Comparative study between methylprednisolone and dexamethasone as submucosal injection for control of edema, trismus and pain of third molar surgery
Ahmed Gamal Hafez, Eman A. Elsharrawy, Abdelbadee Abdalla
Journal Title:Basic Research Journal of Medicine and Clinical Science
Background: Third molar surgery involves injury to the surrounding tissues, producing edema, trismus and pain. Clinical trials in Oral Surgery have supported the hypothesis that preemptive corticosteroids are effective in delaying and preventing many postoperative sequelae. This study aimed to compare between methylprednisolone and dexamethasone as submucosal injection for control of edema, trismus and pain after third molar surgery. Method: This randomized prospective study was done on forty patients required class B mesioangular impacted lower third molar surgery. 4mg dexamethasone, 40 mg, 80 mg, or 120 mg methylprednisolone was submucosally injected preoperatively. Facial width was measured in one dimension, preoperatively and on 2nd and 7th postoperative days. The distance between upper and lower right central incisors during maximal mouth opening was measured, preoperatively and on 2nd and 7th postoperative days. Pain was evaluated using a 10cm VAS during the postoperative week. Result: Edema and pain were greater with dexamethasone, then with 40 mg, then 80 mg and then 120 mg methylprednisolone. Trismus was greater on 2nd postoperative day with 40 mg methylprednisolone, then with dexamethasone, then with 80 mg and then 120 mg methylprednisolone. It was greater on 7th day with 40 mg, then with 80 mg methylprednisolone, then with dexamethasone and then with 120 mg methylprednisolone. 120 mg and 80 mg methylprednisolone were significantly better. Conclusion: Submucosal 80 mg methylprednisolone controls edema, trismus and pain better than 40 mg methylprednisolone or dexamethasone. Increasing methylprednisolone dose from 80 mg to 120 mg provided no significant benefit.
Keywords: edema, trismus, pain, dexamethasone, methylprednisolone, submucosal injection