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在拔除下颌阻生第三磨牙手术中,地塞米松与甲泼尼龙单次剂量的咬肌内注射预先给药对比:前瞻性双侧对照、随机三盲临床研究

Pre-emptive Single Dose of Intramasseteric Administration of Dexamethasone Versus Methylprednisolone in Surgical Extraction of Impacted Mandibular Third Molars: Prospective Split-Mouth, Randomised Triple Blinded Clinical Study.

作者信息

Praneetha Snigdha, Shenoy Vandana, Christopher Pradeep, Gopi Gayathri, Manonmani B

机构信息

Department of Oral and Maxillofacial Surgery, Dr. MGR Educational and Research Institute (Thai Moogambigai Dental College and Hospital), Chennai, India.

出版信息

J Maxillofac Oral Surg. 2024 Apr;23(2):424-429. doi: 10.1007/s12663-023-02074-4. Epub 2024 Jan 2.

Abstract

AIM

The study aims to contribute in reducing postoperative sequelae and to determine the optimal corticosteroid for reducing postoperative inflammation, pain, swelling, wound healing and quality of life in patients undergoing surgical extraction of impacted mandibular third molars.

MATERIALS AND METHODS

The study included 191 patients who presented to the Department of Oral and Maxillofacial Surgery at Thai Moogambigai Dental College and Hospital in Chennai with bilateral impacted mandibular third molars that needed surgical removal. The effects of pre-emptive single dose of dexamethasone and methylprednisolone on pain, oedema, trismus, wound healing, and quality of life after surgical extraction of impacted lower third molars were investigated.

RESULT

There was no statistical difference between the two steroids, with both achieving identical levels of wound healing and quality of life. On the third postoperative day, there was a statistically significant difference, with methylprednisolone providing clinically superior results in mouth opening and reduction of swelling. However, by the fifth day, both corticosteroids had exhibited identical improvement.

CONCLUSION

Compared to 8 mg of dexamethasone, 40 mg of methylprednisolone administered as a single preemptive dosage in the intrammaseteric region was associated with enhanced quality of life, a reduction in pain and edema, and almost normal mouth opening.

摘要

目的

本研究旨在有助于减少术后后遗症,并确定用于减少接受下颌阻生第三磨牙手术拔除的患者术后炎症、疼痛、肿胀、伤口愈合及生活质量的最佳皮质类固醇。

材料与方法

本研究纳入了191名患者,他们前往钦奈泰穆加姆比盖牙科学院及医院口腔颌面外科就诊,双侧下颌阻生第三磨牙需要手术拔除。研究了术前单次剂量地塞米松和甲泼尼龙对下颌阻生第三磨牙手术拔除后疼痛、水肿、牙关紧闭、伤口愈合及生活质量的影响。

结果

两种类固醇之间无统计学差异,二者在伤口愈合及生活质量方面达到相同水平。术后第三天,存在统计学显著差异,甲泼尼龙在张口及消肿方面提供了临床上更优的结果。然而,到第五天,两种皮质类固醇均表现出相同程度的改善。

结论

与8毫克地塞米松相比,在咬肌内区域单次术前给予40毫克甲泼尼龙可提高生活质量,减轻疼痛和水肿,并使张口几乎恢复正常。

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