What Are the Effects of Methylprednisolone Injection Into the Masseter and Gluteal Muscle on Pain, Edema and Trismus After Impacted Lower Third Molar Surgery? A Randomized Clinical Trial

Methylprednisolone is widely administered after impacted third molar surgery. This study compared the effect of methylprednisolone injection into the masseter and gluteal muscle on pain, edema, and trismus after impacted lower third molar surgery. This was a single-blind placebo-controlled randomized clinical trial. Sixty patients with an impacted lower third molar were included and randomly assigned into 3 groups. Each group received 1 of the following medications half an hour before surgery: Group I: 40 mg methylprednisolone injected into masseter muscle; Group II: 40 mg methylprednisolone injected into gluteal muscle; Group III: considered as control group with no intervention. The level of pain was recorded 1, 5, and 7 days after surgery using visual analog scale, and the amount of edema was measured 5 and 7 days after surgery using ultrasound imaging. The amount of trismus was measured 5 and 7 days after surgery based on the distance between incisor edge of upper and lower centrals. Friedman test was used to compare the level of pain, trismus and edema in each group at different times. Kruskal-Wallis test was used to compare the level of pain, trismus and edema among different groups at each time. Significance level was set at P < .05. There was no significant difference among the 3 groups (a total of 60 patients (31 females and 29 males), aged 19 to 35 years) considering edema (P = .250, CI = 0.22 ± 0.42), trismus (P = .337, CI = −5.93 ± 2.22) and pain (P = .285, CI = −2.91 ± 0.40) relief. Postsurgical pain, edema, and trismus were not reduced by intramuscular injection of methylprednisolone before third molar surgery.