Assessment of pain, swelling and trismus following impacted third molar surgery using injection dexamethasone submucosally: A prospective, randomized, crossover clinical study

Abstract

Background: Corticosteroids are known to reduce inflammation, fluid transudation, and edema. Secreted from the adrenal glands, these compounds have a significant role in maintaining metabolism. One of the essential roles played by steroids is their anti-inflammatory role. Aims and Objectives: This prospective, randomized, crossover, clinical study was conducted with the following aims and objectives: (a) to assess pain, swelling and trismus in patients undergoing surgical removal of impacted third molars, (b) to compare the pain, swelling and mouth opening with injection of submucosal dexamethasone 4 mg administered preoperatively, and (c) to compare the results with similar studies conducted elsewhere. Materials and Methods: The study sample involves 20 patients (40 impacted teeth-split arch) with the following inclusion criteria: Patient's reporting for surgical removal of symptomatic impacted mandibular third molars aged between 18 and 45, impacted mandibular third molar with similar anatomical position, and similar surgical difficulty (Pell-Gregory classification was followed), no allergies to medicines prescribed in the postoperative period, patients who are nonsmokers, nonalcoholics and without any systemic diseases, and not systemically compromised or not under long-term steroid therapy. Syndromic patients, patients with periapical pathologies were excluded from the study. Results: The results of the present study suggest that there is a significant reduction of pain, swelling and improvement in mouth opening following submucosal injection of dexamethasone at the end of the 1st postoperative day and the results are statistically significant. Conclusion: (a) Corticosteroids decrease pain, edema and swelling by exerting their anti-inflammatory role, (b) there is statistically significant difference in reduction of pain, swelling and improvement of mouth opening at the end of 1st postoperative day, (c) submucosal injection of dexamethasone is less traumatic, less painful and is effective in limiting postoperative discomfort to the patient, and (d) a similar prospective study is suggested comparing the efficacy of intravenous dexamethasone versus submucosal administration of dexamethasone.