Research Article
Methylprednisolone and Hyaluronic Acid versus Each Agent
Alone to Control Complication of Impacted Wisdom Removal
Alaa Abdelqader Altaweel ,
1,2
Abd El-Hamid Gaber,
3
Mahmoud Zuhair Alnaffar,
4
Elham Ahmed Alshomrani,
5
Rahaf Asaad Alrehaili,
5
Rahaf Abdulmoeen Alshaikh,
5
Jumana Nader Baeshin,
5
and Elaf Sami Al-akhdar
5
1
Oral & Maxillofacial Surgery Department, Faculty of Dental Medicine for Boys, Al-Azhar University, Cairo, Egypt
2
Oral & Maxillofacial Surgery Department, Vision Colleges, Jeddah, Saudi Arabia
3
Clinical Pharmacology Department, Faculty of Medicine, Menoufia University, Shibin Al Kawm, Menoufia, Egypt
4
Maxillofacial Surgery Department, Vision Colleges, Jeddah, Saudi Arabia
5
Vision Colleges, Jeddah, Saudi Arabia
Correspondence should be addressed to Alaa Abdelqader Altaweel; alaarezk77@azhar.edu.eg
Received 5 October 2021; Accepted 14 March 2022; Published 24 March 2022
Academic Editor: Mario Dioguardi
Copyright © 2022 Alaa Abdelqader Altaweel et al. is is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
Introduction. Extraction of impacted molars is commonest operation in oral cavity and associated with complications disturbing
patient’s quality of life. Hyaluronic acid is a nontoxic agent recommended for wound management due to its anti-inflammatory effects.
Also, methylprednisolone sodium is used to reduce pain and edema. e aim this study was to compare the effect of combined use of
corticosteroid and hyaluronic acid versus each agent alone in controlling postextraction complications of impacted mandibular third
molars. Materials and Methods. is prospective randomized trial included patients suffering from impacted mandibular third molar.
Patients were divided into four groups. Group I, control, and group II received methylprednisolone sodium succinate injection
preoperatively, group III received hyaluronic acid applied in extraction socket, and group IV received preoperative methylprednisolone
sodium succinate injection and topical hyaluronic acid in the socket. All patients were evaluated preoperatively and postoperative day to
assess swelling, pain, mouth opening, and total analgesic dose. Results. Group IV showed insignificant edema along the study period, and
other groups showed significant edema on third postoperative day that improved on seventh postoperative in group II and III and tenth
postoperative day in group I. Significant decreased mouth opening occurred on second postoperative day in group I, while in other
groups, it occurred in third postoperative day. Significant improvement occurred on seventh postoperative day in all groups except in
group I which occurred on tenth postoperative day. ere was less pain and analgesic dose reported in group IV than other groups.
Conclusion. Combined use of methylprednisolone sodium succinate and hyaluronic acid significantly decrease postoperative com-
plications than using each agent alone.
1. Introduction
In oral and maxillofacial surgery, surgical extraction of
impacted third molars accounts for a considerable number
of patients. It necessitates meticulous preoperative planning,
the application of surgical skills during the procedure, and
good postoperative care [1].
Pain, limited mandibular movement, and edema are all
common side effects after removing an impacted lower third
molar. Pain usually begins three hours after surgery and
ranges in intensity from moderate to severe. Furthermore,
impaction removal can cause considerable edema in the
operational area, which is caused by phospholipids being
converted to arachidonic acid by phospholipase A2, and
formation of prostaglandins, leukotrienes, or thromboxane-
related substance [2].
Corticosteroids have a variety of effects on the human
body. e usual rate of hydrocortisone production is
Hindawi
Evidence-Based Complementary and Alternative Medicine
Volume 2022, Article ID 1563513, 8 pages
https://doi.org/10.1155/2022/1563513