Oral and Maxillofacial Surgery
Comparative study of the effect of tube drainage versus methylprednisolone after third molar surgery

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Objective

The purpose of this study was to compare the effects of tube drainage versus a single dose of methylprednisolone (MP) on maximal mouth opening, facial swelling, and pain after third molar surgery.

Study design

Twenty-two patients requiring extraction of bilaterally impacted mandibular third molars were selected. Each patient had 2 operations. In the first operation, a drainage tube was inserted into the buccal fold after the suture procedure and left there for 3 days. In the second operation 1 month after the first surgery, 1.5 mg/kg intravenous methylprednisolone was administered 1 hour before the surgery. The patients were evaluated by the same person for maximal mouth opening, facial swelling, and pain in the immediate preoperative time point and on the second, fifth, and seventh days after surgery.

Results

There was a statistically significant difference in mouth opening on fifth and seventh days but none in facial swelling and pain between MP group and drain group.

Conclusion

We conclude that the use of a drain or methylprednisolone is useful in reducing postoperative discomfort after third molar surgery.

Section snippets

Materials and methods

Twenty-two patients requiring extraction of bilaterally impacted mandibular third molars from the School of Dentistry in Istanbul University (12 males, 10 females; age range 20-31 years) were selected to participate in this study. All patients were healthy without significant medical diseases or history of bleeding problems. Pregnant women and patients with signs of pericoronitis were not included in the study.

The patients showed the same degree of surgical difficulty on panoramic radiographs.

Results

Two patients were excluded because they did not return for the second scheduled surgery. Four patients were not included in this study because the difference between the operation times of the 2 sides was more than 5 minutes. Treatment with drainage was performed in right mandibular third molar side and treatment with MP was performed in left mandibular third molar side. All of the patients tolerated the medication well without serious complications or side effects.

Fig. 2 shows maximal mouth

Discussion

Surgical extraction of impacted mandibular third molar is one of the most frequent procedures in oral and maxillofacial surgery and causes considerable postoperative patient discomfort. There are many studies to determine the preventive effect of antiinflammatory and antibacterial drugs on postoperative pain, swelling, and mouth opening following the surgical extraction of impacted mandibular third molars.10, 12, 15

Drains and steroids such as methylprednisolone are widely used in the surgical

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