Postoperative pain, edema, and trismus are normal sequelae after oral surgery interventions. Their manifestation depends on some individual characteristics and surgery-related factors. To reduce their extent, different medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and enzyme-based products have been used. This literature review aims to discuss the methods for postoperative edema control in oral surgery and analyze their efficiency based on the existing scientific data. An electronic search in Web of Science, PubMed, and Scopus was conducted using a combination of keywords and MeSH terms (edema, oral surgery, control, and management). The results have demonstrated that the most commonly used medications were corticosteroids. They induce the synthesis of endogenous proteins that block the activity of the enzyme phospholipase A2 and thus the release of arachidonic acid. This suppresses the synthesis of prostaglandins (PGs), leukotrienes, and thromboxane, responsible for inflammation and pain. However, there is some study heterogeneity regarding the most appropriate route of administration to limit postoperative edema. Further research is necessary to validate the effect of the other suggested methods for edema control, such as physical therapy, NSAIDs, enzyme products, and hyaluronic acid, as the results in the literature are not uniform.
de Santana-Santos T, de Souza-Santos A, Martins-Filho PR, da Silva LC, de Oliveira E Silva ED, Gomes AC. Prediction of postoperative facial swelling, pain and trismus following third molar surgery based on preoperative variables. Med Oral Patol Oral Cir Bucal. 2013 Jan 1;18(1):e65-70. doi: 10.4317/medoral.18039.
Krishna BP, Reddy BP, Kumar DY, Ummar M, Shekhar V, Tiwari RV. Role of serratiopeptidase and dexamethasone in the control of postoperative swelling. Ann Maxillofac Surg. 2020 Jan-Jun;10(1):108-113. doi: 10.4103/ams.ams_249_19.
Sortino F, Cicciù M. Strategies used to inhibit postoperative swelling following removal of impacted lower third molar. Dental research journal. 2011 Oct;8(4):162. doi: 10.4103/1735-3327.86031.
Pandey C, Speedie A, Jaiswal R, Lanjewar S, Dondulkar Y. Post-Operative Swelling Management in Dental Surgery. Int J Oral Health Med Res 2019;6(3):48-50.
Sreesha S, Ummar M, Sooraj S, Aslam S, Roshni A, Jabir K. Postoperative pain, edema and trismus following third molar surgery - A comparitive study between submucosal and intravenous dexamethasone. J Family Med Prim Care. 2020 May 31;9(5):2454-2459. doi: 10.4103/jfmpc.jfmpc_188_20.
Goodchild JH, Donaldson M; BSP; ACPR; FACHE;2; Conte NR Jr. Mitigating Post-Operative Dental Pain:: As easy as 1, 2, 4, 24. Dela J Public Health. 2017 Aug 30;3(4):52-57. doi: 10.32481/djph.2017.08.012.
Bhandage SG, Kurki MS, Sachdeva G, Shetty N, Kundu M, Yadav AB. Evaluation of efficacy of peri-operative administration of hydrocortisone and dexamethasone in prevention of post-operative complications in oral and maxillofacial surgeries. Rev Esp Cir Oral Maxilofac. 2018 Oct 1;40(4):163-8. doi: 10.1016/j.maxilo.2018.01.001.
Cho H, Lynham AJ, Hsu E. Postoperative interventions to reduce inflammatory complications after third molar surgery: review of the current evidence. Aust Dent J. 2017 Dec;62(4):412-419. doi: 10.1111/adj.12526
Sekhavat L, Davar R, Behdad S. Efficacy of prophylactic dexamethasone in prevention of postoperative nausea and vomiting. J Epidemiol Glob Health. 2015 Jun;5(2):175-9. doi: 10.1016/j.jegh.2014.07.004.
Kumar JN, Ravi P. Postoperative care of the maxillofacial surgery patient. Oral Maxillofac Surg Clin. 2021:239-55. doi: 10.1007/978-981-15-1346-6_12.
Alexander RE, Throndson RR. A review of perioperative corticosteroid use in dentoalveolar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Oct;90(4):406-15. doi: 10.1067/moe.2000.109778.
Markiewicz MR, Brady MF, Ding EL, Dodson TB. Corticosteroids reduce postoperative morbidity after third molar surgery: a systematic review and meta-analysis. J Oral Maxillofac Surg. 2008 Sep;66(9):1881-94. doi: 10.1016/j.joms.2008.04.022.
Herrera-Briones FJ, Prados Sánchez E, Reyes Botella C, Vallecillo Capilla M. Update on the use of corticosteroids in third molar surgery: systematic review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Nov;116(5):e342-51. doi: 10.1016/j.oooo.2012.02.027.
