MICRON-SIZED PEA MICROGRANULES AS AN ADJUNCTIVE STRATEGY FOR POSTOPERATIVE MANAGEMENT AFTER THIRD MOLAR EXTRACTION: A REAL-WORLD EXPERIENCE: V. Schweiger1, F. Lonardi2, A. Bertajola2, A. Lerco2, L. Villagrossi1, A. Martini1, C. Schievano3, E. Polati1, M. Albanese2 | 1Department of Anaesthesia, Intensive Care and Pain Therapy, University of Verona, Verona, Italy; 2Department of Oral and Maxillofacial Surgery, University of Verona, Verona, Italy; 3Innovative Statistical Research, Padua, Italy

Introduction. Surgical extraction of third molars is one of the most common procedures in oral and maxillofacial surgery. Postoperative complications, including swelling, pain and trismus, are frequently reported and largely driven by tissue edema resulting from the inflammatory response to surgical manipulation (1). Palmitoylethanolamide (PEA) is an endogenous Autacoid Local Injury Antagonism (ALIA) lipid amide, produced on demand in response to tissue damage and contributing to restore local homeostasis, mainly through modulation of mast cell and microglia activity (2). In micron-sized formulations - i.e. micronized (mPEA) and ultramicronized (umPEA) - PEA shows increased bioavailability and represents a promising strategy for managing inflammation and pain. This real-world study evaluated the effect of microPEA as an adjunct to standard analgesics on postoperative edema and pain in patients undergoing third molar surgical extraction.Methods. The study included 68 adult patients (≥18 years), of both sexes. During the postoperative week, all patients used analgesics as needed; 34 patients additionally received 2 sachets/day of orodispersible mPEA+umPEA granules (300 mg + 600 mg per sachet; Normast® MPS microgranules). Edema was assessed on postoperative days 3 (T3) and 7 (T7) using clinician-based photographic measurements. Pain severity was recorded daily (T1–T7) using a 0-10 Numeric Rating Scale (NRS), with patients classified at T1 as having absent-to-mild (NRS 0-4) or moderate-to-severe pain (NRS 5-10). Data were analyzed using a generalized linear mixed model (GLMM) with Tukey–Kramer post hoc tests for multiple comparisons. A P value