Clinical and Thermographic Evaluation of the Inflammatory Response to Third Molar Removal

Abstract

This study aimed to compare two different drug protocols to be used during the preoperative period, consisting of different corticoids and with various routes of administration. An observational and longitudinal study was carried out with 30 volunteers who needed the removal of impacted or semi-impacted third molars in the mandible region. Volunteers were equally divided into two groups, with the drug protocol administered in the preoperative phase, one hour before surgery. Two protocols were used: Dexamethasone 8.0 mg orally (VO) and Betamethasone Dipropionate 5mg/mL + Betamethasone Disodium Phosphate 2mg/mL intramuscularly (IM). Postoperative medication was standard for both groups. The volunteers were monitored in the pre- and postoperative periods (third and seventh days). Local temperature, maximum mouth opening, edema, and pain were evaluated. With regard to the skin temperature response, significant effects were identified for the interaction between the moment in which the evaluations were carried out and the corticoid administered in the following regions of interest and analyzed temperatures: Operated mandibular angle (maximum (F(2, 56)=3.89, p=0.026, ηp 2 =0.122), mean (F(2.56)=3.47, p=0.038, ηp 2 =0.110) and minimum (F(2.56)=4.03, p=0.023, ηp 2 =0.126)) and in the Control =0.116 )). The Betamethasone IM group showed an increase in skin temperature on the third postoperative Mandibular Angle (maximum (F(2.56)=3.36, p=0.042, ηp 2 =0.107), and minimum (F(2.56)=3.66, p=0.032, ηp 2 day. In evaluating pain, edema, and maximum mouth opening, a similar behavior tendency was noticed in both drug protocols. It can be concluded that dexamethasone 8.0mg VO and Betamethasone dipropionate 5mg/mL + betamethasone disodium phosphate 2mg/mL IM did not present significant differences in edema, pain, and limitation of mouth opening in the postoperative period when compared, concerning skin temperature, there was a difference when considering the absolute temperature. Considering the results of this study, Dexamethasone is recommended as a preoperative protocol for removing third molars. Keywords: Thermography; Surgery; Impacted third molar; Corticosteroids; Inflammatory response.