Assosiate Professor, Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Science, Mashhad, Iran.
Private Practitioner, Dental School, Mashhad University of Medical Science, Mashhad, Iran.
J Oral Maxillofac Surg. 2021 Sep;79(9):1829-1836. doi: 10.1016/j.joms.2021.03.006. Epub 2021 Mar 13.
Methylprednisolone is widely administered after impacted third molar surgery. This study compared the effect of methylprednisolone injection into the masseter and gluteal muscle on pain, edema, and trismus after impacted lower third molar surgery.
This was a single-blind placebo-controlled randomized clinical trial. Sixty patients with an impacted lower third molar were included and randomly assigned into 3 groups. Each group received 1 of the following medications half an hour before surgery: Group I: 40 mg methylprednisolone injected into masseter muscle; Group II: 40 mg methylprednisolone injected into gluteal muscle; Group III: considered as control group with no intervention. The level of pain was recorded 1, 5, and 7 days after surgery using visual analog scale, and the amount of edema was measured 5 and 7 days after surgery using ultrasound imaging. The amount of trismus was measured 5 and 7 days after surgery based on the distance between incisor edge of upper and lower centrals. Friedman test was used to compare the level of pain, trismus and edema in each group at different times. Kruskal-Wallis test was used to compare the level of pain, trismus and edema among different groups at each time. Significance level was set at P < .05.
There was no significant difference among the 3 groups (a total of 60 patients (31 females and 29 males), aged 19 to 35 years) considering edema (P = .250, CI = 0.22 ± 0.42), trismus (P = .337, CI = -5.93 ± 2.22) and pain (P = .285, CI = -2.91 ± 0.40) relief.
Postsurgical pain, edema, and trismus were not reduced by intramuscular injection of methylprednisolone before third molar surgery.
在拔除阻生第三磨牙术后，常使用甲泼尼龙进行治疗。本研究比较了将甲泼尼龙注射至咬肌和臀肌对拔除下颌阻生第三磨牙术后疼痛、肿胀和牙关紧闭的影响。
这是一项单盲安慰剂对照随机临床试验。纳入 60 名患有下颌阻生第三磨牙的患者，并将其随机分为 3 组。每组患者在术前半小时内接受以下药物之一：I 组：注射 40 mg 甲泼尼龙至咬肌；II 组：注射 40 mg 甲泼尼龙至臀肌；III 组：作为对照组，不进行干预。术后第 1、5 和 7 天使用视觉模拟评分法记录疼痛程度，术后第 5 和 7 天使用超声成像测量肿胀程度。术后第 5 和 7 天根据上下中切牙切缘之间的距离测量牙关紧闭程度。采用 Friedman 检验比较每组不同时间的疼痛、牙关紧闭和肿胀程度。采用 Kruskal-Wallis 检验比较各组在每个时间点的疼痛、牙关紧闭和肿胀程度。显著性水平设为 P <.05。
3 组（共 60 名患者（31 名女性和 29 名男性），年龄 19 至 35 岁）在肿胀（P =.250，CI = 0.22 ± 0.42）、牙关紧闭（P =.337，CI = -5.93 ± 2.22）和疼痛缓解（P =.285，CI = -2.91 ± 0.40）方面无显著差异。
在第三磨牙手术前，肌肉内注射甲泼尼龙不能减轻术后疼痛、肿胀和牙关紧闭。
