Current Concepts and Emerging Therapies for Controlling Postoperative Swelling in Oral and Maxillofacial Surgery: A Narrative Review

from rotating instruments can all exacerbate local inflammatory reactions.Edema is gradually reduced by lymphatic clearance after peak swelling, which typically happens between 48 and 72 hours.Therefore, as shown schematically in Figure 1, effective management must address both the mechanical and biochemical mediators of postoperative swelling. Preoperative Interventions• Corticosteroid prophylaxis: Corticosteroids remain the most robust pharmaceutical option for reducing postoperative inflammation due to their inhibitory effects on phospholipase A₂ and subsequent suppression of arachidonic-acid IntroductIon Importance of Swelling Management in Oral and Maxillofacial SurgeryOne of the most predictable but clinically significant side effects of oral and maxillofacial surgery (OMFS) is postoperative swelling.Excessive swelling can hinder airway assessment, limit mandibular function, exacerbate discomfort, and delay rehabilitation, even though inflammatory edema is a natural reaction to tissue trauma.In orthognathic procedures, implantology, third-molar surgery, and trauma management, where functional restoration and postoperative comfort are essential to treatment outcomes, these implications are especially pertinent.In order to improve the effectiveness and quality of postoperative recovery, modern OMFS thus places a great deal of emphasis on strategic perioperative measures that regulate inflammatory responses. 1Postoperative swelling following third molar surgery has been reported in up to 90% of cases, highlighting its clinical significance. Biological Basis of Postoperative SwellingAn inflammatory cascade that starts as soon as a surgical injury occurs causes swelling.When tissue is disrupted, mast cells become activated and release inflammatory cytokines, prostaglandins, and bradykinin.These substances increase vascular permeability and make it easier for plasma to leak into the extracellular space. 2 Because of its dense lymphatic networks, rich vascularity, and the extensive soft-tissue mobilization necessary for OMFS, the orofacial region is particularly vulnerable.Extended operative time, bone removal, prolonged retraction, and thermal damage