Impacted third molar extraction: methylprednisolone or nimesulide

Objectives: The aim of this study was to evaluate the effect oftwo different drugs (methylprednisolone and nimesulide) to decreasethe swelling, pain and trismus after the surgical extractionof mandibular impacted third molars.Methods: This randomized clinical trial comprised thirty (30)adult patients of both genders (15 male and 15 female) withno local or systemic problems, with bilateral impacted lowerthird molars in similar position (Pell and Gregory’s class IIB),where surgical extraction had been indicated. These patientswere separated in two groups at random: the methylprednisolonegroup and the nimesulide group. A record card was filled inwith preoperative and postoperative epidemiological and clinicdata about inflammation, pain and trismus. The choice of whichside to operate first was made randomly and double-blindly. Theswelling was evaluated by ecography. The pain was evaluated byVAS modificated in GRS. The trismus was evaluated by interincisaldistance.Mean values were compared between the 2 groups with a 2-wayanalysis of variance and a Student’s t-test or the c2 test forqualitative comparisons. The threshold of significance was setat 5%.Results: Patients in the nimesulide group showed a moresevere swelling (p = 4.2175E-06) and a more severe trismus(p = 0.00034); pain was very similar in both groups.Conclusions: The results confirm the efficacy of methylprednisolonein providing a more comfortable postoperative courseafter surgical extraction of impacted lower third molars. It wasmore effective than nimesulide to reduce the degree of swellingand trismus. However, it had no clear effect on pain control.