Third Molar SurgeryPhase 4NCT04200885
Is Therapeutic Elastic Bandage As Effective As Corticosteroids Following Third Molar Surgery?
A Phase 4 study testing Dexketoprofen Trometamol, Dexamethasone 21-Phosphate and Therapeutic Elastic Bandage in people with Third Molar Surgery, run by Tokat Gaziosmanpasa University at 1 site in Turkey (Türkiye).
Trial summary
In this study; Among the patients randomized because of severe postoperative sequelae expected as a result of radiological and clinical examinations; nonsteroid antiinflammatory drug prescribed group compared with preoperative single dose intraoral submucosal corticosteroid administration and therapeutic elastic… Read more about this study
- Who is it for?
- Ages 18 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Third Molar Surgery
- What is being tested?
- Dexketoprofen Trometamol, Dexamethasone 21-Phosphate and Therapeutic Elastic Bandage
- Type of treatment
- Pill or oral medicine, Injection or infusion, Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 52 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 2 May 2019to 21 Nov 2019
- Phase
- Phase 4
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Age between 18-65 years
- American Society of Anesthesiologists (ASA) Class 1 physiological status
- Consistent radiological and clinical data
- Volunteered to participate in the study
- Surgical difficulty score above 5 which was determined according to Pederson scale.
Who cannot join
- Being out of age range
- Analgesic or antibiotic therapy history in last 30 days due to symptoms of related third molar
- Smoking cigarette
- Any pathology associated with impacted third molar
- Active complaints on preoperative examination on the day of surgery
- Immunosuppressed or diagnosed with malignancy
Show all 12Show fewer
- Diagnosed chronic diseases such as; Diabetes mellitus (DM), hypertension, cerebrovascular event, psychiatric diseases, coagulopathies
- Autoimmune diseases
- If total operation time exceeds 45 minutes
- Patients who could not attend regular follow-up visits
- Allergy to the medications prescribed or utilized in study protocol
- Inconsistent clinical and radiological data
Trial locations and contacts
1 site in 1 country.
Turkey (Türkiye)1 site
Tokat Gaziosmanpasa University, Faculty of Dentistry
Tokat Province, 60100
About this study
Official title: Comparison Of The Effectiveness Of Submucosal Corticosteroid Injection And Elastic Therapeutic Bandage Applications On Pain, Swelling And Trismus After Surgical Removal Of Mandibular Third Molar Teeth
In this study; Among the patients randomized because of severe postoperative sequelae expected as a result of radiological and clinical examinations; nonsteroid antiinflammatory drug prescribed group compared with preoperative single dose intraoral submucosal corticosteroid administration and therapeutic elastic bandage application considering inflammatory symptoms' severity and health related quality of life following surgical removal of impacted third molars. The study hypothesis was formed stating that corticosteroid injection and elastic bandage application would reduce the inflammatory symptoms more than NSAID.
- Conditions
- Third Molar Surgery
- Being tested
- Dexketoprofen Trometamol, Dexamethasone 21-Phosphate, Therapeutic Elastic Bandage
- Keywords
- Dexamethasone, Applied Kinesiology, Non-Steroidal Anti-Inflammatory Agents, Teeth, Impacted, Edema, Trismus, Postoperative Pain
- Medical subject headings
- Tooth, Impacted, Edema, Trismus, Pain, Postoperative
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Dexketoprofen TrometamolDrug
Also called Arveles 25 mg 20 tablets
Patients were instructed to record the number of drugs they used until the second and seventh postoperative days.
Dexamethasone 21-PhosphateDrug
Also called Dekort 8mg/2ml Intramuscular (IM)/ Intravenous (IV)
Injections were administered in the immediate preoperative period as a single shot.
