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(50) Formulation and Evaluation of a Degradable Bupivacaine/Carbopol Hydrogel for Extended Pain Relief in Mandibular Third Molar Surgery: A Double-Blind Randomized Clinical Trial

Thursday, September 18, 2025
2:30 PM - 4:00 PM EDT

    Poster Presenter(s)

  • Erfan Khorasani, DDS (he/him/his)

    Research Associate
    USERN Office, Qazvin University of Medical Sciences, Qazvin, Iran
    Milpitas, California, United States

    • Co-Author(s)

  • PJ

    Pejman Janbaz, n/a

    Assistant professor
    Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Qazvin University of Medical Sciences
    Qazvin, Qazvin, Iran

  • MZ

    Mahdieh Zarabadipour, n/a

    Associate Professor
    Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Qazvin University of Medical Sciences
    Qazvin, Qazvin, Iran

  • MM

    Monirsadat Mirzadeh, n/a

    Associate Professor of Community Medicine
    Metabolic Diseases Research Center, Research institute for prevention of non-communicable diseases, Qazvin University of Medical Sciences
    Qazvin, Qazvin, Iran

  • AM

    Arash Mahboubi, n/a

    Professor
    Department of Pharmaceutics, School of Pharmacy, Shahid Beheshti University of Medical Sciences
    Tehran, Tehran, Iran

Disclosure(s):
Erfan Khorasani, DDS: No financial relationships to disclose
Abstract: Effective postoperative pain management following mandibular third molar surgery remains a clinical challenge, with conventional analgesics often associated with adverse effects such as gastrointestinal issues, opioid dependency, and inadequate localized pain control. This study evaluates the efficacy of a degradable Bupivacaine/Carbopol hydrogel as a sustained-release localized analgesic to reduce pain following third molar surgery.

A double-blind, split-mouth randomized clinical trial was conducted on 16 patients, each undergoing bilateral mandibular third molar extraction with a one-month interval between procedures. A Bupivacaine/Carbopol 934 hydrogel was applied to the extraction socket in one surgery, while a placebo hydrogel was administered in the contralateral site during the second surgery. Both hydrogels were delivered using sterile insulin syringes immediately after extraction, before wound closure. Patients recorded their pain levels using a visual analog scale (VAS) at 2, 6, 12, 24, 48, and 72 hours postoperatively and documented their painkiller consumption. Statistical analyses, including repeated measures ANOVA and independent t-tests, were performed using SPSS 24.

The Bupivacaine/Carbopol hydrogel significantly reduced postoperative pain at all time points beyond the first two hours (P < .05), while the placebo group reported consistently higher pain levels. Despite the analgesic benefits observed, painkiller consumption did not significantly differ between groups (P > .05), indicating that habitual medication use may play a role in patient pain management.

This study highlights the potential of hydrogel-based sustained drug delivery in oral and maxillofacial surgery, demonstrating its efficacy in reducing localized pain while minimizing systemic drug exposure. Further research with larger cohorts and pharmacokinetic analyses is required to optimize formulation and dosing strategies.

1. Davis B, Erickson S, Wojtalewicz S, et al. Entrapping bupivacaine-loaded emulsions in a crosslinked-hydrogel increases anesthetic effect and duration. Int J Pharm. 2020;588:119703.

2. Bender L, Boostrom HM, Varricchio C, et al. A novel dual-action monolithic thermosetting hydrogel loaded with lidocaine and metronidazole for alveolar osteitis treatment. Eur J Pharm Biopharm. 2020;149:85-94.
Figure 1. Pain in 72 hours post-surgeryFigure 2. Painkiller consumption in 72 hours post-surgery in each group