Mannitol Reduces Pain and Trismus after Impacted Mandibular Third Molar Surgery: A Comparative Study

Objective: To compare the efficacy of local 20% W/V Mannitol infiltration with the standard care for minimizing postoperative pain, edema, and trismus after impacted mandibular third molar removal. Study Design: Quasi-experimental study. Place and Duration of the Study: Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from May 2024 to Jul 2025. Methodology: Forty subjects who underwent extraction of impacted mandibular third molar were divided into two equal groups, i.e., Mannitol and control group. In group A, apart from standard treatment, 20% w/v Mannitol infiltrated, while in group B, only standard treatment was applied. Pain assessment was done after 6, 24, and 48 hours, while swelling and trismus were recorded before surgery and 48 and 72 hours after surgery. Results: There was a significant decrease in pain after surgery for Mannitol at 6 hours [6.00 (1.00) versus 9.00 (1.00); p<0.001] and 24 hours [3.00 (1.00) versus 5.00 (0.50); p<0.001] when compared with controls. The amount of swelling was significantly decreased at 48 hours [7.00 (1.00) versus 11.00 (1.00); p<0.001] and 72 hours [5.00 (1.00) versus 6.00 (2.00); p=0.001]. Trismus was also significantly decreased in the Mannitol group at 48 and 72 hours (p<0.001). Within-group analysis showed significant improvements in pain, swelling, and trismus over time in both groups (p<0.001). Conclusion: Local 20% W/V Mannitol infiltration effectively decreases early postoperative pain, swelling, and trismus after third molar surgery, providing a non-steroidal supplement to postoperative management.