Surgical procedures and medications
tissue damage, bleeding, fever, painful symptoms, pain, mucoperiosteal detachment, infection, tooth, Tooth
SUPPURATION, BLEEDING, INFILTRATION, INFECTION, COLD, COMPLICATIONS
A single surgeon who strictly followed all biosafety protocols performed all surgical procedures. Before the procedure, all patients underwent intraoral antisepsis with 0.12% chlorhexidine gluconate mouthwash for one minute, and extraoral antisepsis with 2% povidone-iodine solution. For each patient, the same surgical protocol was performed in both surgeries in order to standardize the intensity of tissue damage caused in both surgical sites. All patients were anesthetized using a carpule syringe equipped with a long needle and 2 cartridges (4% articaine) of local anesthetic with 1:100,000 epinephrine for truncal anesthesia of the inferior alveolar nerve and infiltrations in the buccal and lingual nerve. A No. 15 blade attached to a No. 3 scalpel handle was used for the initial incision in the distal region of the second molar resting on the retromolar bone, followed by an intra-sucular incision around the gingival sulcus of the second molar. If the surgeon deemed it necessary, a relaxing incision was made, preserving the interdental papilla between the first and second molars in an inferior direction in the buccal sulcus. Continuing, a molt #9 dissector was used for mucoperiosteal detachment. Next, a channel-shaped peripheral osteotomy was performed around the third molar with the aid of a high-speed handpiece coupled to a 702 trunk-conical surgical drill, and if necessary, tooth section was performed at the same time using the same equipment. Tooth removal was performed with the aid of levers and at the end of removal; bone regularization was performed with the aid of a bone file and abundant 0.9% saline solution irrigation. The final suture was performed using 4.0 silk thread and removed one week after the surgical procedure. It is noteworthy that the surgery time (from the beginning of anesthesia to the end of the suture) was always tracked to assess the standardization of procedures.All patients received orientations on the need for postoperative care in relation to rest, food, and oral hygiene. In addition, the patients were guided to contact the team in case of any complications such as excessive bleeding, exaggerated pain, or signs of infection (fever and suppuration). In addition, all received the postoperative medication nimesulide 100mg, to be taken one tablet every 12 hours for 3 days; and further, only in case of painful symptoms, to ingest a 500mg dipyrone tablet. Now if the pain persisted, they could continue using a 500mg dipyrone tablet every 6 hours, always recording the amount of rescue analgesic ingested. Each patient received a card in which they recorded the amount of rescue medication taken on each postoperative day. In this card was written the postoperative recommendations like - first and second postoperative day: cryotherapy, liquid and cold diet; third day: warm compress and mouthwash with 0.12% chlorhexidine and at the seventh day the suture was removed.