Beneficial effect of methylprednisolone after mandibular third molar surgery: a randomized, double-blind, placebo-controlled split-mouth trial

Abstract

In case of missing contraindications, the preoperative administration of methylprednisolone is recommended, a routine medication for more extended procedures in oral surgery.

A Prospective Randomised Double Blind Study Evaluating the Efficacy of Intra Venous Methylprednisolone in Third Molar Surgery.

“…This suggests that post-operative dose of the steroid was effective in limiting the rebound swelling that would occur within the first 48-72 hours. This was in accordance with the studies of Lorens et al 21 , Ibrahim et al 24 , Ustun et al 20 , Stephan Acham et al 18 and C. Holland. 19 Trismus in both the groups was high on second post-operative day but the steroid group showed a significantly (p< 0.05) greater amount of mouth opening when compared to placebo group according to the paired "t" test and unpaired "t" test analysis.…”

“…Mouth opening has returned to the pre-operative measurements by 7 th post-operative day in both the groups. Similar observations were also recorded by Ibrahim et al 24 , Ustun et al 20 , Stephen et al 18 , Carmen et al 22 Milles et al 17 .…”

“…Milles et al 17 and Stefen et al 18 found that less number of analgesic tablets were taken by patients in steroid group when compared to placebo. Few other investigators using visual analogue scale, found that the pain scores were significantly higher in placebo on 2 nd post-operative day and the scores returned to the preoperative scores by 7 th post-operative day in both the groups.…”

“…31 But there are several stringent reasons, such as a slow onset of action highly dependent on the rate of blood flow at the site of administration, an increased risk of adrenal suppression and local complications like necrosis, hematoma and abscess formation which discourage the intramuscular route of drug administration. 18 Carmen et al 22 , Ibrahim Gatta et al 24 , found that oral administration of methylprednisolone significantly reduced swelling and pain after third molar surgery. Though oral dosing is possibly the most comfortable option for the patient, it does not seem to be as effective as parenteral administration.…”

“…Few other investigators using visual analogue scale, found that the pain scores were significantly higher in placebo on 2 nd post-operative day and the scores returned to the preoperative scores by 7 th post-operative day in both the groups. 24,20,21,18 We recorded pain scores by using visual analogue scale and analysed the severity of pain statistically by Mann Whitney U test and Wilcoxon matched paired test. The results showed a statistically significant (p< 0.05) reduction of pain on second post-operative day in steroid group when compared to placebo but the difference was insignificant (p >0.05) by 7 th post-operative day.…”