The influence of bolus of methylprednisolone on post- orthognathic surgery symptoms: a controlled clinical trial

Abstract

Abstract Objective: Despite improvements in maxillary and mandibulary osteotomy, complications still result around 20 %. Post and intra-operative standard therapies, based on the use of betametasone and tranexamic acid, could help to minimize the onset of side-effects. The aim of our study was to compare the role of a supplementary bolus of methylprednisolone rather than the standard therapy in the onset of postoperative symptoms. Methods: We enrolled 10 patients, affected by Class II and III Dentoskeletal, submitted to our institution for maxillomandibular repositioning osteotomy between October 2020 and April 2021. Patients were divided in 2 groups as following: 5 patients (group A) received standard therapy consisting in the administration of 4 mg of Betamethasone, intraoperatively, and 1 gr of tranexamic acid in two administrations. The remaining five patients (Group B) received a supplementary bolus of 20 mg methylprednisolone before the end of the surgery. All patients received, in the postoperative period, 4 mg of Betamethasone every 12 hours, for 3 days. Postoperative outcomes were evaluated with questionnaire evaluating speaking discomfort, pain when swallowing, feeding discomfort, drinking discomfort, swelling, ache. Each parameter was associated to a numeric rating scale ranging from 0 to 5. Results: We observed that patients treated with a supplementary bolus of methylprednisolone (Group B) had a statistically significative reduction of all post-operative symptoms as compared with patients of Group A (p<0.05, **p<0.01 Figure 1). Conclusion: Our study highlighted that the additional bolus of methylprednisolone improved all of the 6 parameters investigated by the questionnaire submitted to our patients, resulting in a faster recovery and improvement of the patient’s compliance to surgery. Further studies with larger population are needed to confirm our preliminary results.