Submucosal Injection Of Dexamethasone Research Articles

Efficacy of Submucosal versus Pterygomandibular Dexamethasone Injection in Surgical Extraction of the Impacted Lower Third Molar

Objectives: This study aimed to evaluate the efficacy and postoperative complications of preoperative submucosal dexamethasone injection compared to preoperative dexamethasone injection into the pterygomandibular space for surgical extraction of the impacted lower third molar. Study design and setting: This was a quasi-experimental, cross-sectional study conducted at the Department of Oral and Maxillofacial Surgery, Dow International Dental College, Dow University of Health Sciences, Karachi, from April to July 2021. Methodology: The study sample consisted of 72 patients who reported surgical extraction of their lower wisdom teeth and consented to participate in this study. The patients were randomly divided into the submucosal injection group (SM) and the pterygomandibular space (PM) group. The injection time was recorded on the second and seventh postoperative days. Results: No significant differences in the duration of the intervention were observed between the two groups (23.08 min in PM, 23.07 min in SM). The postoperative facial swelling was significantly reduced transversely (ear lobe to the angle of the mouth) in both groups compared to their respective baselines on the first postoperative day. On the secondpostoperative day, significant changes were observed in the submucosal group in postoperative swelling. Conclusions: Using intraoral dexamethasone injections in third molar surgery significantly reduces conventional complications of surgery while avoiding the systemic side effects of steroids. Dexamethasone should be used regardless of the administration site when warranted, with less apprehension than is common in dentistry

Efficacy of pre-operative submucosal injection of dexamethasone and triamcinolone acetonide on post-operative pain following endodontic treatment of teeth with irreversible pulpitis: A randomised clinical trial

Post-endodontic pain is a challenge to clinicians. In this context the evidence for use of preoperative medication is not consistent. The study's objective is to assess the effects of dexamethasone and triamcinolone acetonide administered submucosally in single doses on postoperative pain following single-visit root canal treatment for teeth with symptomatic irreversible pulpitis. Thirty patients were randomly allocated in three groups. Group I received saline (control), Group II received dexamethasone (8mg) and Group III received triamcinolone acetonide (40mg) before endodontic treatment was initiated. Root canal treatment was performed in a single appointment for all the participants. Post-operative pain was assessed using Heft-Parker visual analogue scale (HP VAS). Comparison of HP VAS scores was done using Kruskal Wallis Test and Mann Whitney Test. There was no significant difference in the mean HP VAS scores between 3 groups at pre-op period (P=0.74). At 6,12 and 24h post-operative period the mean HP VAS scores in Group 2 and 3 was significantly lesser as compared to Group 1. Corticosteroid preoperative dosages led to a reduction in post endodontic pain after single visit root canal treatment of teeth with symptomatic irreversible pulpitis.

Preoperative Submucosal Dexamethasone Injection for Minimizing Postoperative Pain, Trismus, and Oedema Associated with Impacted Mandibular Third Molar Surgery

Aim: Is To evaluate the relative ability of 4mg dose of preoperative Dexamethasone, administered submucosally, to reduce the postoperative pain, swelling and trismus after third molar surgery.
 Methods: The total 40 patient required surgical removal of a single mandibular third molar were included and divided into two groups, The experimental group (20 cases) received intraoperative submucosal injection of 4 mg Dexamethasone buccally around the tooth at three points after the onset of anesthesia and the control group (20 cases) received no drugs. The maximum interincisal distance and facial contours were measured at baseline and at post-surgery days 2 and 7. The measurement of pain was done using visual analog scale (VAS).
 Results: There was a statistically significant reduction in the severity of postoperative edema in the experimental group by the second postoperative day. While both groups saw a reduction in discomfort and trismus, there were no statistically significant differences between them.
 Conclusion: The findings support submucosal injection of Dexamethasone (4 mg) to decrease postoperative edema. Low-dose Dexamethasone injection at the surgical site enhances drug concentration at the injury site without loss owing to diffusion or excretion. The submucosal technique was significantly effective in reduction of postoperative swelling and trismus.