Therapeutic Elastic BandageDevice
Also called Kinesio Tex Gold Fingerprint (FP)
The bands' lengths were individually measured and divided into five equal parts up to 2/3 of their lengths to obtain fan-type shape.
| Study group | Role | What they receive |
|---|---|---|
| Postoperative NSAID Prescription | Active comparator | Patients in this arm received common postoperative prescriptions following removal of their impacted third molars for seven days; twice a day 500 mg amoxicillin+125 mg clavulanic acid, twice a day 25 mg dexketoprofen trometamol and three times a day 1.5 mg/ml clorhexidine gluconate+1.2 mg/ml benzydamine hydrochloride containing 200 ml mouthwash. Receives: Drug: Dexketoprofen Trometamol |
| Preoperative Submucosal Corticosteroid Injection | Active comparator | Patients in this arm were administered 8mg/2ml dexamethasone 21-phosphate preoperatively after local anesthesia were obtained. Injection site was the depth of buccal sulcus near operation site. For the patients in this arm 25 mg dexketoprofen trometamol was excluded from postoperative prescription in order not to affect the anti-inflammatory effects of corticosteroid. Instead of NSAID, three times a day 500 mg paracetamol was prescribed. The patients were advised not to exceed maximal dosage of 3000 mg (6 tablets) in a day. Receives: Drug: Dexamethasone 21-Phosphate |
| Postoperative Therapeutic Elastic Bandage Application | Active comparator | In this arm the therapeutic elastic bandage applications were immediately performed after removal of mandibular third molars. The distance between tragus-lateral commissura line and supraclavicular lymph nodes was measured and the tapes were then cut into 5 tails. The base of the tape was placed on supraclavicular lymph nodes and tails were placed on the site to cover parotid, submandibular, submental and superficial cervical lymph nodes. The tapes were removed on postoperative second day. Receives: Device: Therapeutic Elastic Bandage |
What is being measured
The primary outcome is the main question the study is designed to answer.
Preoperative Pain Intensity
The patients were asked to mark their pain intensities on a Numerical Rating Scale in which '0' means no pain, '5' means moderate pain and '10' means worst imaginable pain on the day of surgery preoperatively.
Measured: On the day of surgery preoperatively
Change From Baseline Maximal Mouth Opening on Postoperative Follow Up Visits
All patients' maximal mouth opening were measured and recorded as the distance between upper and lower right central incisors.
Measured: Preoperatively on the day of surgery, postoperative second and seventh days.
Change From Baseline Facial Measurements on Postoperative Follow Up Visits
Measurements were performed on the ipsilateral site between tragus and lateral commissura, lateral canthus and angle of mandible with a flexible ruler. The obtained values' average amounts were calculated and recorded for each patient.
Measured: Preoperatively on the day of surgery, postoperative second and seventh days.
Oral Analgesic Consumption-1
The patients were asked to record the amounts of consumed analgesic tablets (tablets per day) until first follow up visit.
Measured: Postoperative Second Day
Postoperative Pain Intensity-1
The patients were asked to mark their pain intensities on a Numerical Rating Scale in which '0' means no pain, '5' means moderate pain and '10' means worst imaginable pain.
Measured: Postoperative Second Day
Postoperative Pain Intensity-2
The patients were asked to mark their pain intensities on a Numerical Rating Scale in which '0' means no pain, '5' means moderate pain and '10' means worst imaginable pain.
Measured: Postoperative Seventh Day
Oral Analgesic Consumption-2
The patients were asked to record the amounts of consumed analgesic tablets (tablets per day) between first and last follow up visits.
Measured: Postoperative Seventh Day
Secondary outcomes (3)
Wound Healing Scores
Extraction wound healing rates were evaluated by Landry's healing index. The index scores were classified as; 1. Very poor, 2. Poor, 3. Good, 4. Very Good and 5. Excellent.
Measured: Postoperative second and seventh days.
Oral Health Impact Profile
Oral health-related quality of life was followed up with Oral Health Impaction Profile-14 questionnaire (Turkish Version). The investigators aimed to detect the alterations in quality of life due to surgical intervention and the other treatment modalities. The obtainable scores vary between 0-56 points. Lower scores indicate better postoperative physical and psychological conditions.
Measured: Preoperatively on the day of surgery, postoperative second and seventh days.
