Beneficial effect of methylprednisolone after mandibular third molar surgery: a randomized, double-blind, placebo-controlled split-mouth trial

Objectives

Third molar (M3) removal is the model most frequently used for pain trials in oral surgery. Corticosteroids are frequently administered to reduce trismus and swelling after dentoalveolar surgical procedures. The purpose of this investigation was to evaluate the influence of a single, preoperative oral application of methylprednisolone on postoperative trismus, pain intensity, and the subjective need for analgesic medication after surgical removal of impacted mandibular M3 (LM3).

Materials and methods

Sixteen healthy patients requiring similar bilateral surgical LM3 removal were included in a prospective, randomized, placebo-controlled, double-blind study in a split-mouth design. At random, each patient received either weight-dependent methylprednisolone (40–80 mg) or a placebo orally 1 h prior to surgery. In each case, the right and left LM3 were treated in independent visits. Trismus, swelling, pain measured on a 100-mm visual analog scale, and the postoperative demand of analgesics were assessed.

Results

Statistical analysis indicates a significant reduction of trismus, swelling, pain intensity, and patient-controlled intake of analgesics during the whole postsurgical period of investigation (first to seventh day).

Conclusions

The results of this study suggest that a single preoperative weight-dependent administration of methylprednisolone is a safe and effective concept for diminishing postoperative discomfort, pain intensity, and the total intake of analgesics after wisdom tooth extractions.

Clinical relevance

In case of missing contraindications, the preoperative administration of methylprednisolone is recommended, a routine medication for more extended procedures in oral surgery.