Short-term Haematological Parameters Following Surgical Removal of Mandibular Third Molars with Different Doses of Methylprednisolone Compared with Placebo. A Randomized Controlled Trial.

OBJECTIVES: To evaluate the influence of a single intraoperative injection of methylprednisolone on short-term haematological parameters following surgical removal of mandibular third molars. MATERIAL AND METHODS: Fifty-two patients with indications for surgical removal of bilateral impacted mandibular third molars were included in a randomized, split-mouth and double-blinded study design. Each molar were randomly allocated into one of following four groups: 20 mg methylprednisolone, 30 mg methylprednisolone, 40 mg methylprednisolone and placebo. Peripheral blood samples were obtained before and three days after surgery. Haematological parameters involving haemoglobin, white blood cell count and C-reactive protein (CRP) were evaluated and expressed as mean changes. Level of significance was 0.05. Furthermore, outcomes were correlated for age, sex, smoking and time of surgery. RESULTS: There were no significant differences in postoperative haematological parameters with different doses of methylprednisolone compared with placebo. Peripheral blood samples revealed decreased level of haemoglobin and increased level of leucocytes and CRP in each group. Smokers displayed a significant lower level of haemoglobin and CRP compared with non-smokers (P < 0.05) and level of eosinophils decreased significantly with increasing age (P < 0.05). CONCLUSIONS: This study indicates that a single intraoperative injection of methylprednisolone seems not to cause suppression of short-term haematological parameters compared with placebo following surgical removal of mandibular third molars.

Therapeutic efficacy of cryotherapy on facial swelling, pain, trismus and quality of life after surgical removal of mandibular third molars: A systematic review.

The objective was to test the hypothesis of no difference in facial swelling, pain, trismus and immediate quality of life after surgical removal of mandibular third molars, with or without post-operative cryotherapy. A MEDLINE (PubMed), EMBASE database and Cochrane library search in combination with a hand search of relevant journals were conducted by including human randomised controlled trials published in English until 17 July 2018. The search identified 37 titles. Six studies with low or unclear risk of bias fulfilled the inclusion criteria. Intermittent cryotherapy for 30 minutes during the first post-operative days significantly diminished facial swelling, pain and trismus compared with no cryotherapy. Patient's satisfaction and perception of recovery were significantly increased with cryotherapy. Therapeutic efficacy of intermittent cryotherapy on post-operative facial swelling, pain and trismus seems to be improved compared with continuous cryotherapy. Considerable variations in study design, diversity of used evaluation methods, outcome measures and various methodological confounding factors posed serious restrictions to review the literature in a quantitative systematic manner. Thus, conclusions drawn from the results of this systematic review should be interpreted with caution. Further well-designed randomised controlled trials including standardised protocol, larger patient sample, blinded outcome assessors, patient-reported outcome measures and three-dimensional volumetric analysis of facial swelling are required before evidence-based recommendations can be provided.

Different Dosages of Corticosteroid and Routes of Administration in Mandibular Third Molar Surgery: a Systematic Review.

OBJECTIVES: The objective of the present systematic review was to test the hypothesis of no difference in facial swelling, pain and trismus after surgical removal of mandibular third molar with different dosages of corticosteroids and administration routes. MATERIAL AND METHODS: A MEDLINE (PubMed), Embase database and Cochrane Library search in combination with a hand-search of relevant journals was conducted by including randomized controlled trials published in English until 1st December 2017. RESULTS: Seven studies fulfilled the inclusion criteria. Considerable variation in the included studies prevented meta-analysis from being performed. Preoperative submucosal injection of corticosteroids significantly diminishes facial swelling, pain and trismus compared with placebo. However, different dosages of corticosteroid and administration routes reveal contrary results indicating that administration of a higher dosage of corticosteroids do not necessarily cause a further decrease in facial swelling, pain and trismus. CONCLUSIONS: Consequently, the optimal dosage of corticosteroids and administration route for diminishing postsurgical morbidity and improve quality of life after surgical removal of mandibular third molar is presently unknown. Therefore, further well-designed randomized clinical trials including a standardised protocol, patient-reported outcome measures and three-dimensional analysis of facial swelling is needed.

Orthognathic Surgery: Outcome in a Facebook Group.

The literature shows that the indications for orthognathic surgery (OS) are often functional problems and unsatisfactory facial esthetics. This study investigated the esthetic outcomes and overall satisfaction following OS. Somatosensory change is a relatively common complication and its influence on the level of satisfaction was studied. The social-networking web site Facebook was used to identify the study population. An online questionnaire was performed using the website SurveyMonkey. In all, 105 (9%) respondents from the Danish Facebook group about OS, called Kaebeoperation (jaw surgery), were enrolled in the study. The respondents consisted of 12 men and 93 women, with a mean age of 27 ±â€Š9 years. Fifty-four percent replied that esthetic concerns were the reason for the OS. Eighty-four percent reported improvement in facial esthetics after the OS. Men indicated a higher degree of improvement in beauty than women (P = 0.030). Sixty-four percent replied that their attractiveness had been increased after OS. Eighty-six percent were happy with the results and 89% would recommend the surgery to others in need. No significant differences in esthetic results and satisfaction were seen with regard to sex, age, and somatosensory change. High satisfaction and improvement in facial esthetic after OS were seen. Young patients (16-25 years) and men indicated a higher degree of satisfaction than old (>25 years) patients and women. The use of social media seems to be an interesting platform for qualitative scientific research in certain age groups. Further prospective and objective studies about the esthetic improvement after OS should be performed.