Summary
In a placebo-controlled double-blind study, we examined the effect of perioperative oral administration of 6 mg dexamethasone, given once 12 h before and once 12 h after osteotomy of two impacted molar teeth, on postoperative edema, limitation of jaw opening, and intensity of postoperative pain. On the first day after surgery the difference in the increase in cheek swelling was 54.3% (P<0.001) as measured with a tape, 46% (P<0.001) measured with a gauge in the first molar area and 29% (P≤0.056) by sonographic measurement of the cheek diameter in the molar area. The limitation in the jaw opening was reduced by 17.7% (P<0.002) after dexamethasone. Pain assessed by visual analog scale was reduced by dexamethasone by 50% (P<0.01). The amount of analgesics required postoperatively (codeine phosphate) was reduced by 37% (P=0.02) following dexamethasone administration. Seventy-six percent of our patients preferred perioperative medication of dexamethasone.
This is a preview of subscription content, log in via an institution to check access.
References
Beirne OR, Hollander B (1986) Effect of methylprednisolone on pain, trismus and swelling after removal of third molars. Oral Surg 61: 134–138
Dixit KS, Kumar P, Saxena RC, Bhargava KP (1984) A double blind comparision of the analgesic efficacy of soluble aspirin, plain aspirin and placebo. Acta Therapeut 10: 333–339
Flower R (1978) Steroidal antiinflammatory drug as inhibitors of phospholipase A2. Adv Prostaglandin Thromboxane Leukotriene Res 3: 105–112
Flower R (1981) Glucocorticoids, phospholipase A2 and inflammation. TIPS: 186–189
Flower R (1988) Lipocortin and the mechanism of action of the glucocorticoids. Br J Pharmacol 94: 987–1015
Frees KH, Harnisch H (1970) Maßnahmen zur postoperativen Ödemprophylaxe. Dtsch Z Zahn, Mund Kieferheilkd 22: 592–595
Gabka J, Matsumura T (1971) Messtechnische und klinische Prüfung eines Antiphlogistikums (tantum). Munch Med Wochenschr 6: 198–203
Goldberg MH, Nemarich AN, Marco WP II (1985) Complications after mandibular third molar surgery: a statistical analysis of 500 consecutive procedures in private practice. J Am Dent Assoc 111: 277–279
Greenfield W, Caruso WA (1978) Systemic use of steroids following oral surgery. NY State Dent J 42: 482–485
Haak B, Günther D, Kunkel G, Lichtwald K, Täuber U, Vescei P (1981) Radioimmunologische Bestimmung von synthetischen Glucocoricoiden. Atemw Lung Krankenh 7: 283–289
Huffmann GG (1977) Use of methylprednisolone sodium succinate to reduce postoperative edema after removal of impacted third molars. J Oral Surg 35: 198–199
Kern JA, Lamit RJ, Reed JC, Daniele RP, Novell PC (1988) Dexamethasone inhibition of Interleukin 1 beta production by human monocytes. Posttransscriptional mechanisms. J Clin Invest 81: 237–244
Linenberg WB, Westfield NJ (1965) The clinical evaluation of dexamethasone in oral surgery. Oral Surg Oral Med Oral Pathol 20: 6–28
Lokken P, Skjelbred P (1980) Analgesic and anti-inflammatory effects of paracetamol evaluated by bilateral oral surgery. Br J Clin Pharmacol 12: 253–260
Mead SV, Lynch DF, Mead SG (1964) Triamcinolone given orally to control postoperative reactions to oral surgery. J Oral Surg 22: 454–487
Nathanson NR, Seifert DM (1964) Betamethasone in dentistry. Oral Surg Oral Med Oral Pathol 18: 715–721
Schaberg SJ, Stuller CB, Edward SM (1984) Effect of methyl-prednisolone on swelling after orthognathic surgery. J Oral Maxillofac Surg 42: 356–361
Schmelzeisen R, Buchweitz I-K, Frölich J-C (1988) Sonographische Objektivierung der Wangenschwellung nach perioperativer Ödemprophylaxe mit Dexamethason bei Weisheitszahnosteotomien. Dtsch Z Mund, Kiefer, Gesichtschir 12: 233–239
Schubö W, Uehlinger H-M (1984) Handbuch der Programmversion 2 SPSS X. Fischer, Stuttgart New York
Seymour RA, Williams FM, Luyk NM, Boyle MA, Whitfield PM, Nicholson E, P Ward Booth, MD Rawlins (1986) Comparative efficacy of soluble aspirin and aspirin tablets in postoperative dental pain. Eur J Clin Pharmacol 30: 395–498
Shuttee TS (1962) Hyaluronidase in relief on postoperative trismus, swelling and pain. Oral Surg Oral Med Oral Pathol 15: 115–120
Sisk AL, Bonnington GJ (1985) Evaluation of methylprednisolone and ibuprofen for inhibition of the postoperative inflammatory response. Oral Surg 60: 137–144
Skjelbred P, Lokken P (1982) Postoperative pain and inflammatory reaction reduced by injection of a corticosteroid. Eur J Clin Pharmacol 21: 391–396
Skjelbred P, Lokken P (1982) Reduction of pain and swelling by a corticosteroid injected 3 hours after surgery. Eur J Clin Pharmacol 23: 141–146
Skjelbred P, Album B, Lokken P (1977) Acetylsalicylic acid vs paracetamol: effects on postoperative course. Eur J Clin Pharmacol 12: 257–264
Spilka CJ (1961) The place of corticosteroids and antihistamines in oral surgery. Oral Surg Oral Med Oral Pathol 14: 1034–1042
Sveen K, Gilhuus-Moe O (1975) Paracetamol/codeine in relieving pain following removal of impacted mandibular third molars. Int J Oral Surg 4: 258–266
Wood GD, Branco JA (1979) A comparision of three methods of measuring maximal opening of the mouth. J Oral Surg 37: 175–177
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Schmelzeisen, R., Frölich, J.C. Prevention of postoperative swelling and pain by dexamethasone after operative removal of impacted third molar teeth. Eur J Clin Pharmacol 44, 275–277 (1993). https://doi.org/10.1007/BF00271371
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1007/BF00271371