Efficacy of various administrative techniques of methylprednisolone on oedema, trismus and pain after lower third molar surgery

  • Authors

    • Vaibhav Mukund Associate Professor, Department of Oral & Maxiofacial surgery, ITS-CDSR Ghaziabad
    • Sukumar Singh MDS, Department of Oral & Maxiofacial surgery, ITS-CDSR Ghaziabad
    • Sanjeev Kumar HOD & Professor, Department of Oral & Maxiofacial surgery, ITS-CDSR Ghaziabad
    • Rishi Rath HOD & Professor, Department of Pharmacology, ITS-CDSR Ghaziabad
    • Siddharth Tevatia MDS, PERIODONTOLOGY & ORAL IMPLANTOLOGY
    2017-10-30
    https://doi.org/10.14419/ijdr.v5i2.8343
  • Abstract

    Due to their anatomical position, the surgical removal of impacted third molars results in oedema, pain, and trismus. The purpose of this study was to evaluate the efficacy of four different routes of administration of methylprednisolone on oedema, trismus and pain after lower third molar surgery. This randomized, perspective, and controlled study included 150 patients. The patients were randomly divided into five groups: Group A (control; no steroids), Group B (Submucosal injection), Group C (oral tablets), Group D (i.v. injection) and Group E (Intramuscular Injection). On days 2 and 7 following surgery, linear oedema was determined using facial landmarks, and maximal mouth opening was measured. Postoperative mouths opening and swelling were evaluated for each route of methylprednisolone administration and compared. The female (59%) to male (41%) ratio was 1.44; the mean age of the patients was 29.6 years. The level of significance was set at P < 0.01 for mouth opening and P < 0.05 for oedema. With regard to trismus, all four routes of administration demonstrated better efficacy in comparison to the control. While oral administration and i.v. injection of methylprednisolone achieved similar results, masseter injection provided better results in reducing oedema and trismus when compared with the control following lower third molar surgery.

  • References

    1. [1] Bamgbose BO, Akinwande JA, Adeyemo WL, Ladeinde AL, Arotiba GT, Ogunlewe MO. Effects of co-administered dexametha- sone and diclofenac potassium on pain, swel-ling and trismus following third molar surgery. Head Face Med 2005; 7:11. https://doi.org/10.1186/1746-160X-1-11.

      [2] Laureano Filho JR, Maurette PE, Allais M, Cotinho M, Fernandes C. Clinical compara-tive study of the effectiveness of two dosages of dexamethasone to control postoperative swelling, trismus and pain after the surgical extraction of mandibular impacted third molars. Med Oral Pathol Oral Cir Bucal 2008; 13:129–32.

      [3] Kulkarni D, Kshirsagar K. Comparison of the efficacy of dexamethasone and methylpredni- solone during post-operative period of surgi- cal removal of impacted mandibular third molar—a clinical study. JIDA 2011; 5:683–6.

      [4] Hirschman JV. Some principles of systemic glucocorticoid therapy. Clin Exp Dermatol 1986; 11:27–33. https://doi.org/10.1111/j.1365-2230.1986.tb00420.x.

      [5] Ustun Y, Erdogan O, Esen E et al. Comparison of the effects of 2 doses of methylprednisolone on pain, swelling, and trismus after third molar surgery. OralSurg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96:535-9. https://doi.org/10.1016/S1079-2104(03)00464-5.

      [6] Yuasa H, Sugiura M. Clinical postoperative findings after removal of impacted mandibular third molars: prediction of postoperative facial swelling and pain based on preoperative variables. Br J Oral Maxillofac Surg. 2004; 42:209-14. https://doi.org/10.1016/j.bjoms.2004.02.005.

      [7] Sancho-Puchades M, Valmaseda-Castellón E, Berini-Aytés L,Gay-Escoda C. Quality of life following third molar removal under conscious sedation. Med Oral Patol Oral Cir Bucal. 2012; 17:994-9. https://doi.org/10.4317/medoral.17677.

      [8] Filho JRL, Maurette PE, Allais M, Cotinho M, Fernandes C. Clinical comparative study of the effectiveness of two dosages of dexamethasone to control postoperative swelling, trismus and pain after the surgical extraction of mandibular impacted third molars.Med Oral Pathol Oral Cir Bucal. 2008; 13:129-32.

      [9] Huffman GG. Use of methylprednisolone sodium succinate to reduce postoperative oedema after removal of impacted third molars. J Oral Surg1977; 35:198-9.

      [10] Novak E, Stubbs SS, Seckman CE, Hearron MS. Effects of a single large intravenous dose of methylprednisolone sodium succinate. Clin Pharm Ther 1970; 11:711–7. https://doi.org/10.1002/cpt1970115711.

      [11] Vegas Bustamante E, Mico Liorens J, Gargalio Albiol J et al. Efficacy of methylprednisolone injected into the masseter muscle following the surgical extraction of impacted third molars. Int J Oral Maxillofac surg. 2008; 37:260-63. https://doi.org/10.1016/j.ijom.2007.07.018.

      [12] G. Koc¸er, E. Yuce, A. Tuzuner Oncul, O. Dereci, O. Koskan: Effect of the route ofadministration of methylprednisolone on oedema and trismus in impacted lower third molar surgery. Int. J. Oral Maxillofac. Surg. 2014; 43: 639–43. https://doi.org/10.1016/j.ijom.2013.11.005.

      [13] Milles M, Desjardins PJ. Reduction of postoperative facial swelling by low dose Methylprednisolone: an experimental study. J Oral Maxillofac Surg. 1993; 51:987-91. https://doi.org/10.1016/S0278-2391(10)80041-2.

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  • How to Cite

    Mukund, V., Singh, S., Kumar, S., Rath, R., & Tevatia, S. (2017). Efficacy of various administrative techniques of methylprednisolone on oedema, trismus and pain after lower third molar surgery. International Journal of Dental Research, 5(2), 186-190. https://doi.org/10.14419/ijdr.v5i2.8343

    Received date: 2017-09-10

    Accepted date: 2017-10-19

    Published date: 2017-10-30