Corticosteroid Therapy and Impacted Third Molar Surgery: A Randomized Controlled Clinical Trial
Background and aim: postoperative pain, inflammation and trismus have been the most commonly faced postoperative complications of surgical removal of impacted mandibular third molars. The present study aims to assess in a randomized controlled clinical trial the effectiveness of corticosteriod therapy in combination with antibiotics to control these complications.
Materials and Methods: included were 30 patients with asymptomatic mesioangular and vertical impacted mandibular third molars. The patients were randomly allocated to two groups of control (30 penicillin V 500mg capsules, one every 8 hours) and corticosteroid therapy (penicillin V + oral dexamethasone 1mg every 6 hours for three days from the day before to the day after surgery). Inflammation (using two tongue depressors, one tangent to the ramus and cheek and the other tangent to the lower border of mandible, and a ruler; in mm), trismus (the maximum interincisal distance of maxilla and mandible in mm), and pain (five point scale from no to most severe) were assessed pre-, and 24 hours and a week postoperatively. Repeated measure ANOVA was used for statistical analysis.
Results: Included were 12 males and 18 females 20 to 32 years old. The mean inflammation before surgery was respectively 57.9 ± 4.3 and 60.4 ± 4.4 (p > 0.05) mm in the control and steroid groups. 24 hours and a week later, these values were respectively 72.1 ± 6.3/65.7 ± 6.8 (p = 0.01) and 66.7 ± 5.1/63.6 ±6.5 (p = 0.01) mm. The mean interincisal opening was respectively 26.9 ± 7.2 and 47.2 ± 6.8 (p > 0.05) mm in the control and steroid groups. 24 hours and a week later, these values were respectively 26.9 ± 7.2/38.3 ± 10.0 (p = 0.01) and 39.0 ± 5.0/41.9 ±7.5 (p > 0.05) mm. 40% of the corticosteriod group and 0% of the control had no pain (p= 0.01).
Conclusion: within the limitations of the present study, the use of corticosteroids seems to be effective in eliminating postoperative complications of the surgical removal of impacted third molars