Anti-Inflammatory Effectiveness of Oral Dexamethasone 4 mg on Mandibular Third Molar Surgeries: A Split-Mouth Randomized Clinical Trial

Abstract

This study aimed to evaluate the anti-inflammatory effect of oral dexamethasone 4mg in a single dose preemptively administered to reduce pain, swelling, and trismus following mandibular third molar surgeries. A split-mouth randomized clinical trial was performed including 22 participants undergoing surgical removal of bilateral and symmetrically positioned third molars. A total of 44 teeth were allocated by simple randomization to either the test or nonintervention/control side. Oral dexamethasone 4mg was administered on the test side an hour before the surgery. All of the participants were unaware of the medication studied, and only 1 surgeon, blinded to the medication intake, performed all of the procedures. Anti-inflammatory effect was evaluated using the clinical parameters of mouth opening, swelling, and rescue analgesic medication intake to control pain. The statistical analysis was blinded to the allocation groups, and a significance value P<.05 was adopted for all the tests. Dexamethasone reduced the mean of rescue analgesic medication intake by 5 times (P=.002). Facial swelling was lower on the test side by 72h postsurgery in comparison with the control side (P=.036). No significant difference in mouth opening was found between the groups. Preemptive use of oral dexamethasone 4mg proved to be effective in controlling pain and reducing the need for rescue medication and had a beneficial effect in reducing swelling during a short postoperative period.