衝撃下顎第3大臼歯抜歯後の術後炎症性合併症を軽減するための新しい治療法

A novel therapeutic approach for reducing postoperative inflammatory complications after impacted mandibular third molar removal.

抄録

背景:

この研究は、デキサメタゾンと蜂蜜の併用と、各薬剤の単独使用とで、下顎第三大臼歯の埋伏歯除去に伴う合併症の抑制効果を比較することを目的とした。

BACKGROUND: This study was designed to compare effect of combined use of dexamethasone and honey versus each agent alone in controlling complications associated with removal of impacted mandibular third molar.

方法:

この無作為臨床研究は、下顎智歯の埋伏に苦しむ患者を対象とした。患者は無作為に4群に分けられた。第I群はコントロール、第II群は術前にデキサメタゾンを注射、第III群は抜歯後の創部にハチミツを局所投与、第IV群は術前にデキサメタゾンを注射し、ハチミツを局所投与した。すべての患者を術前および術後に評価し、顔面浮腫、切歯間距離、疼痛、および使用した鎮痛薬の総量を評価した。

METHODS: This randomized clinical study included patients suffering from impacted mandibular wisdom teeth. Patients were divided randomly into 4 groups. Group I, control, group II, received dexamethasone injection preoperatively, group III, received honey locally in the wound after extraction, and group IV, received dexamethasone injection preoperatively and topical honey application. All patients were evaluated preoperatively and postoperatively to assess facial edema, interincisal distance, pain, and total analgesic dose used.

結果:

I群では他の群よりも有意な浮腫が発生し、II群とIII群では術後7日目に、I群では術後10日目に有意に改善した。切歯間距離は全群で術後3日目に有意に減少し、I群を除く全群で術後7日目に有意に改善し、術後10日目に改善した。疼痛はIV群で他群より有意に小さく、I群で最大であった。

RESULTS: Significant edema developed in group I than other groups and improved significantly in group II and III on seventh postoperative day, and tenth postoperative day in group I. Insignificant edema developed in group IV. Significant decrease in interincisal distance occurred in all groups on third postoperative day that improved significantly on seventh postoperative days in all groups except group I, it improved on tenth postoperative day. Pain was significantly minimum in group IV than other groups and its maximum degree was in group I.

結論:

デキサメタゾンとハチミツはともに、下顎第三大臼歯埋伏歯抜歯後の腫脹、疼痛、顎関節症を最小限に抑える有効な方法である。両薬剤の単独または併用は、術後の不快感をなくすための簡便、安全、無痛で費用対効果の高い方法である。しかし、デキサメタゾンまたは蜂蜜は下顎第三大臼歯の外科的抜歯に関連する合併症を減少させることができ、この点では両剤の同時適用がより効果的な方法である。

CONCLUSION: Both dexamethasone and honey are an effective way of minimizing swelling, pain, and trismus after removal of impacted lower third molars. Both agents either alone or in combination provide simple, safe, painless, and cost-effective method to eliminate postoperative discomfort. However, dexamethasone or honey can decrease complications related to surgical extraction of mandibular third molar, the simultaneous application of both agents is more effective method in this regard.