Reduction of postoperative facial swelling by low-dose methylprednisolone: an experimental study

The effectiveness of a low-dose, preoperative regimen of methylprednisolone for the reduction of postoperative facial edema after impacted third molar surgery was evaluated using the facial plethysmograph. Eleven patients were given 16 mg methylprednisolone orally the evening before surgery, combined with 20 mg methylprednisolone intravenously immediately preoperatively, in a double blind, randomized, crossover study. Facial contour was measured preoperatively, and then on days 1, 2, 3, 4, and 7 postoperatively. The low dose of methylprednisolone reduced swelling by 42% at 24 hours and 34% at 48 hours postoperatively. By the third day the difference was only 19%, suggesting the need for either a sustained release formulation or a multiday course. Trismus or the need for analgesic medication were not affected by this dose of methylprednisolone.