Manual lymph drainage efficiently reduces postoperative facial swelling and discomfort after removal of impacted third molars.

The removal of wisdom teeth is often associated with severe postoperative edema and pain, and operation on the third molar can cause local inflammation that impairs lymph transport. The objective of the study was to assess the efficacy of manual lymph drainage (MLD) in reducing swelling following bilateral wisdom tooth removal. Ten consecutive patients with bilateral impacted wisdom teeth that required surgical removal were enrolled in the study. Each patient was postoperatively treated with MLD (after Vodder's method) on one side of the neck region with the untreated contralateral side as a control. Swelling was evaluated using a tape-measure placed in contact with the skin. The six landmarks of measurement included tragus-lip junction, tragus-pogonion, mandibular angle-external corner of eye, mandibular angle-ala nasi, mandibular angle-lip junction, and mandibular angle-median point of chin. Subjective assessment of MLD was conducted with self-evaluation using a visual analogue bar scale (VAS, range 0-100 mm). Of the 6 linear measurements, 4 lines (2, 4, 5, 6) showed a significant reduction of swelling on the side of MLD compared to the untreated side. Mean score of VAS of pretreatment condition was 35.5 +/- 20.60 mm that decreased to 22 +/- 19.32 mm measured after MLD (p=0.0295). This initial study demonstrates that MLD may promote an improvement of lymph circulation and work in an adjunctive role for reduction of postoperative swelling and pain following removal of impacted third molars.