Evaluation and comparison of locally infiltrated methylprednisolone and intramuscularly injected methylprednisolone in controlling the postoperative sequelae of impacted mandibular third molar extraction

Surgical removal of impacted mandibular third molars is commonly associated with postoperative pain, swelling, and trismus. Corticosteroids are widely used to reduce these inflammatory sequelae, but the optimal route of administration remains debated. To evaluate and compare the effectiveness of submucosal and intramuscular methylprednisolone in reducing postoperative pain, swelling, and trismus following impacted mandibular third molar surgery. A prospective observational clinical study was conducted on 105 patients, divided into three groups: submucosal methylprednisolone, intramuscular methylprednisolone, and control. Postoperative pain (VAS), facial swelling, trismus, and analgesic consumption were assessed on postoperative days 2 and 7. Both methylprednisolone groups showed significantly reduced pain, swelling, trismus, and analgesic consumption compared with controls (p < 0.05), with no significant difference between the two routes. A single preoperative dose of methylprednisolone effectively reduces postoperative morbidity, with submucosal administration offering a clinically convenient alternative to intramuscular injection.