Postoperative Symptom Severity Evaluation
Postoperative inflammatory symptoms were evaluated with the postoperative symptom severity scale at the end of the follow-up period individually. The scale scores vary between 0%-100%. The higher scores indicate that the individual experienced severe symptoms. The investigators aimed to detect the severity of symptoms from the point of the patient's view.
Measured: Postoperative seventh day.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Dec 2019
- Study start2 May 2019
- Primary completion26 Aug 2019
- Study completion21 Nov 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Third Molar SurgeryStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Among the patients randomized because of severe postoperative sequelae expected as a result of radiological examination prior to surgical extraction of lower third molar teeth; postoperatively nonsteroid antiinflammatory drug prescribed group compared with preoperative single dose intraoral submucosal corticosteroid administration and postoperative therapeutic elastic bandage application.
- Masking
- None (open label)
- Enrolment
- 52 participants (actual)
Sponsor and investigators
- Lead sponsor
- Tokat Gaziosmanpasa University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Aras Erdil, Tokat Gaziosmanpasa University
- Investigators
- Nihat Akbulut, Assoc. Dr., Study director, Tokat Gaziosmanpasa University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04200885
- Sponsor's protocol ID
- 19-KAEK-100
- Status last verified
- Dec 2019
- First submitted
- 8 Dec 2019
- Last updated
- 17 Dec 2019
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: All individual participant data (IPD) related to study protocol and results will be shared during submitting as an article.
Publications
Ristow O, Hohlweg-Majert B, Sturzenbaum SR, Kehl V, Koerdt S, Hahnefeld L, Pautke C. Therapeutic elastic tape reduces morbidity after wisdom teeth removal--a clinical trial. Clin Oral Investig. 2014 May;18(4):1205-1212. doi: 10.1007/s00784-013-1067-3. Epub 2013 Aug 21.
PubMed 23963616Alcantara CE, Falci SG, Oliveira-Ferreira F, Santos CR, Pinheiro ML. Pre-emptive effect of dexamethasone and methylprednisolone on pain, swelling, and trismus after third molar surgery: a split-mouth randomized triple-blind clinical trial. Int J Oral Maxillofac Surg. 2014 Jan;43(1):93-8. doi: 10.1016/j.ijom.2013.05.016. Epub 2013 Jun 28.
PubMed 23810681Deo SP. Single-Dose of Submucosal Injection of Dexamethasone Affects the Post Operative Quality of Life After Third Molar Surgery. J Maxillofac Oral Surg. 2016 Sep;15(3):367-375. doi: 10.1007/s12663-015-0846-6. Epub 2015 Dec 7.
PubMed 27752209Erdil A, Akbulut N, Altan A, Demirsoy MS. Comparison of the effect of therapeutic elastic bandage, submucosal dexamethasone, or dexketoprofen trometamol on inflammatory symptoms and quality of life following third molar surgery: a randomized clinical trial. Clin Oral Investig. 2021 Apr;25(4):1849-1857. doi: 10.1007/s00784-020-03487-y. Epub 2020 Aug 15.
PubMed 32803439
Study at a glance
From the registry record, last updated by the sponsor on 17 Dec 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison Of The Effectiveness Of Submucosal Corticosteroid Injection And Elastic Therapeutic Bandage Applications On Pain, Swelling And Trismus After Surgical Removal Of Mandibular Third Molar Teeth
- ClinicalTrials.gov ID
- NCT04200885
- Acronym / sponsor ID
- 19-KAEK-100
- Conditions
- Third Molar Surgery
- Keywords
- Dexamethasone, Applied Kinesiology, Non-Steroidal Anti-Inflammatory Agents, Teeth, Impacted, Edema, Trismus, Postoperative Pain
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 52 participants (actual)
- Lead sponsor
- Tokat Gaziosmanpasa UniversityUniversity, hospital or other
- Study start
- 2 May 2019 (actual)
- Primary completion
- 26 Aug 2019 (actual)
- Study completion
- 21 Nov 2019 (actual)
- First posted
- 16 Dec 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
In this study; Among the patients randomized because of severe postoperative sequelae expected as a result of radiological and clinical examinations; nonsteroid antiinflammatory drug prescribed group compared with preoperative single dose intraoral submucosal corticosteroid administration and therapeutic elastic bandage application considering inflammatory symptoms' severity and health related quality of life following surgical removal of impacted third molars. The study hypothesis was formed stating that corticosteroid injection and elastic bandage application would reduce the inflammatory symptoms more than NSAID.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
- Model description
- Among the patients randomized because of severe postoperative sequelae expected as a result of radiological examination prior to surgical extraction of lower third molar teeth; postoperatively nonsteroid antiinflammatory drug prescribed group compared with preoperative single dose intraoral submucosal corticosteroid administration and postoperative therapeutic elastic bandage application.
