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Postoperative pain is one of the main complications following impacted mandibular third molar (IMTM) surgery. The aim of this study was to assess the effect of the local application of bupivacaine on reducing early postoperative pain following IMTM surgery. A prospective, single-blinded, randomized controlled study was conducted on 40 patients who had undergone the surgical removal of an IMTM under local anesthesia. In the study group (n = 20), absorbable gelatin sponge (AGS) soaked in 3 mL of 0.5% plain bupivacaine hydrochloride was locally applied in the post-extraction socket. In the control group (n = 20), AGS soaked in 3 mL of normal saline was used. Pain intensity was assessed using a pain numerical rating scale (NRS) 4 and 12 h postoperatively. The variables were compared between the 2 groups and probability values <0.05 were considered statistically significant. The pain scores in the study group were significantly lower than those recorded in the control group at 4 h postoperatively (p = 0.003), whereas the difference in the pain scores between the 2 groups 12 h after surgery was not statistically significant (p = 0.443). The local application of bupivacaine is effective in reducing postoperative pain 4 h after the surgical extraction of IMTMs without any significant complications.


Mohanad Ali Shabat, Salwan Yousif Bede. Effect of the local application of bupivacaine in early pain control following impacted mandibular third molar surgery: A randomized controlled study. Dental and medical problems. 2021 Oct-Dec;58(4):483-488

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PMID: 34971304

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