Evaluation of the effect of manual lymphatic drainage method on edema, pain and trismus after impacted bilateral mandibular third molar surgery: a randomized clinical trial.

Background: The aim of this study was to evaluate the effect of manual lymphatic drainage (MLD) on edema, pain and trismus after impacted mandibular third molar surgery.

Materials and methods: 46 patients with bilateral impacted mandibular third molar teeth were included in our study. The study was designed as a split-mouth, single-blinded, and controlled randomized clinical trial. Patients in the study group received MLD therapy, while the control group followed routine postoperative care including drug treatment. After extractions, the records were compared statistically and edema, pain and trismus parameters were evaluated on the 3rd and 7th days. The primary outcome variables was swelling and secondary outcome variables were pain and trismus. Swelling was evaluated using the 3dMD FACE SYSTEM (3dMD, Atlanta, GA). To assess pain, the Visual Analog Scale (VAS) was used and trismus was measured using with a digital caliper.

Results: The present study was conducted on a total of 46 patients, aged between 18 and 26 years (18.7174 ± 1.50056), with bilaterally similar, symmetrical impacted mandibular third molars. The group consisted of 14 males (30.4%) and 32 females (69.6%). Postoperative edema, pain and trismus were found to be significantly lower in the MLD group compared to the control group (p < 0.05).

Conclusion: MLD technique is a useful method for reducing postoperative morbidity after impacted third molar extraction. The MLD technique is a simple method free from undesirable side effects and may be more effective than classical methods in reducing edema, pain and trismus after third molar extraction.

Trial registration: The trial was registered retrospectively on ClinicalTrials.gov (ID: NCT06787027, on 22/01/2025). Approved by Izmir Katip Celebi University Clinical Research Ethics Committee (Decision No: ID 19, on 15/02/2018).