: 17178485 (View on PubMed)

Markovic AB, Todorovic L. Postoperative analgesia after lower third molar surgery: contribution of the use of long-acting local anesthetics, low-power laser, and diclofenac. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Nov;102(5):e4-8. doi: 10.1016/j.tripleo.2006.02.024. Epub 2006 Aug 10.

Reference Type BACKGROUND
PMID: 17052624 (View on PubMed)

Mellor DJ, Mellor AH, McAteer EM. Local anaesthetic infiltration for surgical exodontia of third molar teeth: a double-blind study comparing bupivacaine infiltration with i.v. ketorolac. Br J Anaesth. 1998 Oct;81(4):511-4. doi: 10.1093/bja/81.4.511.

Reference Type BACKGROUND
PMID: 9924222 (View on PubMed)

Mettes TG, Nienhuijs ME, van der Sanden WJ, Verdonschot EH, Plasschaert AJ. Interventions for treating asymptomatic impacted wisdom teeth in adolescents and adults. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD003879. doi: 10.1002/14651858.CD003879.pub2.

Reference Type BACKGROUND
PMID: 15846686 (View on PubMed)

Mico-Llorens JM, Satorres-Nieto M, Gargallo-Albiol J, Arnabat-Dominguez J, Berini-Aytes L, Gay-Escoda C. Efficacy of methylprednisolone in controlling complications after impacted lower third molar surgical extraction. Eur J Clin Pharmacol. 2006 Sep;62(9):693-8. doi: 10.1007/s00228-006-0164-5. Epub 2006 Aug 11.

Reference Type BACKGROUND
PMID: 16902792 (View on PubMed)

Moore PA. Bupivacaine: a long-lasting local anesthetic for dentistry. Oral Surg Oral Med Oral Pathol. 1984 Oct;58(4):369-74. doi: 10.1016/0030-4220(84)90325-6.

Reference Type BACKGROUND
PMID: 6387571 (View on PubMed)

Nayyar MS, Yates C. Bupivacaine as pre-emptive analgesia in third molar surgery: Randomised controlled trial. Br J Oral Maxillofac Surg. 2006 Dec;44(6):501-3. doi: 10.1016/j.bjoms.2005.09.012. Epub 2006 Feb 2.

Reference Type BACKGROUND
PMID: 16457912 (View on PubMed)

Neal JA, Welch TB, Halliday RW. Analysis of the analgesic efficacy and cost-effective use of long-acting local anesthetics in outpatient third molar surgery. Oral Surg Oral Med Oral Pathol. 1993 Mar;75(3):283-5. doi: 10.1016/0030-4220(93)90136-r.

Reference Type BACKGROUND
PMID: 8469535 (View on PubMed)

Osborn TP, Frederickson G Jr, Small IA, Torgerson TS. A prospective study of complications related to mandibular third molar surgery. J Oral Maxillofac Surg. 1985 Oct;43(10):767-9. doi: 10.1016/0278-2391(85)90331-3.

Reference Type BACKGROUND
PMID: 2995624 (View on PubMed)

Renton T, Hankins M, Sproate C, McGurk M. A randomised controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and removal of mandibular third molars. Br J Oral Maxillofac Surg. 2005 Feb;43(1):7-12. doi: 10.1016/j.bjoms.2004.09.002.

Reference Type BACKGROUND
PMID: 15620767 (View on PubMed)

Schultze-Mosgau S, Schmelzeisen R, Frolich JC, Schmele H. Use of ibuprofen and methylprednisolone for the prevention of pain and swelling after removal of impacted third molars. J Oral Maxillofac Surg. 1995 Jan;53(1):2-7; discussion 7-8. doi: 10.1016/0278-2391(95)90486-7.

Reference Type BACKGROUND
PMID: 7799116 (View on PubMed)

Sisk AL, Hammer WB, Shelton DW, Joy ED Jr. Complications following removal of impacted third molars: the role of the experience of the surgeon. J Oral Maxillofac Surg. 1986 Nov;44(11):855-9. doi: 10.1016/0278-2391(86)90221-1.

Reference Type BACKGROUND
PMID: 3464711 (View on PubMed)

Skjelbred P, Lokken P. Effects of naloxone on post-operative pain and steroid-induced analgesia. Br J Clin Pharmacol. 1983 Feb;15(2):221-6. doi: 10.1111/j.1365-2125.1983.tb01489.x.

Reference Type BACKGROUND
PMID: 6849755 (View on PubMed)

Song F, O'Meara S, Wilson P, Golder S, Kleijnen J. The effectiveness and cost-effectiveness of prophylactic removal of wisdom teeth. Health Technol Assess. 2000;4(15):1-55.

Reference Type BACKGROUND
PMID: 10932022 (View on PubMed)

UStun Y, Erdogan O, Esen E, Karsli ED. Comparison of the effects of 2 doses of methylprednisolone on pain, swelling, and trismus after third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 Nov;96(5):535-9. doi: 10.1016/S1079210403004645.

Reference Type BACKGROUND
PMID: 14600686 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

01.01.08Jen

Identifier Type: -

Identifier Source: secondary_id

2008-000866-22

Identifier Type: -

Identifier Source: org_study_id