The IIIrd molar postextractional complications, therapeutical and surgical prophylaxis

Abstract

Introduction. Wisdom tooth pathology remains an issue in oral surgery and general dentistry because of multiple complications and contradictions regarding its treatment. According to Canopkene’s research (2004), from 785 patients aged 16-90 years with various inflammatory processes in oralmaxillofacial region, the inflammatory process of 48.2% was caused by M3. The extraction of impacted third lower molars is a common procedure in oral surgery. It involves trauma of soft and hard tissues accompanied by edema, limited mouth opening, pain, postsurgical complications etc. This is a serious impact on the quality of life. This study was done to evaluate the therapeutic effect of corticosteroids when administered two hours before surgery.

Materials and methods. The study was based on clinical and paraclinical results of 23 patients (aged between 20-35 years) including 14 men and 9 women with pathology of the lower IIIrd molar. They were then divided into two groups: the study group who received oral administration of predinosolon (10 mg) and the control group who did not receive medication. To evaluate the edema, two measurements were performed pre and post surgery. The first one was the distance between the corner of the mouth and the ear lobe, and the second one was the distance between the lateral angle of the eye and the angle of the jaw. To determine the mouth opening limitation due to the muscular postoperative contraction, the initial opening of the mouth (measured with the callipers) was compared to the postoperative condition.

Discussion results. After comparing the 2 groups, the study group demonstrated a significant reduction of edema and pain without limiting the mouth opening comparing to the control group.

Conclusion. Anti-inflammatory steroids inhibit the prostaglandin synthesis, the thromboxanes and the conversion of phospholipids into arachidonic acid, which helps to reduce the transudate. Thus, corticosteroids should be used before surgery in order to reduce the post surgical discomfort and swelling.