Clinical and Radiographic Evaluation of Local Application of Melatonin on Postoperative Outcomes after Surgical Removal of Impacted Mandibular Third Molar: A Randomized Controlled Study
of all impacted teeth. The frequency of impaction of the mandibular third molar ranges from 33% to 58.7% (Breik O and Grubor D.,2008). A tooth is considered to be impacted when its eruption time has passed or when the eruption interferes with the normal functional occlusion with other teeth or the overlying bone or soft tissues in the oral cavity (Celikoglu et al.,2010)). The surgical removal of an impacted third molar is an everyday procedure in oral surgery clinics. However, it is known to disturb the quality of life of the patient by restricting the ability to chew food, open the mouth, and speak (Lago-Mendez et al., 2007). Furthermore, there is a danger of periodontal damage on the distal root of the adjacent molar which could affect healing (Richardson et al., 2005), 43% of the patients had a periodontal pocket depth of 7 mm or more at the distal root of the mandibular second molar 2 years post extraction of an impacted mandibular third molar. The healing of periodontal defects related to the distal root of the adjacent molar may be compromised by intra-bony defects and bone loss after the removal of the impacted tooth. Alternative strategies, such as different flap designs, soft-tissue suturing, socket preservation, and tissue regeneration techniques with autologous bone, allografts, xenografts, or alloplastic grafts, have been proposed to prevent periodontal defects and physiological bone resorption after the surgical extraction of the mandibular third molar (Toledano-Serrabona et al.,2021). Melatonin is a growth hormone secreted mainly by the pineal gland and other structures, such as the retina, skin, gastrointestinal tract, lymphocytes, and bone marrow (Radogna et al.,2010).It has antioxidant and anti inflammatory properties. It inhibits the production of reactive oxidants by reducing the expression of cyclooxygenase-2 and prostaglandin. In addition, it attracts polymorphonuclear cells to the site of injury (Cutando et al.,2007).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
20
the extraction socket will be left empty followed by suture of the socket after extraction
3 mg of melatonin into 2 ml of 2% hydroxyethyl cellulose gel will be packed into the socket after extraction
Faculty of Dentistry Suez Canal University
Ismailia, Egypt, Egypt
Bone density
Assess relative bone density at the center of the extracted socket using digital periapical radiograph in the center of the socket.
Time frame: 1 and 4 months postoperatively
Post-operative pain levels
Post-operative pain levels by VAS (Visual Analog Scale)
Time frame: 1, 3 and 7 days Postoperatively
Measure Edema scale
Measure Edema scale using flexible ruler
Time frame: 1, 3 and 7 days Postoperatively
Measure Maximal Mouth opening (MMO)
Measure Maximal Mouth opening (MMO) using digital caliper.
Time frame: 1, 3 and 7 days Postoperatively
Measure the incidence of post-operative complications
Measure the incidence of post-operative complications (e.g., dry socket, infection) in both groups.
Time frame: 1, 3 and 7 days Postoperatively
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