EFFECT OF SUBMUCOSAL INJECTION OF DEXAMETHASONE ON POSTOPERATIVE SEQUELAE FOLLOWING SURGICAL REMOVAL OF IMPACTED THIRD MOLARS: A CLINICAL STUDY.

Background and Objectives: Impacted third molar surgery is one of the most common procedures performed by maxillofacial surgeons in the outpatient setting. Since the region of surgery is highly vascularized and constituted mostly by loose connective tissue that contains blood and lymph vessels, a series of functional and structural alterations occur after extraction which is expressed as pain, swelling and trismus. These sequelae can have a serious impact on the patient's quality of life; therefore, a reduction of postoperative complications seems a logical goal, particularly if healing is not compromised. Method:A hospital-based case-control study with a study population of 50 patients was done to assess the efcacy of submucosal injection of 8mg dexamethasone on reducing the post-operative sequelae such as oedema, pain and trismus following surgical removal of impacted third molars. The study was conducted in patients with bilaterally impacted mandibular third molars where one side is randomly selected and 8mg dexamethasone is administered submucosally and the other side is selected as control. All the patients selected for the study were followed up on rst, third and seventh post-operative day. Result: The submucosal injection of dexamethasone showed signicant improvement in oedema and trismus on all postoperative days but decrease in postoperative pain was not signicant on rst and third days but signicant on seventh day. Submucosal injection of dexamethasone 8 mg is an effective therapeutic strategy for improving the quality of life after surgical removal of impacted lower third molars.

Can adjunctive corticosteroid therapy improve patient-centered outcomes following third molar surgery? A systematic review.

Background Third molar surgery is frequently associated with postoperative discomfort such as pain, edema and trismus. We aimed to evaluate the current evidence on the efficacy of adjunctive corticosteroid therapy in improving patient-centered outcomes following third molar surgery.Material and Methods This systematic review assessed and searched PubMed, Google scholar, Scopus, web of science, clinicaltrials.gov and Cochrane central for controlled trials, up to May 2021. The primary outcome measures were patient-centered outcomes such as quality of life following the use of adjunctive corticosteroid therapy in third molar removal. Only randomized controlled trials published in English language were included.Results A total of 355 studies were initially identified, and 12 studies were finally included. The results showed that both methylprednisolone and dexamethasone decreased postoperative side effects such as pain, trismus, and edema and consequently were improving patient reported outcomes. In this regard, none of the included papers reported any significant statistical difference between these two drugs (p > 0.05). The analysis regarding the route of administration for the corticosteroids showed that local and intravenous injection of dexamethasone had equivalent effects, and both methods showed better results as compared to simple oral administration.Conclusions Adjunctive use of corticosteroid drugs may improve patient-centered outcomes following third molar surgery. However, there is no significant difference between drugs and routs of administration. Comparing various administration routs, local submucosal injection of dexamethasone seems to be a straightforward, painless and cost-effective adjunctive therapy. Key words:Third molars, corticosteroids, patient-reported outcomes, health related quality of life.

Efficacy of Submucosal Dexamethasone Injection on Postoperative Adverse Outcomes Following Third Molar Surgery

Introduction: The most common dento-alveolar procedure is surgical removal of an impacted third molar, which is associated with post-operative pain, swelling, and trismus.
 Objective: To determine the effect of submucosal dexamethasone injection on the post-operative outcomes in third molar surgeries.
 Materials and Methods: It was a descriptive study conducted in Department of Oral & Maxillofacial Surgery, Liaquat College of Medicine & Dentistry, Karachi between November 7, 2019 to May 6, 2020. All patients who fulfilled the inclusion criteria and visited to LCMD, Karachi were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. In our study, all the patients (n=65) received 4mg submucosal dexamethasone injection. The duration of surgery was recorded with postoperative outcomes in terms of pain, trismus and swelling were measured on 3rd and 7th day. All the collected data were entered into the proforma and used electronically for research purpose.
 Results: The mean SD of age was 25.9 ± 7.2 years. Right side surgery was documented in 39 (60%) patients, while left side surgery was documented in 26 (40%) patients. On the third and seventh day, the mean SD of VAS pain score was (5.9 ± 3.2), (3.8 ± 4.4), swelling was (2.5 ± 1.1), (0.9 ± 0.6) mm, and trismus was (16.9 ± 9.7), (11.8 ± 9.1) mm, respectively.
 Conclusion: It is to be concluded that a significant difference in outcomes was observed between the third and seventh post-operative days in patients who had submucosal dexamethasone injections in third molar surgeries.

