Manual lymphatic drainage and muscle energy techniques after third molar surgery: A randomized split-mouth clinical trial

Abstract

Objective: The aim was to verify if manual lymphatic drainage (MLD) and muscular energy techniques (MET) helps on pain control and amplitude of mouth opening, in patients submitted to bilateral third molars surgeries. Methods: Thirty consecutive patients, aged between 18 and 45 years, 53.7% males, were randomized in two groups: physical therapy group (PG), treated with MLD and MET on one random side of the mouth, being the other side, the control (CG). Additionally, for CG, paracetamol and dexamethasone were prescribed. The control of pain and inflammation in the PG was performed using manual therapy techniques (MLD and MET) and paracetamol. Postoperative pain was evaluated through visual analogue scale (VAS) and maximum active mouth opening by using a digital caliper. Results: On the 8th postoperative day the VAS were 2.13 ± 1.84 in the CG and 0.33 ± 1.45 in the PG (p < 0.05); the maximum active mouth opening range were 36.85 ± 6.39 mm in the CG and 53.30 ± 6.66 mm in the PG (p < 0.001). Conclusion: The present study emphasized that physical therapy is a good, noninvasive, alternative for the control of pain and limitation of mouth opening in the postoperative period of third molars surgery. Impact Statement: The postoperative physical therapy (PPT) represents an efficient modality of treatment that allows a faster and better noninvasive postoperative recovery after third molar surgery. PPT can be used in public health services by integrating physiotherapists in the dental teams reducing the need for pharmacological therapies. (c) 2021 British Association of Oral Surgeons and John Wiley & Sons Ltd