title: A comparative evaluation of the effect of diclofenac sodium with and without per-orally administered methylprednisolone on the sequelae of impacted mandibular third molar removal: A cohort randomized double-blind clinical trial.
abstract: OBJECTIVE
  This study evaluated the efficacy of oral methylprednisolone and diclofenac sodium on post-operative sequelae after third molar surgery.
  
  
  METHODS
  A randomized double-blind clinical trial was conducted (with institutional and university approval for dissertation) to evaluate the effect of methylprednisolone with diclofenac sodium (group A) as compared with diclofenac sodium and placebo (group B) on three variables: Pain, swelling and trismus, after third molar surgery.
  
  
  METHODS
  Thirty consecutive consenting patients for surgical removal of mandibular impacted third molar were randomly placed into two groups of 15 each (groups A and B). Pain, swelling and trismus were observed by visual analog scale, facial measurements and inter-incisal opening. Scores were recorded after 24 and 72 h and on the seventh post-operative day. Results were subjected to the Chi-square test and independent sample t-test (P = 0.05).
  
  
  RESULTS
  Mean difference in pain experienced between the two groups was statistically significant at 24 h (P = 0.015) and 72 h (P = 0.001) and on the seventh day (P = 0.005). Difference in inter-incisal distance was insignificant (P = 0.239) pre-operatively, but significant after 24 h (P = 0.014) and 72 h (P = 0.001) and on the seventh post-operative day (P = 0.001). Mean difference in swelling was highly significant after 24 h (P = 0.001) and 72 h (P = 0.0001) and on the seventh post-operative day (P = 0.047).
  
  
  CONCLUSIONS
  The combination of oral dose of methylprednisolone (a corticosteroid) diclofenac sodium (a non-steroidal anti-inflammatory drug) was found to be more effective than diclofenac sodium alone on the sequelae of surgical removal of impacted mandibular third molar.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Swami Devi Dayal Hospital and Dental College, Panchkula, Haryana, India.
authors.forename: Deepti V
authors.initials: DV
authors.lastname: Prashar
authors.affiliation: Department of Oral and Maxillofacial Surgery, B.R.S. Dental College and Hospital, Panchkula, Haryana, India.
authors.forename: Deepti
authors.initials: D
authors.lastname: Pahwa
authors.affiliation: Department of Oral and Maxillofacial Surgery, B.R.S. Dental College and Hospital, Panchkula, Haryana, India.
authors.forename: Vimal
authors.initials: V
authors.lastname: Kalia
authors.affiliation: Department of Oral and Maxillofacial Surgery, Gian Sagar Dental College and Hospital, Ram Nagar, Rajpura, India.
authors.forename: Govind
authors.initials: G
authors.lastname: Jindal
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sukhmani Dental College and Hospital, Derabassi, Punjab, India.
authors.forename: Rupinder
authors.initials: R
authors.lastname: Kaur
keywords: Glucocorticosteroid; non-steroidal anti-inflammatory drug; pain; swelling; trismus