What’s new for the clinician? - Excerpts from and summaries of recently published papers

Extraction of third molars is one of the most common procedures performed by oral surgeons. Generally, these surgeries do not encounter difficulties but at times can result in complications. Postoperative complications may include swelling, pain, trismus, prolonged bleeding, dry socket, infection and sensory alterations of the inferior alveolar nerve or lingual nerve. For the swelling, the most common therapies include corticosteroids, non-steroid anti-inflammatory drugs (NSAIDs), or a combination of these agents. Elastic bandage application (Kinesio taping) is a technique that originates from sports sciences. Studies have reported its beneficial effects on swelling and trismus symptoms after oral and maxillofacial surgeries.1It has been claimed that elastic tapes reduce postoperative swelling by creating space between the dermis and fascia layers and thus increasing lymphatic and blood flow.1 Their alleviating effect on postoperative pain is due to dermal stimulation.1 Erdil and colleagues (2021)1 reported on a trail that sought to compare the effectiveness of submucosal dexamethasone injection, a therapeutic elastic bandage (Kinesio tape), and an NSAID (dexketoprofen trometamol) on postoperative swelling, trismus, pain following third molar surgery and alterations in the quality of life in the first postoperative week.

Comparison of Submucosal Injection of Dexamethasone and Triamcinolone Acetonide for Control of Postoperative Pain after Impacted Mandibular Third Molar Surgery- A Prospective Randomized Controlled Trial

The aim of the study was to compare the efficacy of submucosal injection of dexamethasone and triamcinolone acetonide on postoperative pain, swelling, occurring after impacted mandibular third molar surgery. A total of 150 patients with asymptomatic, unilateral, impacted mandibular third molar, and without any systemic disease were included in this study. Patients were divided into three groups randomly, one group dexamethasone, and the second group triamcinolone acetonide third group placebo. Dexamethasone and triamcinolone acetonide were injected into submucosa at about 0.5 cm to 1 cm above the surgical area submucosally. Pain evaluation was performed by visual analog scale (VAS).There were statistically significant differences between the three groups on the different days of the postoperative period. The effect of triamcinolone acetonide works postoperatively and the effect of triamcinolone acetonide on trismus and pain was better than other groups. There was no significant difference between the effects of dexamethasone and triamcinolone acetonide regarding postoperative complications. The submucosal injection of dexamethasone and triamcinolone acetonide might be an effective treatment following impacted mandibular third molar surgery, and triamcinolone acetonide could be applied as an alternative to dexamethasone for reducing pain post operatively for impacted mandibular third molar surgery.

Submucosal administration of dexamethasone versus methyl prednisolone in management of postoperative sequelae after mandibular third molar impaction - A systematic review

Third molar extraction is one of the most commonly performed minor surgical procedure in any dental practice worldwide, often accompanied by various postoperative sequelae such as swelling pain and trismus which intern affects the quality of life of a patient. Over the past few decades, different methods have been proposed in the literature and were clinically evaluated to reduce the postoperative discomfort after mandibular third molar impaction and out of which corticosteroids, have shown promising results. Dexamethasone (administered either orally, submucosally, IV or IM), methylprednisolone acetate and methylprednisolone sodium succinate (IV or IM or submucosal) are most commonly preferred corticosteroids in oral and maxillofacial surgery. The main objective is to systematically review the comparison of the effectiveness of submucosal administration of dexamethasone with methylprednisolone following mandibular third molar impaction in reducing the postoperative sequelae, and its discomfort and searches were performed in the PubMed, Medline, Scopus, and Cochrane Library databases. Two articles were most relevant, and the results of the comparison of the selected articles were analysed. From this deliberate audit, it is very well may be inferred that submucosal injection of dexamethasone plays a promising role in reducing the postoperative sequelae which includes swelling, pain and trismus and its discomfort following mandibular third molar impaction when compared with that of methylprednisolone.

