Does Betamethasone Injection Into the Pterygomandibular Space Affect the Postoperative Outcomes of Impacted Lower Third Molar Surgery?

Abstract

Pain, swelling, and trismus are common outcomes following impacted lower third molar surgery. The purpose of the study was to evaluate the effect of betamethasone injection into the pterygomandibular space on the aforementioned sequelae of third molar surgery. A split-mouth, double-blind, randomized clinical trial was conducted on 40 patients with symmetrical bilateral impacted lower third molars. The surgeries were performed at an outpatient clinic under local anesthesia. The predictor variable is the steroid treatment. The experimental group received a 1mL (6mg) betamethasone injection into the pterygomandibular space, while the control group received a normal saline. The primary outcome variable was postoperative pain assessed using a visual analog scale. The secondary outcome variables were the number of analgesic tablets consumed, facial swelling, and trismus. The age and sex of the patients, the direction of impaction, and the duration of surgery were recorded. Comparisons between the groups were carried out using an unpaired t test. An analysis of variance test was used to assess intragroup differences. The significance was considered at P≤.05. Of the 265 patients initially screened for study enrollment, the final sample included 40 subjects, with a mean age of 28.3years (±7.4), 28 (70%) were mal and 12 (30%) were female. There was no significant difference between the two groups concerning postoperative pain or the number of consumed analgesic tablets. However, the betamethasone group exhibited significantly reduced facial swelling and increased mouth opening. On the first postoperative day, the visual analog scale pain score did not significantly differ between the betamethasone group (6.0±1.7) and the control group (6.8±1.4), with a P value of 0.112. On the first postoperative day, facial swelling measured 4.2±1.3mm in the betamethasone group compared to 6.0±0.9mm in the control group (P<.001). Mouth opening in the betamethasone group was 30.8±6.7mm, while in the control group, it measured 21.9±5.5mm(P<.001). Local betamethasone has no effect on pain after third molar surgery, but facial swelling and trismus are significantly reduced.