Prevention of trismus with different pharmacological therapies after surgical extraction of impacted mandibular third molar

摘要

Aim To assess prevention and reduction of trismus after surgicallyextracted impacted mandibular third molars with individualand combined therapy with corticosteroids and anti-inflammatoryanalgesics.Methods The research included 60 randomly selected patients (3groups) attended to the Dental Oral Surgery of the Public InstitutionHealthcare Center Zenica during the period January-December2008. Patients of both genders, 18-45 years of age, werepresented without pain and other inflammatory symptoms at thetime of surgery. According to a scheme established in the researchprotocol, two medications were administered orally: methylprednisolone(corticosteroid) 32 mg and meloxicam (non-steroidal anti-inflammatory analgesic, NSAID) 15 mg as a single drug, or acombination of both drugs. The level of trismus is assessed on thebasis of differences of preoperative and postoperative values of interincisalspaces when fully opening the mouth on the second andthe seventh post-operative day. The differences between groups ofpatients were evaluated by means of Tukey’s HSD test.Results On the second and on the seventh post-operative day significantlybetter results were registered in the group that receivedonly corticosteroids and in the group that received both, corticosteroidsand NSAIDs compared to the group that received onlyNSAIDs. A tendency of trismus reduction was present in all patientgroups for the second and seventh day after surgery.Conclusion Prevention and control of postoperative trismus aftersurgical extraction of impacted mandibular third molars with combinedtherapy is effective and superior comparing to individualtherapy with meloxicam-or methylprednisolone alone