Intramuscular versus submucosal Dexamethasone injection in surgical extraction of impacted mandibular third molars: Narrative review

The aim of this narrative review is to compare the results of different studies concerning the intramuscular route versus the submucosal route for injection of dexamethasone in cases of surgical extraction of mandibular impacted third molars. The advantages and disadvantages of the different techniques will be reported. Studies discussed in this paper revealed that the submucosal route featured so many benefits over the intramuscular one by being simple, comfortable, highly bioavailable, painless, less risky and able to reduce trismus.

Kinesiology Tape in Comparison with Submucosal Injection of Dexamethasone in Reducing Pain and Swelling After Surgical Removal of Impacted Lower Wisdom Teeth

The purposes of the suggested research are to assess the effectiveness of different protocols in decreasing oedema and aching post extraction of third wisdom teeth. Materials and Methods: The research involved thirty patients whom had impacted mandibular wisdom teeth of different local anatomical locations. Kinesiology adhesive tape put for one week only for 15 cases and Dexamethasone 8 mg submucosaly injected directly post operatively for other 15 cases. swelling was calculated by a tape scale means from known points and mean taken also pain evaluated by VAS using ribbon gauge degreed from 1 to 10. Calculations had been applied for the first day of surgical intervention, 3rd day and seventh day. Results: There was no significant statistical differences were documented statistically for oedema readings concerning two study methods on the reading day one, three and seven following the operation, and there were highly significant readings related to pain parameters. Conclusions: Usage of Kinesiology adhesive tape clinically was closely with a same advantageousness with Dexamethasone injection submucosaly in dropping the oedema and pain parameter, although clinically dexamethasone was better in both parameters than Kinesiology tape, so it can be used additionally in contraindicated cases of prescribing steroids for alleviating ache, oedema following to wisdom teeth surgery.

The Effect of Submucous Dexamethasone Injection on the Post-Operative Sequelae After Impacted Third Molar Surgery

Background: Different method were attempted by many researchers to reduce postoperative inflammatory response following surgical extraction of lower wisdom teeth because this is a very common procedure and is usually associated with pain, difficulty in mouth opening and swelling. Aims: To assess the effect of sub mucosal injection of 4mg/1ml dexamethasone on reduction of postoperative pain, facial swelling and trismus following the surgical extraction of impacted lower wisdom teeth. Materials and Method: forty patients were selected to be included in this randomized clinical study with a total number of 42 impacted mandibular third molars, they divided randomly into two groups, control and study group of twenty patients for each, patients in the study group received 4mg/1 ml submucos injection of dexamethas one, while patients in the control group received placebo (normal saline) five minutes after local anesthesia administration, and surgical removal of impacted teeth was done after further five minutes. evaluation of mouth opening and swelling was done as a baseline and on the second and seventh post-operative days after surgery, while pain was scored daily until the 7 th postoperative day by the patient according to numerical rating scale. Assessment of trismus was done by measuring the maximum interincisal distance swelling was evaluated by measuring the distance between five selected points. Every one of these factors in addition to the time of surgery were compared between the two groups. Results: Study group showed less limitation in mouth opening than control group but there was no statistically significant difference between them however study group showed a significant reduction in pain scores on the first and the second post-operative days and a significant improvement of swelling compared with the control group at the 48 hour follow up. Conclusion: Submucosal injection of dexamethasone was effective in minimizing facial swelling, Pain and trismus after surgical extraction of mandibular third molar.