| Arm | Type | Receives |
|---|---|---|
| Postoperative NSAID Prescription | Active comparator | Drug: Dexketoprofen TrometamolPatients in this arm received common postoperative prescriptions following removal of their impacted third molars for seven days; twice a day 500 mg amoxicillin+125 mg clavulanic acid, twice a day 25 mg dexketoprofen trometamol and three times a day 1.5 mg/ml clorhexidine gluconate+1.2 mg/ml benzydamine hydrochloride containing 200 ml mouthwash. |
| Preoperative Submucosal Corticosteroid Injection | Active comparator | Drug: Dexamethasone 21-PhosphatePatients in this arm were administered 8mg/2ml dexamethasone 21-phosphate preoperatively after local anesthesia were obtained. Injection site was the depth of buccal sulcus near operation site. For the patients in this arm 25 mg dexketoprofen trometamol was excluded from postoperative prescription in order not to affect the anti-inflammatory effects of corticosteroid. Instead of NSAID, three times a day 500 mg paracetamol was prescribed. The patients were advised not to exceed maximal dosage of 3000 mg (6 tablets) in a day. |
| Postoperative Therapeutic Elastic Bandage Application | Active comparator | Device: Therapeutic Elastic BandageIn this arm the therapeutic elastic bandage applications were immediately performed after removal of mandibular third molars. The distance between tragus-lateral commissura line and supraclavicular lymph nodes was measured and the tapes were then cut into 5 tails. The base of the tape was placed on supraclavicular lymph nodes and tails were placed on the site to cover parotid, submandibular, submental and superficial cervical lymph nodes. The tapes were removed on postoperative second day. |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Age between 18-65 years
- American Society of Anesthesiologists (ASA) Class 1 physiological status
- Consistent radiological and clinical data
- Volunteered to participate in the study
- Surgical difficulty score above 5 which was determined according to Pederson scale.
Key exclusion criteria (12 listed)
- Being out of age range
- Analgesic or antibiotic therapy history in last 30 days due to symptoms of related third molar
- Smoking cigarette
- Any pathology associated with impacted third molar
- Active complaints on preoperative examination on the day of surgery
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Dexketoprofen TrometamolAlso: Arveles 25 mg 20 tabletsPatients were instructed to record the number of drugs they used until the second and seventh postoperative days. | Drug | Postoperative NSAID Prescription |
| Dexamethasone 21-PhosphateAlso: Dekort 8mg/2ml Intramuscular (IM)/ Intravenous (IV)Injections were administered in the immediate preoperative period as a single shot. | Drug | Preoperative Submucosal Corticosteroid Injection |
| Therapeutic Elastic BandageAlso: Kinesio Tex Gold Fingerprint (FP)The bands' lengths were individually measured and divided into five equal parts up to 2/3 of their lengths to obtain fan-type shape. | Device | Postoperative Therapeutic Elastic Bandage Application |
Primary outcome
Preoperative Pain Intensity
Time frame: On the day of surgery preoperatively
The patients were asked to mark their pain intensities on a Numerical Rating Scale in which '0' means no pain, '5' means moderate pain and '10' means worst imaginable pain on the day of surgery preoperatively.
