Background. Various methods have been introduced for anxiety control during third‐molar extraction surgery. Dexmedetomidine (DEX) is known to have analgesic, anxiolytic, and sympatholytic properties with minimal adverse effects. This study aimed to evaluate the impact of the local injection of the combination of DEX and Lidocaine on patients’ anxiety and the surgeon’s satisfaction during third‐molar extraction surgery. Methods. A total number of 26 healthy volunteers with symmetrical bilateral impacted mandibular third‐molar teeth indicated for surgical removal were included in this double‐blind randomized controlled trial. A single experienced surgeon performed two surgical extraction procedures within at least four‐week time intervals using anesthetic cartridges containing “DEX + LIDO” or “LIDO alone” used randomly on each side for each patient. The Visual Analog Scale and the SDFQ index were used to evaluate patients’ anxiety and surgeon satisfaction during the procedure. Results. SDFQ reports showed that patients in the “DEX” group were 1.5 times more relaxed than those in the “LIDO alone” group. As a result, the level of sedation was considered statistically significant between the two groups (Wilcoxon test, P value <0.019). Wilcoxon test results also showed significant differences between the two groups regarding patients’ overall cooperation in terms of interfering movement and verbal presentation of discomfort (P value 0.05). Moreover, both the surgeon and the patients reported a significantly higher satisfaction rate in the DEX group (paired T‐test, df = 25, P value <0.05). Conclusions. It was inferred from the outcomes of the present study that the application of DEX added to the LIDO local anesthesia cartridge could significantly benefit anxious patients with previous unpleasant dental treatment experiences. Trial Registration. This trial is registered with the clinical trial registration number: IRCT20200406046966N.

Background and objective: Obstructive sleep apnea (OSA) can be related to changes in the levels of adipokines and neuropeptides, which in turn may affect the energy balance components of neuronal cells. Herein, a systematic review and meta-analysis checked the changes in serum/plasma levels of omentin-1 (OM-1: an adipokine) and orexin-A (OXA: a neuropeptide) in adults (age > 18 years old) with OSA (aOSA) compared to controls. Materials and methods: Four databases (Cochrane Library, PubMed, Web of Science, and Scopus) were systematically searched until 14 November 2022, without any restrictions. The Joanna Briggs Institute (JBI) critical appraisal checklist adapted for case–control studies was used to assess the quality of the papers. The effect sizes were extracted using the Review Manager 5.3 software for the blood levels of OM-1 and OXA in aOSA compared with controls. Results: Thirteen articles, with six studies for OM-1 levels and eight for OXA levels, were included. The pooled standardized mean differences were −0.85 (95% confidence interval (CI): −2.19, 0.48; p = 0.21; I² = 98%) and −0.20 (95%CI: −1.16, 0.76; p = 0.68; I² = 96%) for OM-1 and OXA levels, respectively. Among the studies reporting OM-1, five were high and one was moderate quality. Among the studies reporting OXA, six were moderate, one was high, and one was low quality. Based on the trial sequential analysis, more participants are needed to confirm the pooled results of the analyses of blood levels of OM-1 and OXA. In addition, the radial plot showed outliers as significant factors for high heterogeneity. Conclusions: The main findings indicated a lack of association between the blood levels of OM-1 and OXA and OSA risk. Therefore, OM-1 and OXA did not appear to be suitable biomarkers for the diagnosis and development of OSA.

Leukocyte- and platelet-rich fibrin (L-PRF) could be considered a preventive measure in Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ). The present experiment aimed to assess the preventive effects of L-PRF on osteonecrosis of the jaw in rats. In this interventional animal study with a split-mouth design, 28 rats were randomly allocated to saline (negative control), bisphosphonate (positive control), and Bis + L-PRF (case) groups. Bilateral extraction of maxillary molar teeth was performed followed by random application of L-PRF to one of the extraction sockets treated with Zoledronic acid for four weeks. Clinical occurrence of BRONJ and histopathologic evaluations were done, and data were subjected to the Kruskal-Wallis test, Mann-Whitney U test and exact Fisher test performed using SPSS 25. The significance level was set at 0.05. The application of L-PRF resulted in a 41.67% reduction in osteonecrosis centers and the number of osteoclast cells. Also, Kruskal Wallis test results showed a significant difference among the three groups regarding the frequency distribution of inflammation severity. However, no significant difference was detected regarding the frequency distribution of the blood vessels (Kruskal Wallis test, P-value = 0.649). It could be inferred that possible preventive effects on the clinical occurrence of osteonecrosis could be expected from the application of L-PRF.

Introduction: Suture materials selection and application have gained more importance, especially with the increasing number of patients seeking oral surgeries. Since lying in a bacterial-filled environment, sutures make the tissue prone to infection. Suture material plays an essential role in reducing the risk of infection. This study aimed to assess the success rate of an antibacterial suture, Vicryl Plus (Ethicon Inc, Johnson and Johnson Company, Somerville, NJ), in preventing bacterial growth in the surgical site of the mandibular third molar. Materials and Methods: About 27 patients were included in this double-blinded randomized clinical trial study. Surgical extraction of the mandibular wisdom tooth was done, and the incision was managed by randomly using Vicryl Plus and Vicryl (Ethicon Inc) sutures. After 7 days, sutures were removed and assessed microbiologically. Indicator species of Streptococcus mutans and Lactobacillus were assessed, and the total number of colonies on each suture was counted. Results: There was a significant difference between the two suture materials in the colony number-length ratio of Lactobacillus (P = 0.031) and total bacterial colonies (P = 0.016), but not for S. mutans species (P = 0.201). Conclusion: Antibacterial Vicryl suture can be a useful tool to reduce bacterial accumulation on the suture material in third molar extraction surgery.