• Journal of Periodontal and Implant Science
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• v.30 no.1
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• pp.1-11
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• 2000

Although various analgesics have been administrated for postoperative pain control, postoperative pain has not been adequately controlled . The purpose of this study was to evaluate the effects and patient's satisfaction of $Myprodol^{(R)}$(combination analgesics with codeine, ibuprofen, paracetamol) compared to Acetamionphen and placebo drug after periodontal surgery and dental implant surgery. We studied 98 cases of outpatients which were composed of 67 cases of flap operation(which separated to 3 groups: Placebo group(n=25), $Myprodol^{(R)}$ group(n=22), Acetaminophen group(n=20)) and 21 cases of dental implant surgery(which separated to 3 groups : Placebo group(n=10), $Myprodol^{(R)}$ group(n=12), Acetaminophen group(n=9)). We evaluated the postoperative pain(Pain 1), Pain after first drug administraion(Pain 2), the degrees of pain reduction(pain 3), patient's satisfaction for drug, and side-effects. We obtained following results; 1. In Pain 1, making a comparison among groups, there was no significant difference in both cases of flap operation-group and dental implant surgery-group 2. In Pain 2, establishing a comparison among groups, there was no significant difference in flap operation-group, but significant difference was seen between placebo group and $Myprodol^{(R)}$ group in cases of dental implant surgery group(P<0.05). 3. In Pain 3, making a comparison among groups, $Myprodol^{(R)}$ group showed significant differences compared to placebo group and Acetaminophen group in both cases of flap operation group and dental implant surgery group(P<0.05). 4. In patient's satisfactory score, making a comparison among groups, there were significant differences between placebo group and $Myprodol^{(R)}$ group in cases of flap operation group and between $Myprodol^{(R)}$ group and Acetaminophen group in cases of dental implant surgery group(P<0.05). 5. Making a comparison in side-dffect, no significant differrence was seen. Our conclusion is that $Myprodol^{(R)}$ is a effective oral analgesics to the patients who underwent periodontal surgery or implant surgery for it's synergism among three dugs.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.5
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• pp.245-256
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• 2023

Background: Surgical and non-surgical periodontal procedures often lead to postoperative pain. Clinicians use pharmacological methods such as anesthetics, anti-inflammatory drugs, and analgesics for relief. However, the multitude of options makes it challenging to select the best approach for routine dental care. Objective: This review aimed to describe previous studies regarding the pharmacological management used for pain control during periodontal procedures as well as factors that may interfere with patients' perception of pain. Methods: We included studies (period of 2000-2023, whose approach corresponded to the pharmacological protocols used for preoperative, trans-operative, and postoperative pain control in adult patients undergoing surgical and non-surgical periodontal therapy. Results: A total of 32 studies were included in the analysis, of which 17 (53%) were related to anesthetic methods and 15 (47%) were related to therapeutic protocols (anti-inflammatory/analgesic agents). These studies predominantly involved nonsurgical periodontal procedures. Studies have reported that factors related to age, type of procedure, and anxiety can influence pain perception; however, only seven of these studies evaluated anxiety. Conclusions: Numerous methods for pain control can be applied in periodontal therapy, which are accomplished through anesthetic methods and/or therapeutic protocols. Factors such as anxiety, age, and type of procedure are related to pain perception in patients. Thus, it is the responsibility of dentists to evaluate each clinical situation and define the best protocol to follow based on the literature.

• Journal of Periodontal and Implant Science
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• v.26 no.3
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• pp.753-761
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• 1996

The purpose of present study is to assess the effects of capsaicin topically applicated to the chronic periodontal pain suffering area. In the First study, twenty patients with chronic pain caused by mild periodontal disease were selected, and periodontal pack containing capsaicin(PPC) was attached to these patients gingiva around pain suffering area. Then the presence of discomfort had been recorded every ten minutes for the first 1 hour. After 1 hour again, It had been recorded according to the presence of pack and to the existence of pain. In the second study, twenty moderate periodontitis patients were selected. After subgingival curettage of two quadrant area, non-euginol periodontal pack or PPC were attached to the curetted gingival margins of them (Non-euginol pack bearing area and capsaicin pack bearing area is supposed to control group and test group respectively.), and the degrees of pain with time had been recorded eight times with 1 hour interval (at that day) or recorded once in a day (from the next day to the next appointment day). The results are as follows : 1. PPC has caused discomfort accompanied by burning sensation to the mild periodontitis patients with chronic pain. 2. PPC has given little effects to improve the pain after subgingival curettage of moderate periodontitis patients.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.193-200
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• 2007

