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Background <p>Surgical removal of impacted mandibular third molars is commonly associated with post-operative pain, swelling, trismus, and inflammation. Heat generated during osteotomy may contribute to bone necrosis and inflammatory sequelae. This study compared cold saline (4&#xa0;°C) irrigation during osteotomy with pre-operative intravenous dexamethasone (8&#xa0;mg) for post-operative outcome control.</p> Methods <p>This single-center, split-mouth, single-blind, randomized controlled trial was approved by the Ethics Committee and registered with the Clinical Trial Registry. The study included 26 healthy adults with bilaterally symmetrical mesioangular or horizontal impacted mandibular third molars. Each participant received cold saline irrigation (4&#xa0;°C) for one side (test) and pre-operative intravenous dexamethasone (8&#xa0;mg) with room temperature saline for the contralateral side (control). Post-operative pain, swelling, and trismus were assessed pre-operatively and on post-operative days (POD) 1, 3, and 7.</p> Results <p>No significant differences were observed for swelling and trismus at any time point. However, pain scores were significantly lower in the test group on POD3 (<i>P</i> = 0.012), while analgesic consumption was significantly higher in the control group on POD3 and POD7 (<i>P</i> = 0.019 and 0.006, respectively). One case each of inferior alveolar nerve injury and dry socket was noted in the control group.</p> Conclusion <p>Cold saline (4&#xa0;°C) is a simple, cost-effective, non-invasive, non-pharmacological solution for the control of post-operative inflammation after surgical removal of lower impacted third molars. The limited sample size and short follow-up duration may restrict the broader applicability of the results.</p>

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Effect of Cold Saline Irrigation in the Reduction of Post-operative Complications After Surgical Removal of Lower Third Molars: A Split-Mouth Randomized Controlled Trial

  • 期刊论文

  • 发表日期：

    2026年7月9日

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  • Mehul Saha,
  • Srikanth Gadicherla,
  • Kalyan C. Pentapati,
  • Aakriti Arora,
  • Adarsh Kudva,
  • Chithra Aramanadka,
  • Anupam Singh,
  • Leonardo Saigo,
  • Murali Venkata Rama Mohan Kodali,
  • Joanna Baptist

摘要

Background

Surgical removal of impacted mandibular third molars is commonly associated with post-operative pain, swelling, trismus, and inflammation. Heat generated during osteotomy may contribute to bone necrosis and inflammatory sequelae. This study compared cold saline (4 °C) irrigation during osteotomy with pre-operative intravenous dexamethasone (8 mg) for post-operative outcome control.

Methods

This single-center, split-mouth, single-blind, randomized controlled trial was approved by the Ethics Committee and registered with the Clinical Trial Registry. The study included 26 healthy adults with bilaterally symmetrical mesioangular or horizontal impacted mandibular third molars. Each participant received cold saline irrigation (4 °C) for one side (test) and pre-operative intravenous dexamethasone (8 mg) with room temperature saline for the contralateral side (control). Post-operative pain, swelling, and trismus were assessed pre-operatively and on post-operative days (POD) 1, 3, and 7.

Results

No significant differences were observed for swelling and trismus at any time point. However, pain scores were significantly lower in the test group on POD3 (P = 0.012), while analgesic consumption was significantly higher in the control group on POD3 and POD7 (P = 0.019 and 0.006, respectively). One case each of inferior alveolar nerve injury and dry socket was noted in the control group.

Conclusion

Cold saline (4 °C) is a simple, cost-effective, non-invasive, non-pharmacological solution for the control of post-operative inflammation after surgical removal of lower impacted third molars. The limited sample size and short follow-up duration may restrict the broader applicability of the results.