Hydrocortisone irrigation for postoperative control of edema in inferior third molar removal – A pilot study

Rodrigues, Vitor Pereira; Deboni, Maria Cristina Zindel; Cecchetti, Marcelo Minharro; Ocaña, Ricardo Pelletti; Frare, João Gilberto; Araújo, Júlia Gomes Lúcio de; Naclério‐Homem, Maria da Graça

doi:10.1016/j.ajoms.2020.04.004

Cited by 2 publications

(5 citation statements)

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“…Evaluations were made of mouth opening, swelling, and facial edema. There was substantial decrease in edema on the second postoperative day and trismus was significantly improved 21 . Thirty-three participants in another randomised clinical trial had their impacted wisdom teeth surgically removed.…”

Section: Discussionmentioning

confidence: 87%

Importance of Dexamethasone for Control of Edema and Pain at Surgical Site in the Mandibular Fracture Osteosynthesis Treatment

Mubeen¹,

Farheen²,

Khattak³

et al. 2021

PJMHS

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Dexamethasone is highly sensitive to low dosages and is widely used in oral surgical procedures with variable dosage, timing and route of administration. Aim of the study: Comparison of the results of treatment with placebo and dexamethasone in terms of the edema and mean pain at the surgical site in patients with osteosynthesis of the mandible. Methods: This randomised controlled trial was held in the Oral and Maxillofacial surgery department of different dental hospitals of Lahore for one-year duration from June 2021 to May 2022. A total of 100 patients with mandibular fractures of both sexes, aged 20 to 60, were included in the study. Patients with other associated facial fractures, patients with a history of diabetes mellitus, heart and kidney disease due to chronic drug use, and pregnant women were excluded. The experimental group was given eight milligrams of dexamethasone with submucosal infiltration at the surgical incision site and the normal saline was given in the control group. Edema and pain were evaluated by means of visual analog scale at a nine-line measurement at twenty-four and seventy-two hours postoperatively, respectively. Results: In this study, 24 hours after the procedure, the visual analog scale was 2.16 ± 0.89 in group I (experimental group) and 3.51 ± 1.23 in group II (placebo group) and 2.29 ± 0.89 in control group and 0.62 ± 0.19 in group given dexamethasone at seventy-two hours. Postoperative edema score was significantly less up to 4.26 ± 1.42 in patients receiving group I (dexamethasone), in comparison to group II (placebo group) 5.38 ± 1.01 twenty-four hours afterwards surgical procedure and 2.06 ± 0.64 in the placebo group and 0.042 ± 1.23 in the group given dexamethasone at seventy-two hours. Conclusions: This study found that patients with osteosynthesis of the mandible had lower rates of pain and swelling after applying dexamethasone to the surgical site. Keywords: Dexamethasone, Mandibular osteosynthesis, Edema.

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Section: Discussionmentioning

confidence: 87%

Importance of Dexamethasone for Control of Edema and Pain at Surgical Site in the Mandibular Fracture Osteosynthesis Treatment

Mubeen¹,

Farheen²,

Khattak³

et al. 2021

PJMHS

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“…Additionally, the intravenous approach is employed, particularly when the third molar extraction is carried out under general anesthesia, because of its effectiveness in reducing pain and edema, as well as in preventing nausea and vomiting. This might be regarded as one of the finest methods of administration [9,18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, it guarantees quick and nearly total absorption. Although the relative merits of different routes are always in discordance, corticosteroids should be used if considerable postoperative soft tissue edema is anticipated [9,18]. In this context, the current study was conducted to assess the effectiveness of hydrocortisone, povidone-iodine, and normal saline as irrigating solutions during impacted mandibular third molar surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Fortunately, some trials using a single dose of prednisolone or dexamethasone postoperatively showed substantial differences in edema, trismus, and pain [18,20], while others found conflicting results [21,22]. On the contrary, some studies have shown that using hydrocortisone as an intraoperative irrigating solution has a rapid and effective effect on managing postoperative edema [9,23].…”

Section: Discussionmentioning

confidence: 99%

“…A full-thickness incision was made to prepare a muco-periosteal flap. The flap was elevated and reflected, and bone guttering (tooth sectioning if required) was performed using a bur on a straight handpiece under abundant irrigation with hydrocortisone 500 mg concentration in 250 ml normal saline for group 1, povidone-iodine 0.5 mg concentration per ml in 250 ml of normal saline for group 2 and 0.9% concentration of 250 ml of normal saline for group 3 [8,9]. After completing the extraction, curettage of the socket was performed to remove any unhealthy granulation tissue.…”

Section: Methods Of Operationmentioning

confidence: 99%

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Efficacy of Hydrocortisone, Povidone-Iodine, and Normal Saline as an Irrigating Solution During Surgical Removal of Impacted Mandibular Third Molars: A Randomized Controlled Trial

Ahmed,

Baliga,

Baliga

et al. 2024

Cureus

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BackgroundThe surgical removal of mandibular third molars is one of the most common procedures in dentistry. Researchers have extensively studied the treatment of postoperative sequelae such as pain, edema, trismus, and alveolar osteitis throughout the past six decades. Many approaches have been used to address clinical difficulties after third molar surgery, including various flap designs and irrigating solutions. The aim of this study was to compare the effects of three irrigating solutions, hydrocortisone, povidone-iodine, and normal saline, on pain, trismus, and edema following surgical removal of the impacted mandibular third molar. MethodologyThe study involved 105 participants who required surgical extraction of mandibular third molars. The patients' ages ranged from 18 to 40 years, and they fulfilled the inclusion criteria. Using a simple random sampling technique, they were divided into three groups (group 1: hydrocortisone, group 2: povidoneiodine, group 3: normal saline). The parameters evaluated were edema, pain, and trismus on the second and seventh postoperative days. All data were input into Microsoft Excel (Microsoft ® Corp., Redmond, USA) worksheets and analyzed using Stata 17.0 (StataCorp LLC, College Station, USA). The visual analog scale (VAS) score was used to measure postoperative pain, and postoperative swelling was measured using linear measurements from four fixed anatomical points and compared to preoperative values. To assess trismus, the inter-incisal distance was measured in millimeters with a caliper. A p-value of <0.01 was considered statistically significant. ResultsThe mean VAS score for pain in group 1 was lower than the other two groups. The effect of group 1 was significant on the second postoperative day but insignificant on the seventh postoperative day for swelling. The effect of all three groups on trismus was significant on the second and seventh days. ConclusionsHydrocortisone as an irrigating solution showed promising results in managing postoperative swelling in the first 48 hours, but its effect gradually declined by the seventh postoperative day. Additionally, it was effective in controlling postoperative pain and trismus. This suggests that utilizing hydrocortisone as an irrigating solution, compared to povidone-iodine, has been proven to be a significantly effective option in reducing postoperative pain, edema, and trismus resulting from the surgical removal of impacted teeth.

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Hydrocortisone irrigation for postoperative control of edema in inferior third molar removal – A pilot study

Cited by 2 publications

References 16 publications

Importance of Dexamethasone for Control of Edema and Pain at Surgical Site in the Mandibular Fracture Osteosynthesis Treatment

Importance of Dexamethasone for Control of Edema and Pain at Surgical Site in the Mandibular Fracture Osteosynthesis Treatment

Efficacy of Hydrocortisone, Povidone-Iodine, and Normal Saline as an Irrigating Solution During Surgical Removal of Impacted Mandibular Third Molars: A Randomized Controlled Trial

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