During periodontal examination and periodontal recall visit, patients might feel pain. Probing with 0.45mm diameter probe, "overprobing" into connective tissue underlying periodontal pocket could be the primary aspect of pain. The purpose of present study, performed during recall visit, was to compare the levels of pain experienced by patients during periodontal probing using probes with the tip diameter of either 0.45mm or 0.63mm. Twenty patients were enrolled: 3 periodontists each exammined 20 patients at the Dankook university dental hospital. in each patient at six sites per tooth, diagonal maxillary/mandibular quad-rants were probed with 0.45mm diameter and 0.63mm diameter probe. Lower pain responses following probing with the 0.63mm diameter probe as compared to the 0.45mm probe were observed for patients of therapist 2 and the upper VAS quartile Groups(P<0.05). For therapist 1 and 3 groups, no differences were found. Patient worry about the pain while dental treatment procedures. If therapist use 0.63mm diameter probe while periodontal examination and recall visit, the patient's pain and discomfort could be reduced. Therefore, patient will cooperate more during the treatment, which leads to a better result. Dental therapists should make an effort to minimize the degree of discomfort during treatment. Dental therapist periodically should evaluate this part of their skill by asking patients and promote this skill.

• Journal of Oral Medicine and Pain
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• v.40 no.4
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• pp.135-139
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• 2015

Desquamative gingivitis (DG) is a gingival manifestation of systemic mucocutaneous disorders such as mucous membrane pemphigoid, oral lichen planus, and pemphigus vulgaris. The lesion is very painful, so affects the patient's ability to do proper oral hygiene practices. This may be a potential risk factor for long-term periodontal health. However, there is some controversy about the relationship between the existence of DG and periodontal status. Although the correlation between DG-associated diseases and periodontal status is not to be certain, early diagnosis and appropriate treatment including adequate plaque control and removal of local factors is very important for preventing the progression of diseases and destruction of periodontal tissues.

• The Journal of the Korean dental association
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• v.49 no.2
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• pp.95-103
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• 2011

Purpose : The purpose of this study was to identify and assess factors that may contribute to pain of patients undergoing implant surgery. Materials and Methods: A total of 24 patients who underwent implant surgery were included in the study. Each patient's anxiety was measured using Corah's dental anxiety score(DAS) and modified Spielberger's state-trait anxiety inventory(STAI) immediately after the operation. Also, level of pain was measured using visual analog scale(VAS) during the operation and 48 hours after the surgery. The effect of various factors, such as demographic variables, previous dental experiences and operation time were also analyzed. Results: Postoperative pain levels were relatively low than expected. However, DAS and STAI were high among patients, and it showed that patients had anxieties about implant surgery according to DAS and STAI values. The previous dental experience did not affect the pain level, but the duration of surgery and the presence of accompanied advanced surgery did. Conclusion: To reduce patient's pain, proper management of anxiety will be required and careful attention is needed when performing local infiltration.

• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.693-703
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• 1999

Since they were introduced by Ward in 1923, periodontal dressing have been routinely used following the periodontal surgery to avoid pain, infection, desensitizing teeth, inhibiting food impaction of the surgical areas, and immobilizing injured areas. Recently, however, the value of periodontal dressings and their effects on periodontal wound healing have been questioned, several authors have been reported that the use of dressing has little influence on healing following periodontal surgical procedures. In addition, there is evidence that when good flap adaptation is achieved, the use of a periodontal dressing does not add to patient comfort nor promote healing. The purpose of this study was to evaluate patient postoperative pain experience and discomfort with and without the use of periodontal dressing following periodontal surgery. Twenty-eight patients, 11 male and 17 female. were selected for this study; The age range was 31 to 56, with an average of 40.2years. Patient selection was based on existence of two bilateral sites presenting similar periodontal involvement, as determined by clinical and radiographic assessment, and requiring comparable bilateral surgical procedures. Using a splitmouth dressing. one site received a periodontal dressing while the other site did not. Pain assessment was made according to a horizontal, rating scale(0-10). After at least a two-week period, the second surgical precedure was performed using the alternate postoperative treatment. At the conclusion of the trial, a self-administered questionnaire on postoperative experience was administered, and were asked of their preference of either, dressed or undressed. The results were as follows: 1. A similar trend for mean pain and discomfort scores as assessed by patients both dressed and salinetreated procedures was evident during 7-day postsurgical period. 2. Statistical analysis of differences between the dressed side and salinetreated side with respect to pain, discomfort and patient's experiences revealed that both treatment sides behaved similarly at any postoperative day(P>0.05). 3. Considering the patient's preference, on the basis of pain and discomfort experienced, 43% preferred the saline-mouthwash and 32% preferred the dressing, 25% showing no preference for either the dressing or the saline-mouthwash. There is evidence to support the use of a periodontal dressing in retention of an apically positioned flap by preventing coronal displacement, or its use to provide additional support to stabilize a free gingival graft. However, there will always be a use for periodontal dressing although routine use of dressings may decrease because of better surgical techniques and the use of antibacterial mouth rinses.

