A comparison of the effects of methylprednisolone and tenoxicam on pain, edema, and trismus after impacted lower third molar extraction

Abstract

BackgroundThe aim of the present study was to compare the effects of preemptive intravenous tenoxicam and methylprednisolone administrations on extraction of impacted third molars.Material/MethodsThis was a placebo-controlled, randomized, double-blind, clinical trial. A total of 60 adult patients ages 18–40 years with the complaints of impacted third molar teeth were included in the study.ResultsThe postoperative swelling ratios (p<0.05) and pain scores (p<0.05) were significantly better in both study groups than in the control group and there was no statistically significant difference between methylprednisolone and tenoxicam groups with regards to the edema and pain relief.ConclusionsPreoperative administration of 80 mg methylprednisolone achieves better control of trismus than tenoxicam without any significant differences in edema and pain control in impacted third molar teeth extraction.

Efficacy of corticosteroids versus placebo in impacted third molar surgery: systematic review and meta-analysis of randomized controlled trials

“…After the removal of duplicates and reading of the titles and abstracts, 65 articles were selected for fulltext analysis, 48 of which were excluded for not meeting the eligibility criteria. Thus, 17 articles were included in the present systematic review [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] . Figure 1 displays the flowchart of the article selection process.…”

“…The 17 studies selected included a total of 730 patients aged 15 to 45 years. It was possible to quantify the number of male (n = 314) and female (n = 346) subjects in 15 of the studies; two of the studies did not offer a distinction of the sex of the patients 11,12 . With regard to the corticosteroids administered to the study groups, long-duration drugs were used in 11 studies, nine of which employed dexamethasone [13][14][15][16][17][18][19][20][21] and two betamethasone 22,23 .…”

“…With regard to the corticosteroids administered to the study groups, long-duration drugs were used in 11 studies, nine of which employed dexamethasone [13][14][15][16][17][18][19][20][21] and two betamethasone 22,23 . Mediumduration corticosteroids were used in six studies, five of which employed methylprednisolone 11,12,[24][25][26] and one prednisolone 27 . In all studies, the placebo group was given either glucose pills (oral administration) or saline solution (submucosal, intramuscular, intravenous, intra-alveolar, or pterygomandibular space).…”

“…In the analysis of the results of the articles included in the present review, 13 studies demonstrated a positive effect of corticosteroid use in comparison to placebo use with regard to postoperative pain [11][12][13][14]16,[19][20][21][22][24][25][26][27] , and three studies found no difference 15,17,23 . The studies by Boonsiriseth et al 20 and Chopra et al 22 demonstrated no difference in the evaluation performed at 7 days following surgery.…”

Edema Management in Oral and Maxillofacial Surgery

“…The chemical mediators of acute inflammation include histamine, prostaglandins, leukotrienes, serotonin, and various cytokines. It is known that prostaglandin associated to bradykinin has the most potent pain-activating effect [14,47,48].…”