Avaliação do efeito da ozonioterapia na percepção da dor, edema e trismo pós-operatório em exodontia de terceiros molares mandibulares: estudo clínico randomizado cego

Abstract

The extraction surgery of third molars is considered the most frequently performed procedure by oral and maxillofacial surgeons. The impaction of these teeth can be asymptomatic or followed by complications such as cysts or odontogenic tumors, pain, pericoronitis, and root resorption of the second molar. The exodontia of third molars induces an inflammatory response based on a clinical triad: pain, edema, and trismus. Ozone therapy has been used as a non-pharmacological alternative due to its anti-inflammatory and antimicrobial properties to assist in oral surgeries. The aim of this study was to evaluate the use of ozonated water and oil in reducing these symptoms compared to 0.9% saline solution. The double-blind randomized clinical trial involved 13 volunteer patients who were treated at the Dental Hospital of the Federal University of Uberlândia (HOUFU), presenting semi-impacted and symmetrically impacted third molars bilaterally. To assess pain, the Visual Analog Scale (VAS) was used, for edema, measurements were taken with a tape measure at three points on the face, and trismus was evaluated by measuring the maximum mouth opening with a digital caliper. Data were analyzed using Sigma Plot 12.0 software. Parametric analyses used Student’s T test, paired T test, One-Way ANOVA, and Holm-Sidak, while non-parametric analyses used Mann-Whitney and Friedman tests. The significance level was set at alpha 0.05. The results showed that both groups exhibited a reduction in pain after 7 days, but in the test group, pain was reduced to nearly 0 after 72 hours. When comparing the control and test groups at 24 hours, 72 hours, and 7 days, no statistically significant difference was observed at any of the time points evaluated. Edema was present in both groups, but the peak of edema occurred at 24 hours in the test group and at 72 hours in the control group. Trismus was observed in both groups; however, when comparing the two groups (control and test), no statistical difference was found at different time points. It was concluded that ozone therapy showed similar properties when compared to saline therapy for pain reduction. Regarding edema, ozone therapy reduced the facial swelling time in the postoperative period. As for trismus, it was not effective, but the statistical values should be carefully evaluated due to the small sample size. Therefore, it is suggested that further clinical trials with larger samples be conducted to validate or reject its use as a standardized clinical protocol.