Kim K, Brar P, Jakubowski J, Kaltman S, Lopez E. The use of corticosteroids and nonsteroidal antiinflammatory medication for the management of pain and inflammation after third molar surgery: a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:630–40.
Esen E, Taşar F, Akhan O. Determination of the anti-inflammatory effects of methylprednisolone on the sequelae of third molar surgery. J Oral Maxillofac Surg. 1999 Oct;57(10):1201-6; discussion 1206-8. doi: 10.1016/s0278-2391(99)90486-x.
Krishna BP, Reddy BP, Kumar DY, Ummar M, Shekhar V, Tiwari RV. Role of serratiopeptidase and dexamethasone in the control of postoperative swelling. Ann Maxillofac Surg. 2020 Jan-Jun;10(1):108-13. doi: 10.4103/ams.ams_249_19.
Gerova-Vatsova T. Investigating the efficacy of regenerative therapy with autogenous platelet-rich plasma in vertical bone defects. Cureus. 2024;16(10):e72686. doi:10.7759/cureus.72686.
Gerova-Vatsova T. The efficacy of collagen barrier membranes in regenerating vertical bone defects: a clinical and cone beam computed tomography (CBCT) assessment. Cureus. 2024;16(10):e72550. doi:10.7759/cureus.72550.
Mehlisch DR. The efficacy of combination analgesic therapy in relieving dental pain. J Am Dent Assoc. 2002 Jul;133(7):861-71. doi: 10.14219/jada.archive.2002.0300.
Moore RA, Wiffen PJ, Derry S, Maguire T, Roy YM, Tyrrell L. Non‐prescription (OTC) oral analgesics for acute pain‐an overview of Cochrane reviews. Cochrane Database Syst Rev. 2015;2015(11). doi: 10.1002/14651858.CD010794.pub2.
Gerova-Vatsova T. Initial clinical and cone-beam computed tomography (CBCT) outcomes of enamel matrix derivative-based regenerative therapy in vertical bone defects. Cureus. 2024;16(10):e72180. doi:10.7759/cureus.72180.
Gerova-Vatsova T. Treatment approach to generalized severe periodontitis with the potential for additional tooth loss: a case report. Cureus. 2024;16(11):e73336. doi:10.7759/cureus.73336.
Bailey E, Worthington HV, van Wijk A, Yates JM, Coulthard P, Afzal Z. Ibuprofen and/or paracetamol (acetaminophen) for pain relief after surgical removal of lower wisdom teeth. Cochrane Database Syst Rev. 2013 Dec 12;2013(12):CD004624. doi: 10.1002/14651858.CD004624.pub2.
Gerova-Vatsova T. Beyond Bone Grafts: Exploring the Efficacy of Alternative Regenerative Therapies. Cureus. 2024;16(11):e73745. doi:10.7759/cureus.73745.
Peres MF, Ribeiro FV, Ruiz KG, Nociti-Jr FH, Sallum EA, Casati MZ. Steroidal and non-steroidal cyclooxygenase-2 inhibitor anti-inflammatory drugs as pre-emptive medication in patients undergoing periodontal surgery. Braz Dent J. 2012;23(6):621-8. doi: 10.1590/s0103-64402012000600001.
Yaltirik M, Oral CK, Oral O, Kasapoğlu Ç, Çebi V. Comparison by magnetic magnetic resonance imaging of the effects of two different non-steroidal anti-inflammatory drugs on edema following the surgical extraction of impacted third molars. Turkish J Med Sci. 2001;31(2):151-4.
Samson J, Descroix V, Torres JH, Blanchard P, Bouldouyre MA, Catherine JH, et al. Recommendations for prescription of oral anti-inflammatory agents in oral surgery in adults FRENCH-SPEAKING SOCIETY OF ORAL MEDICINE AND ORAL SURGERY Working group [Internet]. Available from: https://societechirorale.com/wp-content/uploads/2023/06/recommandations_anti-inflammatoires-EN.pdf
Zandi M, Amini P, Keshavarz A. Effectiveness of cold therapy in reducing pain, trismus, and oedema after impacted mandibular third molar surgery: a randomized, self-controlled, observer-blind, split-mouth clinical trial. Int J Oral Maxillofac Surg. 2016 Jan;45(1):118-23. doi: 10.1016/j.ijom.2015.10.021.
Salmerón-Escobar JI, del Amo-Fernández de Velasco A. Antibiotic prophylaxis in Oral and Maxillofacial Surgery. Med Oral Patol Oral Cir Bucal. 2006 May 1;11(3):E292-6.
Email this article (Login required) 
