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比较治疗弹性绷带、黏膜下地塞米松或右旋酮洛芬氨丁三醇对第三磨牙手术后炎症症状和生活质量的影响:一项随机临床试验。

Comparison of the effect of therapeutic elastic bandage, submucosal dexamethasone, or dexketoprofen trometamol on inflammatory symptoms and quality of life following third molar surgery: a randomized clinical trial.

机构信息

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokat Gaziosmanpasa University, Kaleardi Mahallesi, Muhittin Fisunoglu Caddesi, Omcalik Sokak, Ali Sevki Erek Yerleskesi, Dis Hekimligi Fakultesi, Tokat, Turkey.

Private Practice, Arabacialani Mahallesi, Mert Sokak, No: 25, Sakarya, Turkey.

出版信息

Clin Oral Investig. 2021 Apr;25(4):1849-1857. doi: 10.1007/s00784-020-03487-y. Epub 2020 Aug 15.

Abstract

OBJECTIVES

We aimed to compare the effects of preoperative single-dose submucosal corticosteroid injection and postoperative elastic therapeutic bandage application with postoperative non-steroid anti-inflammatory drug therapy on postoperative inflammatory symptoms and quality of life following mandibular third molar surgeries.

MATERIALS AND METHODS

A single-center, randomized, clinical trial was conducted with 52 patients (36 female, 16 male) who expected severe postoperative sequelae as a result of the extraction of impacted mandibular third molars. The patients were randomized into three groups. In the preoperative submucosal corticosteroid injection group (n = 16), 8 mg/2 ml dexamethasone 21-phosphate was administered near operated sites. In the postoperative therapeutic elastic bandage application group (n = 19), Kinesio tapes were applied to operated sites. Paracetamol 500 mg was prescribed for the patients in the corticosteroid and elastic bandage application groups. In the postoperative non-steroid anti-inflammatory drug group (n = 17), 25 mg dexketoprofen trometamol was prescribed. Maximal mouth opening, swelling, pain, and Oral Health Impaction Profile scores were quantified preoperatively and postoperatively on the second and seventh days. Additionally, all patients were asked to evaluate the postoperative period by the Postoperative Symptom Severity Scale.

RESULTS

Analysis of the obtained data revealed that on the second postoperative day, postoperative edema and trismus were significantly lower in the submucosal corticosteroid (p = 0.025, p = 0.03) and therapeutic elastic bandage (p = 0.032, p = 0.014) groups, and the patients in these groups had a more comfortable postoperative period than the group prescribed a postoperative non-steroid anti-inflammatory drug (p = 0.016).

CLINICAL RELEVANCE

In oral surgery, postoperative elastic bandage application can provide results similar to those of preoperative submucosal corticosteroid injection with respect to inflammatory symptoms and quality of life.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04200885. Date of Registration: December 2019 (retrospectively registered).

摘要

目的

比较术前单次黏膜下皮质类固醇注射与术后弹性治疗带应用以及术后非甾体抗炎药治疗对下颌第三磨牙手术后炎症症状和生活质量的影响。

材料和方法

这是一项单中心、随机临床试验,共纳入 52 名(36 名女性,16 名男性)预计因拔除阻生下颌第三磨牙而出现严重术后后遗症的患者。患者随机分为三组。在术前黏膜下皮质类固醇注射组(n=16)中,在手术部位附近注射 8mg/2ml 地塞米松 21-磷酸。在术后弹性治疗带应用组(n=19)中,将 Kinesio 胶带贴在手术部位。皮质类固醇和弹性带应用组的患者服用扑热息痛 500mg。在术后非甾体抗炎药组(n=17)中,服用 25mg 右旋酮洛芬氨丁三醇。在术前、术后第 2 天和第 7 天,测量最大张口度、肿胀、疼痛和口腔健康影响评分。此外,所有患者均使用术后症状严重程度量表对术后期间进行评价。

结果

数据分析显示,术后第 2 天,黏膜下皮质类固醇(p=0.025,p=0.03)和弹性治疗带(p=0.032,p=0.014)组的术后肿胀和张口受限明显低于术后非甾体抗炎药组(p=0.016),且这些组的患者术后舒适度更高。

临床相关性

在口腔手术中,与术前黏膜下皮质类固醇注射相比,术后弹性带应用在炎症症状和生活质量方面可获得相似的效果。

临床试验注册

ClinicalTrials.gov 标识符:NCT04200885。注册日期:2019 年 12 月(回顾性注册)。

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