Change From Baseline Maximal Mouth Opening on Postoperative Follow Up Visits
Time frame: Preoperatively on the day of surgery, postoperative second and seventh days.
All patients' maximal mouth opening were measured and recorded as the distance between upper and lower right central incisors.
Change From Baseline Facial Measurements on Postoperative Follow Up Visits
Time frame: Preoperatively on the day of surgery, postoperative second and seventh days.
Measurements were performed on the ipsilateral site between tragus and lateral commissura, lateral canthus and angle of mandible with a flexible ruler. The obtained values' average amounts were calculated and recorded for each patient.
Oral Analgesic Consumption-1
Time frame: Postoperative Second Day
The patients were asked to record the amounts of consumed analgesic tablets (tablets per day) until first follow up visit.
Postoperative Pain Intensity-1
Time frame: Postoperative Second Day
The patients were asked to mark their pain intensities on a Numerical Rating Scale in which '0' means no pain, '5' means moderate pain and '10' means worst imaginable pain.
Postoperative Pain Intensity-2
Time frame: Postoperative Seventh Day
The patients were asked to mark their pain intensities on a Numerical Rating Scale in which '0' means no pain, '5' means moderate pain and '10' means worst imaginable pain.
Oral Analgesic Consumption-2
Time frame: Postoperative Seventh Day
The patients were asked to record the amounts of consumed analgesic tablets (tablets per day) between first and last follow up visits.
3 secondary outcomes
Wound Healing Scores
Time frame: Postoperative second and seventh days.
Oral Health Impact Profile
Time frame: Preoperatively on the day of surgery, postoperative second and seventh days.
Postoperative Symptom Severity Evaluation
Time frame: Postoperative seventh day.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Dec 2019.
- Background: PubMed 23963616Ristow O, Hohlweg-Majert B, Sturzenbaum SR, Kehl V, Koerdt S, Hahnefeld L, Pautke C. Therapeutic elastic tape reduces morbidity after wisdom teeth removal--a clinical trial. Clin Oral Investig. 2014 May;18(4):1205-1212. doi: 10.1007/s00784-013-1067-3. Epub 2013 Aug 21.
- Background: PubMed 23810681Alcantara CE, Falci SG, Oliveira-Ferreira F, Santos CR, Pinheiro ML. Pre-emptive effect of dexamethasone and methylprednisolone on pain, swelling, and trismus after third molar surgery: a split-mouth randomized triple-blind clinical trial. Int J Oral Maxillofac Surg. 2014 Jan;43(1):93-8. doi: 10.1016/j.ijom.2013.05.016. Epub 2013 Jun 28.
- Background: PubMed 27752209Deo SP. Single-Dose of Submucosal Injection of Dexamethasone Affects the Post Operative Quality of Life After Third Molar Surgery. J Maxillofac Oral Surg. 2016 Sep;15(3):367-375. doi: 10.1007/s12663-015-0846-6. Epub 2015 Dec 7.
- Derived from this study: PubMed 32803439Erdil A, Akbulut N, Altan A, Demirsoy MS. Comparison of the effect of therapeutic elastic bandage, submucosal dexamethasone, or dexketoprofen trometamol on inflammatory symptoms and quality of life following third molar surgery: a randomized clinical trial. Clin Oral Investig. 2021 Apr;25(4):1849-1857. doi: 10.1007/s00784-020-03487-y. Epub 2020 Aug 15.
- Individual participant dataSharing planned: Yes. All individual participant data (IPD) related to study protocol and results will be shared during submitting as an article.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Nihat Akbulut, Assoc. Dr. study director
Tokat Gaziosmanpasa University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Dexketoprofen Trometamol, Dexamethasone 21-Phosphate and Therapeutic Elastic Bandage in people with Third Molar Surgery, run by Tokat Gaziosmanpasa University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 17 Dec 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Preoperative Pain Intensity (time frame: On the day of surgery preoperatively). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04200885, which also lists 4 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Dec 2019.