Comparison of intraosseous and submucosal dexamethasone injection in mandibular third molar surgery: a split-mouth randomized clinical trial

The objective of this study was to compare the effect of intraosseous dexamethasone injection and submucosal dexamethasone injection on postoperative sequelae after mandibular third molar surgery. This was a randomized, triple-blind, split-mouth clinical trial. Fifty-four mandibular third molars (27 patients) were subdivided according to the side (right and left); intraosseous injection of dexamethasone (4mg) was randomly assigned to one side and submucosal injection to the other. All surgeries were performed by one surgeon. Postoperative pain was evaluated by visual analogue scale score immediately after surgery and on postoperative days 1, 3, and 7. Postoperative swelling (determined using two linear measurements) and mouth opening (determined by measurement of the inter-incisal distance) were assessed on postoperative days 3 and 7. The number of analgesics consumed was recorded. No significant difference in pain or swelling was found between the two injection techniques. However, there was significant difference in trismus on postoperative day 3, with submucosal injection showing a better outcome (P<0.001). Both techniques of dexamethasone injection were effective in controlling pain and swelling after mandibular third molar surgery, but submucosal injection was superior for the control of trismus.

EFFICACY OF INTRA-MASSETERIC AND SUBMUCOSAL DEXAMETHASONE INJECTION IN SURGICAL EXTRACTION OF IMPACTED LOWER THIRD MOLAR.

Objectives: To determine the efficacy of intra-masseteric and submucosal dexamethasone injection to minimize the postoperative discomfort after the surgical extraction of impacted lower third molar. Study Design: Cross sectional study (Comparative). Setting: Department of Oral &amp; Maxillofacial Surgery, Institute of Dentistry, Liaquat University of Medical &amp; Health Sciences Jamshoro / Hyderabad. Period: January 2017 to June 2017. Subjects and Methods: All surgical extractions were done under local anaesthesia by giving conventional inferior alveolar nerve block. An envelope mucoperiosteal flap was raised to expose the third molar. Then tooth was extracted. After the removal of tooth any sharp bone was smoothened by bone filer and the socket was washed and sutured. The severity of pain was recorded by using Visual Analogue Scale from 0 (no pain) to 10 (worst pain) described as mild, moderate or severe. Degree of swelling was measured by facial size through Amin and laskin criteria which was measured in millimeters. Mouth opening was measured by interincisal distance through ruler (35-45mm normal value). Results: From sixty four patients it was observed that the minimum age was 28.03+6.12 years. There were 35 male patients and 29 female patients. When Chi square test was applied, there was a significant association found between Groups (A and B). By using independent sample t-test, it was observed that there was a significant association found in both groups concerning facial swelling (Facial size in mm) having p-value 0.00. When the independent t-test was applied on the data, there was a significant association found in Group A and B regarding mouth opening (in mm) having p-value 0.001. Conclusions: Dexamethasone has a good efficacy for reducing the postoperative symptoms including severe pain, facial swelling and trismus after the surgical extraction of impacted lower third molar. The better outcomes perceived when it was administered submucosally.

Effect of intramuscular and submucosal dexamethasone injection after lower third molar surgical extraction: preliminary study

Effect of intramuscular and submucosal dexamethasone injection after lower third molar surgical extraction: preliminary study

Efficacy of Pre-Operative Submucosal Injection of Dexamethasone in Mandibular Third Molar Surgery: A Randomized Control Trial

INTRODUCTION: Surgical extraction of third molar irrespective of any technique results in postoperative pain, swelling of face and limited mouth opening. The aim of the present study was to assess and compare the effects of Dexamethasone (4mg) administered prior to surgery.MATERIALS AND METHOD: A randomized control trial was conducted which included a total of fifty patients. All the patients were randomly put in two groups of twenty five each. Group I patients underwent transalveolar extraction of third molar under local anesthesia and standard oral drug regime. Group II patients received an additional submucosal injection of dexamethasone 4 mg, thirty minutes prior administration of local anaesthesia. Pain, swelling and mouth opening was recorded on second, seventh and tenth post-operative days after surgery.RESULTS: The difference in pain scores on second post-operative day between two groups were found statistically non-significant. However, there was significant reduction in pain scores on seventh and tenth day in both groups. Mouth opening showed statistically significant difference between the two groups.CONCLUSION: The observations of the present study provide a fundamental basis for the use of corticosteroids such as dexamethasone sodium phosphate in the form of submucosal administration in lower than usual doses to decrease postoperative inflammation when compare to other routes of drug administration.

