MANUAL LYMPH DRAINAGE EFFICIENTLY REDUCES POSTOPERATIVE FACIAL SWELLING AND DISCOMFORT AFTER REMOVAL OF IMPACTED THIRD MOLARS

Abstract

The removal of wisdom teeth is oftenassociated with severe postoperative edemaand pain, and operation on the third molarcan cause local inflammation that impairslymph transport. The objective of the studywas to assess the efficacy of manual lymphdrainage (MLD) in reducing swelling followingbilateral wisdom tooth removal. Tenconsecutive patients with bilateral impactedwisdom teeth that required surgical removalwere enrolled in the study. Each patientwas postoperatively treated with MLD (afterVodder’s method) on one side of the neckregion with the untreated contralateral sideas a control. Swelling was evaluated using atape-measure placed in contact with theskin. The six landmarks of measurementincluded tragus-lip junction, tragus-pogonion,mandibular angle-external corner of eye,mandibular angle-ala nasi, mandibular anglelipjunction, and mandibular angle-medianpoint of chin. Subjective assessment of MLDwas conducted with self-evaluation using avisual analogue bar scale (VAS, range 0-100mm). Of the 6 linear measurements, 4 lines(2, 4, 5, 6) showed a significant reductionof swelling on the side of MLD compared tothe untreated side. Mean score of VAS ofpretreatment condition was 35.5 ± 20.60 mmthat decreased to 22 ± 19.32 mm measured after MLD (p=0.0295). This initial studydemonstrates that MLD may promote animprovement of lymph circulation and workin an adjunctive role for reduction ofpostoperative swelling and pain followingremoval of impacted third molars.