EFFECT OF CO-ADMINISTERED PREDNISOLONE AND DICLOFENAC POTASSIUM IN REDUCING POSTOPERATIVE TRISMUS AFTER IMPACTED LOWER THIRD MOLAR SURGERY.

Abstract

Objective:
 To determine the effect of adding a combination of oral Diclofenac Potassium with an intramuscular dose of Prednisolone preoperatively to minimize postoperative trismus after the surgical removal of the lower third molar tooth. 
 Materials and Methods:
 A total of 160 patients undergoing surgical removal of their impacted lower third molar tooth were randomized into 2experimental groups; Group A (50mg Diclofenac Potassium oral and 40mg Prednisolone administered intramuscularly one hour before surgery) and Group B (40mg of intramuscular Prednisolone administered one hour before surgery). In this randomized control trial,both groups were prescribed the combination of Paracetamol and codeine as analgesics postoperatively for 48 hours. The maximum inter incisal distance was measured immediately before and 48 hours after surgery.
 Results:
 Mean preoperative maximum inter incisial opening in Group A and Group B were 48.28±5.12 and 47.51±5.18 respectively. On postoperative second day the Mean maximum inter incisial opening in Group A was 34.49±3.73mm when compared to 27.71±5.48 in Group B. The mean postoperative trismus in Group A and Group B were 13.79±6.39mm and 19.95±7.07mm respectively. The mean difference in post operative trismus was 6.160mm which was statistically significant at a 99% confidence interval (p<0.01). 
 Conclusion:
 Preemptive medication with a combination of Prednisolone-Diclofenac Potassium was more effective in reducing postoperative trismus compared to Prednisolone alone.