Postoperative pain is a common complication following mandibular molar extraction and can negatively affect patient comfort and recovery. Tetracycline is a broad-spectrum antibiotic with anti-inflammatory properties that may reduce postoperative inflammation and pain when applied locally to the extraction socket.
This randomized controlled trial aims to evaluate the effect of intraoperative placement of tetracycline on postoperative pain in patients undergoing surgical extraction of mandibular molars. A total of 74 eligible patients will be randomly assigned to receive either intrasocket tetracycline or no local medicament following tooth extraction. All participants will receive the same standard postoperative care and analgesic regimen. Postoperative pain will be assessed using the Visual Analog Scale (VAS) at 24 hours, 48 hours, and 7 days after surgery. The findings of this study will provide evidence regarding the effectiveness of local tetracycline in reducing postoperative pain and may help improve postoperative pain management following mandibular molar extraction.
Inclusion Criteria:
Adults aged 18 to 60 years. Male and female participants. Patients requiring surgical extraction of a mandibular molar. American Society of Anesthesiologists (ASA) Physical Status I or II. Able and willing to provide written informed consent and comply with study follow-up.
Exclusion Criteria:
Pregnant or lactating women. Patients with systemic conditions that contraindicate oral surgery (e.g., uncontrolled diabetes mellitus or immunosuppressive disorders).
Current use of antibiotics or medications that may interfere with wound healing (e.g., anticoagulants or bisphosphonates).
Known allergy or hypersensitivity to tetracycline or related antibiotics. Requirement for simultaneous extraction of adjacent teeth. Presence of active oral infection, including pericoronitis, at the surgical site.
Severely compromised oral hygiene that may affect postoperative healing. Individuals who are unable to cooperate with the study procedures or attend follow-up visits because of physical or cognitive impairment.
This is an open-label study. Participants and the operating surgeon are aware of treatment allocation because the intervention is applied directly into the extraction socket during surgery. Postoperative pain will be assessed using a standardized Visual Analog Scale (VAS).
Participants assigned to this arm will undergo surgical extraction of a mandibular molar followed by placement of 250 mg tetracycline mixed with 0.5 mL sterile saline directly into the extraction socket before primary wound closure. All participants will receive the same standardized postoperative care, including diclofenac sodium and oral hygiene instructions. Postoperative pain will be assessed using the Visual Analog Scale (VAS) at 24 hours, 48 hours, and 7 days.
Participants assigned to this arm will undergo surgical extraction of a mandibular molar without placement of any intrasocket medicament. All participants will receive the same standardized postoperative care, including diclofenac sodium and oral hygiene instructions. Postoperative pain will be assessed using the Visual Analog Scale (VAS) at 24 hours, 48 hours, and 7 days.
Lahore, Pakistan
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