• Journal of Periodontal and Implant Science
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• v.42 no.2
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• pp.45-49
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• 2012

Purpose: The aim of the present clinical trial was to compare pain during injection of anterior middle superior alveolar (AMSA) technique with that of infiltration injection technique in the maxilla in periodontal flap surgeries of patients referring to the Department of Periodontics, Faculty of Dentistry, Tabriz University of Medical Sciences. Methods: Twenty subjects with an age range of 20 to 40 years were selected for the present study. One side of the maxilla was randomly selected as the test side and the other as the control side using a flip of a coin. AMSA technique was used on the test side and infiltration technique was used on the control side for anesthesia. On both sides 2% lidocaine containing 1:80,000 epinephrine was used for anesthesia. The operator obtained the visual analogue scale for each patient immediately after the injection and immediately after surgery. Data was analyzed using descriptive statistical methods (frequency percentages, means and standard deviations) and Wilcoxon's test using SPSS ver. 13 (SPSS Inc.). Statistical significance was defined at P<0.05. Results: There were no statistically significant differences in pain during injection between the two techniques (P=0.856). There were statistically significant differences in postoperative pain between the two injection techniques (P=0.024). Conclusions: Postoperative pain in AMSA injection technique was less than that in the infiltration technique. Therefore, the AMSA technique is preferable in the periodontal surgeries for the anesthesia of palatal tissues given the fact that it has other advantages, too.

• Journal of Oral Medicine and Pain
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• v.42 no.3
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• pp.85-88
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• 2017

Burkitt's lymphoma is a malignant monoclonal proliferation of early B-lymphocyte. Since Burkitt's lymphoma is a highly aggressive disease, early detection is a crucial. This disease often involves jaw and mandibular mass or swelling may also be seen, but in the early phase of Burkitt's lymphoma these symptoms cannot be observed. A rare case of Burkitt's lymphoma without any mandibular mass and the general symptoms was present. The excruciating toothache led the patient to visit the dental clinic and misdiagnosis of chronic periodontal abscess was made initially. Dentists should consider the oral manifestations of systemic disease when the multiple periodontal ligament space widening is observed and the dental treatment for mimicking odontogenic pain has no effect.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.1
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• pp.21-28
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• 2020

Purpose: After periodontal surgery, studies have found that the use of periodontal wound dressing reduces the risk of wound infection and increases healing. The purpose of this study is to evaluate the effect of attachable periodontal wound dressing on the healing and patient satisfaction after periodontal flap surgery. Materials and Methods: Twenty-eight patients requiring periodontal surgery underwent periodontal flap surgery on both quadrants of maxilla or mandible. Postoperative pain, bleeding, dietary discomfort and hypersensitivity in relation to attachable periodontal wound dressing was assessed using Visual Analogue Scale (VAS). Additional survey on frequency of burning sensation and overall satisfaction rates were assessed. Results: VAS mean values for pain, bleeding, and dietary discomfort depending on the presence and absence of attachable wound dressing were; pain: 2.82, 3.96 (P = 0.002), bleeding: 1.61, 2.54 (P = 0.008), dietary discomfort: 2.82, 4.18 (P < 0.001), respectively. Test groups with attachable wound dressing reported significantly lower rates of discomfort. No significant difference was observed in burning sensation and hypersensitivity related with wound dressing. Satisfaction was higher in 75% of patients who received wound dressing. Conclusion: According to the results of this study, patients who received attachable periodontal wound dressing reported less postoperative pain, bleeding, and dietary discomfort. There was no statistical significance related to the use of wound dressing with burning sensation and hypersensitivity.