Zerener Tamer, Aydintug Yavuz Sinan, Sencimen Metin, Bayar Gurkan Rasit, Yazici Mahmut, Altug Hasan Ayberk, Misir Ahmet Ferhat, Acikel Cengizhan
Quintessence Int. 2015 Apr;46(4):317-26. doi: 10.3290/j.qi.a33281.
The aim of the study was to compare the effect of submucosal injection of dexamethasone and triamcinolone acetonide on postoperative pain, swelling, and trismus occurring after impacted mandibular third molar surgery.
A total of 78 patients (aged 18 to 35) with asymptomatic, unilateral, impacted mandibular third molar, and without any systemic disease were included in this study. Patients were divided into three groups randomly (control, dexamethasone, and triamcinolone acetonide). In the experimental groups, dexamethasone and triamcinolone acetonide were injected into submucosa at about 1 cm above the surgical area submucosally. The control group of patients did not take any drug submucosally but the same surgical procedure was applied. Pain evaluation was performed by visual analog scale (VAS). Swelling was measured using a flexible standard ruler measuring the dimensions of the axes between certain points on the face. For trismus evaluation, maximum mouth opening was measured. Measurements taken on the preoperative, and on postoperative first, third, and seventh days were compared with each other and statistically evaluated.
There were statistically significant differences between the control and experimental groups on the different days of the postoperative period. The effect of triamcinolone acetonide on pain started on the first day postoperatively and the effect of triamcinolone acetonide on trismus and pain was better than other groups at the third and seventh days. However, there was no statistically significant difference between the effects of dexamethasone and triamcinolone acetonide regarding postoperative complications.
The submucosal injection of dexamethasone or triamcinolone acetonide might be an effective treatment for postoperative discomfort occurring following impacted mandibular third molar surgery, and triamcinolone acetonide could be applied as an alternative to dexamethasone.
本研究旨在比较地塞米松和曲安奈德黏膜下注射对下颌阻生第三磨牙拔除术后疼痛、肿胀及张口受限的影响。
本研究共纳入78例年龄在18至35岁之间、无症状、单侧下颌阻生第三磨牙且无任何系统性疾病的患者。患者被随机分为三组(对照组、地塞米松组和曲安奈德组)。在实验组中,地塞米松和曲安奈德在手术区域黏膜上方约1 cm处黏膜下注射。对照组患者未进行任何黏膜下药物注射,但接受相同的手术操作。疼痛评估采用视觉模拟评分法(VAS)。肿胀程度使用柔性标准尺测量面部特定点之间的轴线尺寸。对于张口受限评估,测量最大张口度。比较术前、术后第1天、第3天和第7天的测量结果,并进行统计学评估。
术后不同天数,对照组与实验组之间存在统计学显著差异。曲安奈德对疼痛的作用在术后第1天开始显现,在术后第3天和第7天,曲安奈德对张口受限和疼痛的效果优于其他组。然而,地塞米松和曲安奈德在术后并发症方面的效果无统计学显著差异。
地塞米松或曲安奈德黏膜下注射可能是下颌阻生第三磨牙拔除术后不适的有效治疗方法,曲安奈德可作为地塞米松的替代药物应用。