Effect of submucosal injection of dexamethasone on postoperative discomfort after third molar surgery: a prospective study.

Abstract

PURPOSE:

The purpose of this study was to evaluate the effect of submucosal administration of dexamethasone sodium phosphate on discomfort after mandibular third molar surgery.

PATIENTS AND METHODS:

Sixty-one consecutive patients requiring surgical removal of a single mandibular impacted third molar under local anesthesia were randomly placed into 3 groups. After the onset of local anesthesia, the experimental groups received dexamethasone at 2 different doses (4 or 8 mg) as submucosal injection, and the control group received no drug. Standardized surgical and analgesic protocols were followed. Maximum interincisal distance and facial contours were measured at baseline and at postsurgery days 2 and 7. Pain was objectively measured by counting the number of analgesic tablets required. The patients' perception of the severity of symptoms was assessed with a follow-up questionnaire (PoSSe scale).

RESULTS:

On the second postoperative day, facial edema showed a statistically significant reduction in both dexamethasone 4-mg and dexamethasone 8-mg groups compared with the control group, but no statistically significant differences were observed between the 2 dosage regimens of dexamethasone. By contrast, there was no statistically significant difference between all groups when postoperative swelling was evaluated at day 7 (P > .50). The treatment group had a limited and nonsignificant effect on pain and trismus when compared with the control group at the 2 times of evaluation.

CONCLUSIONS:

Parenteral use of dexamethasone 4 mg, given as an intraoral injection at the time of surgery, is effective in the prevention of postoperative edema. Increasing the dose to 8 mg provides no further benefit.

• Authors: Giovanni Battista Grossi, Carlo Maiorana, Rocco Alberto Garramone, Andrea Borgonovo, Mario Beretta, Davide Farronato, Franco Santoro
• Journal: Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons (J Oral Maxillofac Surg) Vol. 65 Issue 11 Pg. 2218-26 (Nov 2007) ISSN: 0278-2391 [Print] United States
• PMID: 17954317 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Analgesics, Non-Narcotic
• Anti-Inflammatory Agents
• Glucocorticoids
• Acetaminophen
• Dexamethasone

Topics

• Acetaminophen (therapeutic use)
• Adult
• Analgesics, Non-Narcotic (therapeutic use)
• Anesthesia, Local
• Anti-Inflammatory Agents (administration & dosage)
• Dexamethasone (administration & dosage)
• Edema (prevention & control)
• Face
• Female
• Follow-Up Studies
• Glucocorticoids (administration & dosage)
• Humans
• Injections
• Male
• Mandible (surgery)
• Molar, Third (surgery)
• Mouth Mucosa
• Pain Measurement
• Pain, Postoperative (prevention & control)
• Postoperative Complications (prevention & control)
• Prospective Studies
• Tooth Extraction
• Tooth, Impacted (surgery)
• Trismus (prevention & control)