Moranon Pimrampai, Chaiyasamut Teeranut, Sakdajeyont Watus, Vorakulpipat Chakorn, Klongnoi Boworn, Kiattavornchareon Sirichai, Wongsirichat Natthamet
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand.
Thai Board of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand.
J Clin Med Res. 2019 Jul;11(7):501-508. doi: 10.14740/jocmr3844. Epub 2019 Jun 11.
The surgical removal of lower third molar is still the most common surgical procedure that is done in oral and maxillofacial surgery field and creates the predictable post-operative sequelae such as pain, swelling, stiffness and difficulty in mouth opening. The purpose of this study is to compare pre-operative dexamethasone injection into pterygomandibular space (PGS) and sublingual space (SLS) in lower third molar intervention of post-operative pain, swelling, and limited mouth opening.
This study is the split-mouth, randomized crossover clinical trial in 30 healthy patients (mean age 21 years). These patients had similar bilateral lower third molar impactions. The patients were randomly divided into two groups receiving either 8-mg dexamethasone injection into SLS or PGS with the 4-week washout period intervention. Clinical assessment of facial swelling and maximum mouth opening was performed before operation and on day 2 and day 7 after operation. The post-operative pain was also measured by patients' response on pain visual analogue scale (VAS) on the first, second and third day after intervention.
There is no significant difference between PGS group and SLS group in pain and swelling on the second and seventh day after operation. However, PGS group showed a greater degree of limited mouth opening than SLS group on the second day after operation.
This study showed that 8-mg dexamethasone injection into PGS or SLS was not different in reduction of pain, swelling, and limited mouth opening. This result suggests that dexamethasone injection into PGS or SLS is similarly effective.
下颌第三磨牙的外科拔除仍是口腔颌面外科领域最常见的外科手术,会产生可预测的术后后遗症,如疼痛、肿胀、僵硬和张口困难。本研究的目的是比较术前将地塞米松注射到翼下颌间隙(PGS)和舌下间隙(SLS)对下颌第三磨牙术后疼痛、肿胀和张口受限的影响。
本研究为30例健康患者(平均年龄21岁)的分口、随机交叉临床试验。这些患者双侧下颌第三磨牙阻生情况相似。患者被随机分为两组,分别接受8毫克地塞米松注射到SLS或PGS,并进行为期4周的洗脱期干预。在手术前以及术后第2天和第7天对面部肿胀和最大张口度进行临床评估。术后疼痛也通过患者在干预后第1、2和3天对疼痛视觉模拟量表(VAS)的反应来测量。
PGS组和SLS组在术后第2天和第7天的疼痛和肿胀方面无显著差异。然而,术后第2天PGS组的张口受限程度比SLS组更大。
本研究表明,8毫克地塞米松注射到PGS或SLS在减轻疼痛、肿胀和张口受限方面没有差异。这一结果表明,将地塞米松注射到PGS或SLS同样有效。