A Comparative Study of the Efficacy of Methylprednisolone Administration Route on Postoperative Sequelae Following Impacted Third Molar Extraction

Abstract

Background: Surgery on the lower-impacted third molar typically includes injury to the heavily vascularized
loose connective tissue due to its anatomical location, leading to inflammatory sequelae during the immediate
post-operative stage, including postoperative pain, oedema and trismus.
Aims: This prospective, randomized, comparative clinical study was conducted in 30 patients to assess pain,
oedema and trismus in patients undergoing surgical removal of impacted third molars.
Method: The study sample involves 30 patients, randomly categorized into 3 groups: group 1 (control;
no steroids), group 2 (Intra-Muscular injection in Masseter muscle), group 3 (oral tablets). Patient aged
between 18 and 30, with a similar anatomical position, and similar surgical difficulty, no allergies, without
any systemic diseases are included. Syndromic patients, patients with periapical pathologies were excluded
from the study. A single surgeon was working on all patients using a standard technique. On the 2nd
and 7th postoperative day, linear oedema and maximal mouth opening were evaluated for both routes of
methylprednisolone administration and compared.
Results: We observed a higher range of mouth opening found in masseter injection group relative to the
oral tablet group on Day 2 & 7, for the steroid treatment groups. On postoperative days 2 and 7, the overall
increase in the tragus-commissure, canthus-gonion and tragus-pogonion lines, for control & oral tablet
groups were identical and higher than the masseter injection group.
Conclusion: Comparison to the control group following lower third molar surgery, intramassetric injection
provided improved outcomes than tablet form in limiting oedema and trismus