Efficacy of sub-mucosal, intra-masseteric and intra-muscular routes of dexamethasone administration on post-operative complications following impacted mandibular third molar surgeries, comparative clinical trial

Purpose: The aim of the current study was to compare the efficacy of dexamethasone injection submucosally, intra-masseteric and intramuscular in surgical removal of mandibular third molars on post-operative swelling, mouth opening and pain.Patients and Methods: forty five patients with impacted mandibular third molars were selected to undergo surgical removal of mandibular third molars. Patients were randomly divided into three groups of fifteen each. Group I, taking sub-mucosal dexamethasone injection, Group II, taking Intra-masseteric dexamethasone injection and Group III, taking intramuscular dexamethasone injection, all patients were injected pre-operatively Assessment of swelling, mouth opening, and pain was done at intervals of 1st, 3rd, and 7th post-operative days.Results: our study showed no statistically significant difference between mean MMO as well as VAS in Group I and II; both showed statistically significant higher mean MMO and VAS than Group III. Significant reduction in pain and swelling in both sub-mucosal, intra-masseteric and intra-muscular but a greater immediate effect on trismus was seen in sub-mucosal and intra-masseteric routesConclusion: It can be concluded that pre-operative dexamethasone injection is an effective pharmacological agent to reduce post-surgical third molar removal sequelae such as pain, swelling and trismus.

The effects of piezosurgery and submucosal dexamethasone injection on post-operative complications after third molar surgery

BackgroundA retrospective clinical study was performed to compare the post-operative effects of the conventional surgery, piezo surgery technique and submucosal dexamethasone injection in lower third molars extractions. MethodsData from 62 patients, subjected to surgical extraction of lower third molars, were pooled and divided into three groups such as: Conventional Group (22 patients), Piezo Group (20 patients) and Dex Group (conventional surgery + 4 mg/1 mL dexamethasone) (20 patients). Pain, swelling, trismus, analgesic consumption and operation time were comparatively evaluated. ResultsPain values were found lower in Dex Group in comparison to Conventional Group at 7th day (P = 0.007). Edema found to be higher in Conventional Group than Dex Group at 2nd day (P = 0.025). Minimally trismus values were found in Dex Group and the difference between the Dex and Conventional Group found to be statistically significant both in 2nd (P = 0.048) and 7th days (P = 0.010). The analgesic consumption in the Conventional Group was found to be higher than Piezo Group at 2nd day (P = 0.002). ConclusionThe better post-operative values were obtained in the Dex Group. Although longer operative time is considered to be a disadvantage for the piezo technique, piezotome may be preferred for surgical procedures due to its positive results in comparison to the conventional technique.

Submucosal injection of dexamethasone and methylprednisolone for the control of postoperative sequelae after third molar surgery: randomized controlled trial

Pain, swelling, and trismus are known sequelae of third molar surgery that can significantly affect the individual’s quality of life (QOL). These should be minimized to improve QOL. The purpose of this study was to compare the effects of the preoperative submucosal administration of equivalent doses of two commonly used steroids on these postoperative sequelae. A randomized controlled clinical trial was conducted involving 60 subjects requiring the removal of impacted mandibular third molars. Extraction cases with a similar difficulty index were included. The participants were allocated randomly to three groups: the placebo group received normal saline injection (control), while the 8mg dexamethasone group and 40mg methylprednisolone group received submucosal injections of these steroids preoperatively. Each participant was assessed for postoperative pain, swelling, and trismus, along with a subjective assessment of QOL through a structured questionnaire. The participants administered dexamethasone showed significant reductions in pain and trismus compared to the control group (P<0.05). Submucosal injection of dexamethasone was found to be superior to methylprednisolone only in terms of the reduction in swelling. QOL was minimally affected in patients administered dexamethasone as compared to methylprednisolone and control subjects. The preoperative submucosal use of steroids can be considered an effective, safe, and simple therapeutic strategy to reduce swelling, pain, and trismus after the surgical removal of impacted mandibular third molars.

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

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.