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Study Explores Opioid Prescribing Patterns and the Complications Associated with Liposomal Bupivacaine Use

Alexandria, VA – A study evaluating opioid prescribing patterns and postoperative complications in patients undergoing third molar removal treated with and without liposomal bupivacaine was presented at the 52nd Annual Meeting & Exhibition of the AADOCR, held in conjunction with the 47th Annual Meeting of the CADR. The AADOCR/CADR Annual Meeting & Exhibition took place at the Oregon Convention Center in Portland on March 15-18, 2023.

In the study, Caitlin B.L. Magraw of Head and Neck Surgical Associates carried out a retrospective review of patients who underwent extraction of impacted mandibular third molars from 2020-2022 by a single surgeon. Data collected included demographics, procedure performed, use of liposomal bupivacaine, number of opioids prescribed for postoperative analgesia, postoperative complications, and number of opioids prescribed for rescue analgesia in the setting of a complication.

The study identified 230 patients with a mean age of 23.6 years (100 males, 130 females). 62 (26.9%) of patients received liposomal bupivacaine. 60 (26%) patients were not prescribed any opioids at the time of their third molar removal (all received liposomal bupivacaine). For patients who were prescribed opioids (170), the average number of opioids prescribed was 8.7 tablets. 10 (4.3%) patients developed surgical site infections requiring antibiotics and 7 of these patients received liposomal bupivacaine. 22 (9.5%) patients developed alveolar osteitis and 4 of these patients received liposomal bupivacaine. Other complications included temporary inferior alveolar nerve paresthesia in 3 (1.3%) patients. 18 (7.8%) patients received a rescue prescription for opioids (average 12.8 tablets).

The administration of liposomal bupivacaine during third molar removal can eliminate the need to prescribe opoids for postoperative analgesia, the study concluded. Surgical site infections were more common in patients who received liposomal bupivacaine. Alveolar osteitis was seen more frequently in patients who did not receive liposomal bupivacaine.

This research was presented as part of the Interactive Talk presentation, “Opioid Prescribing Patterns and Complications Associated with Liposomal Bupivacaine Use”, which took place on Wednesday, March 15, 2023, at 8:20 a.m. Pacific Daylight Time (UTC-07:00) during the “Nerve Repair, Pain Management, OMS Education, & COVID” session from 8 a.m. – 9:30 a.m.

The American Association for Dental, Oral, and Craniofacial Research (AADOCR) is a nonprofit organization with a mission to drive dental, oral, and craniofacial research to advance health and well-being. AADOCR represents the individual scientists, clinician-scientists, dental professionals, and students based in academic, government, non-profit and private-sector institutions who share our mission. AADOCR is the largest division of the International Association for Dental Research. Learn more at