Effect of transcutaneous electrical nerve stimulation on pain, edema, and trismus after surgical removal of impacted third molars: a split-mouth randomized clinical trial

• Ahad Alizadeh ^[1] ; Aida Karagah ^[3] ; Reza Tabrizi ^[2] ; Leyli Shadman ^[1] ; Azin Arjmand ^[1] ; Maryam Tofangchiha ^[4] ; Romeo Patini ^[5]
  1. [1] Qazvin University of Medical Sciences

     Qazvin University of Medical Sciences

     Irán

     
  2. [2] Shahid Beheshti University of Medical Sciences

     Shahid Beheshti University of Medical Sciences

     Irán

     
  3. [3] Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran; Assistant Professor, Department of Oral and Maxillofacial Surgery, Qazvin University of Medical Sciences, Qazvin, Iran
  4. [4] Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran; Professor, Department of Oral and Maxillofacial Radiology, Qazvin University of Medical Sciences, Qazvin, Iran
  5. [5] Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Rome, Italy

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• Localización: Medicina oral, patología oral y cirugía bucal. Ed. inglesa, ISSN-e 1698-6946, Vol. 29, Nº. 2 (March), 2024
• Idioma: inglés
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• Resumen

  • The transcutaneous electrical nerve stimulation (TENS) stimulus inhibits the activity of nociceptive neurons of the central nervous system. Pain relief is achieved by increasing the pulse amplitude of TENS to induce a non-painful paranesthesia beneath the electrodes. This study aimed to assess the effect of TENS on acute pain, edema, and trismus after surgical removal of impacted third molars.

    This randomized, double blind, split-mouth clinical trial was conducted on 37 patients with bilaterally impacted mandibular third molars. The angle and body of mandible at the site of surgery in one randomly selected quadrant underwent TENS immediately after surgery (50 Hz, 100-µs short pulse, 15 minutes for 6 days). The TENS stimulator device was used in off mode for the placebo quadrant. The pain score (primary outcome) was measured for 7 days postoperatively, and edema and trismus (secondary outcomes) were assessed at 2, 4 and 7 days, postoperatively. The results were analyzed by repeated measures ANOVA using R software (alpha=0.05).

    The overall mean pain score was significantly lower in the TENS than the placebo group (P<0.05). The number of taken analgesics in the first 3 days was significantly lower in the TENS group (P<0.001). Postoperative edema in the TENS group was lower than the placebo group but only the difference was not statistically significant (P>.05). The inter-incisal distance, as an index to assess trismus, was not significantly different between the two group at day 2, but it was significantly higher in the TENS group after the second day (P<0.001).

    TENS effectively decreased pain and trismus following impacted third molar surgery, and may be recommended as a non-pharmaceutical method to relieve postoperative symptoms.