Effect of Subperiosteal Ropivacaine After Third Molar Extraction

This study examined whether an additional injection of the long-acting local anesthetic ropivacaine at the surgical site could reduce pain and improve recovery after removal of lower wisdom teeth. Adults aged 18 to 65 years who needed both lower wisdom teeth removed could take part. Each participant underwent two separate wisdom tooth removal procedures, approximately two weeks apart. After one procedure, ropivacaine was injected near the surgical area, while after the other procedure, a sterile saline solution was given in the same way for comparison. Neither the participant nor the surgeon knew which treatment was used at each procedure. Participants recorded their pain after surgery and their use of pain-relieving medication. Mouth opening and the effect of the procedure on daily life and oral health-related quality of life were also assessed. The purpose of the study was to determine whether adding ropivacaine at the surgical site could provide better pain relief and postoperative recovery than standard treatment alone.

Inclusion Criteria: * Age 18 to 65 years. * American Society of Anesthesiologists (ASA) physical status I. * Presence of both mandibular third molars, with both teeth indicated for surgical extraction. * Both mandibular third molars of the same Pell and Gregory classification. * Satisfactory dental and oral health, without acute inflammatory processes at the surgical site or elsewhere in the oral cavity, including pericoronitis, pulpitis, or apical periodontitis. * No use of analgesic medication within 24 hours before surgery. * No use of antibiotics within 1 month before surgery. * Ability and willingness to provide written informed consent. * Willingness and ability to comply with study procedures and follow-up. Exclusion Criteria: * American Society of Anesthesiologists (ASA) physical status II, III, or IV. * Pregnancy or breastfeeding. * Known allergy to amide-type local anesthetics, vasoconstrictors, or related compounds. * Use of dietary supplements that could affect local anesthesia. * History of drug or analgesic abuse. * Unsatisfactory dental or oral health, including untreated dental caries, periodontitis, or periapical lesions.