An interesting article titled “Efficacy of Hydrocortisone, Povidone-Iodine, and Normal Saline as an Irrigating Solution During Surgical Removal of Impacted Mandibular Third Molars: A Randomized Controlled Trial” written by Faheem Ahmed and et. al. appears in Cureus published February 01, 2024. The study sought to compare the effects of three irrigating solutions, hydrocortisone, povidone-iodine, and normal saline, on pain, trismus, and edema following removal of impacted lower wisdom teeth.
Wisdom tooth removal, also known as the surgical removal of impacted third molars, is a common dental procedure, often accompanied by pain, swelling (edema), and difficulty opening the mouth (trismus). Researchers have been looking for ways to alleviate these post-surgical concers. The study metnioned in this article compared the effectiveness of three irrigation solutions used during surgery.
The study involved 105 patients between the ages of 18 and 40 who needed their wisdom teeth removed. All the patients were diagnosed by established clinical and radiographic parameters and were alternatively grouped into three groups irrespective of age, sex, difficulty in impaction, and their response to various drugs to eliminate bias. They were randomly divided into three groups, each receiving a different irrigation solution during the surgery. Researchers then monitored the patients for pain, swelling and trismus on the second and seventh days after surgery.
The results were promising for the patients who received hydrocortisone. Patients in this group experienced significantly lower pain scores compared to the other two groups on the second day after surgery. While the effect on swelling diminished by the seventh day, hydrocortisone also showed effectiveness in controlling both pain and trismus throughout the monitored period.
Photo by Ozkan Guner on Unsplash
The findings suggest that using hydrocortisone as an irrigation solution during wisdom tooth removal surgery can be a valuable tool for dentists to reduce post-surgical pain, swelling, and difficulty opening the mouth. This could significantly improve patient comfort and recovery after this common procedure. The authors state
“Hydrocortisone… performed effectively as an irrigating solution in controlling postoperative pain and trismus, followed by povidone-iodine and normal saline. This implies that using hydrocortisone as an irrigating solution is found to be a highly beneficial and inexpensive alternative in reducing the postoperative pain, swelling, and trismus caused by the surgical removal of impacted teeth.”
Due to the small sample size in the study it is difficult to generalize the results. Therefore, further studies are needed to evaluate the effect of hydrocortisone in managing postoperative pain, swelling, and trismus following the surgical removal of the wisdom teeth. Even so the researchers suggest that hydrocortisone and povidone-iodine can be used routinely as an intraoperative irrigating solution during the surgical extraction of lower wisdom teeth, as they increase patient comfort, control swelling, and alleviate pain and trismus in the right after surgery postoperative.