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

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.

Effect of Various Routes of Administration of Methyl Prednisolone on Swelling, Trismus and Pain in Impacted Mandibular Third Molar Surgery

“…Although there was marked increase in pain reported by the patients of control group and least in IM group, there was no statistically significant difference in mean pain score between control , IM, IV and oral group (p=.270). Our results somewhat differed from results of Vaibhav et al 20 as the mean pain score was significantly different on 7 th postoperative day. On 14 th post op day in our study, with respect to control group, all other groups proved to be better in terms of mean pain score while IM, IV and Oral group provided almost similar results (with a negligible difference of 0.08 on VAS score).…”

“…Intra-group comparison of mean pain score at 3 rd day was done between the groups. There was no significant difference in mean pain score between control, IM, IV and oral group (p=0.119) the result of our study was similar to results in study of Vaibhav et al 20 .…”

“…In a study performed by Vaibhav et al 20 , where he compared the efficacy of intravenous, intramuscular (in masseter muscle), submucosal and oral routes of administration of 20 mg methylprednisolone for decrease in postoperative trismus in patients undergoing lower 3 rd molar surgery. He found no statistically significant difference in mean inter incisal opening on 2 nd and 7 th postoperative day (p = 0.37), (p = 0.29) while in our study, intra group comparison showed statistically significant difference (p=.048) in mean inter incisal opening on the 1 st postoperative day.…”

Comparison of Submucosal With Intramuscular or Intravenous Administration of Dexamethasone for Third Molar Surgeries: A Systematic Review and Meta-Analysis

“…However, no comparative analysis between SM and IV or IM routes could be carried out due to a lack of studies. Mukund et al ( 39 ) in a trial comparing oral, SM, IV, and intramasseteric administration of MP reported better outcomes with the intramasseteric route after third molar surgeries. On the other hand, Selvaraj et al ( 40 ) did not find any difference in outcomes between intramasseteric and IM injections of MP at the gluteal region.…”