The Effectiveness of Submucosal Dexamethasone after Third Molar Extraction. A Single Blind Randomized Clinical Trial
DOI:
https://doi.org/10.51985/JBUMDC202207Keywords:
Dexamethasone, Dental pain, Exodontia, Edema Postoperative complication, TrismusAbstract
Objective: To evaluate the efficacy of dexamethasone in alleviating pain and trismus of the patients who underwent
extraction of the third molars.
Methodology: A total of 120 patients took part in this randomized, controlled trial. The wisdom teeth of patients were
surgically extracted under local anesthesia. The patients were randomly assigned to one of two group and study control
with 60 patients in each group. Preoperative and Postoperative measurements of edema, trismus and pain were analyzed.
In study group, dexamethasone was immediately given after extraction. However, in control group, no dexamethasone was
given to the patients. The paired t-test was carried out to compare the means scores of pains and trismus and. A p value
of = 0.05 was judged significant.
Results: The pain scores of patients in group 1 were mostly pain-free on the third post-operative day after dexamethasone
administration, with complete pain resolution in all patients on the seventh post-operative day. About trismus in post
operative phase almost all of the patients belonging to group 1 did not report to suffer from trismus with just two patients
complaining of mild trismus. Whereas, on the 7th post-operative day, all of the group 1 patients free from trismus. About
the comparison of trismus, pain and Edema in study groups, a significant difference p<0.05 was found.
Conclusion: Inflammatory complications are frequently associated in the post operative phase of extraction of third molars.
Dexamethasone has been proven to be useful in reduction of pain, trismus and edema experienced by the patients when
References
Santosh P. Impacted mandibular third molars: Review of
literature and a proposal of a combined clinical and radiological
classification. Ann Med Health Sci Res [Internet].2015;
(4):229. https://doi.org/10.4103/2141-9248.160177
Patil S, Halgatti V, Khandelwal S, Santosh BS, Maheshwari
S. Prevalence of cysts and tumors around the retained and
unerupted third molars in the Indian population. J Oral Biol
Craniofacial Res [Internet]. 2014 ;4(2):82–7. Available from:
h t t p s : / / l i n k i n g h u b . e l s e v i e r. c o m / r e t r i e v e / p i i /
S2212426814000335
Mello FW, Melo G, Kammer PV, Speight PM, Rivero ERC.
Prevalence of odontogenic cysts and tumors associated with
impacted third molars: A systematic review and meta-analysis.
J Cranio-Maxillofacial Surg [Internet]. 2019 Jun;47(6):
https://doi.org/10.1016/j.jcms.2019.03.026
Sugragan C, Sirintawat N, Kiattavornchareon S, Khoo LK,
KC K, Wongsirichat N. Do corticosteroids reduce postoperative
pain following third molar intervention? J Dent Anesth Pain
Med [Internet]. 2020;20(5):281. https://jdapm. org/DOIx.
php? id= 10.17245/jdapm. 2020. 20.5.2 81
O’Hare PE, Wilson BJ, Loga MG, Ariyawardana A. Effect of
submucosal dexamethasone injections in the prevention of
postoperative pain, trismus, and oedema associated with
mandibular third molar surgery: a systematic review and
meta-analysis. International journal of oral and maxillofacial
surgery. 2019;48(11):1456-69
Hodgens A, Sharman T. Corticosteroids [Internet]. StatPearls.
Available from: . nih.gov/ pubmed/ 32119499
Arora SS, Phull T, Kumar I, Kumar A, Kumar N, Singh H.
A comparative study of the effect of two dosages of submucosal
injection of dexamethasone on postoperative discomfort after
third molar surgery: a prospective randomized study. Oral
and maxillofacial surgery. 2018 Jun;22(2):225-30.
Coutinho AE, Chapman KE. The anti-inflammatory and
immunosuppressive effects of glucocorticoids, recent
developments and mechanistic insights. Mol Cell Endocrinol
[Internet]. 2011 ;335(1):2–13. https://doi.org/10.1016/j.mce.
04.005
Yasir M, Goyal A, Bansal P, Sonthalia S. Corticosteroid
Adverse Effects [Internet]. StatPearls. 2021. Available from:
http://www.ncbi.nlm.nih.gov/pubmed/30285357
Sreesha S, Ummar M, Sooraj S, Aslam S, Roshni A, Jabir K.
Postoperative pain, edema and trismus following third molar
surgery – A comparitive study between submucosal and
intravenous dexamethasone. J Fam Med Prim Care [Internet].
;9(5):2454. Availablefrom: https://journals.lww.
com/jfmpc/Fulltext/ 2020/09050/ Postoperative_ pain,_edema_
and_trismus_ following.57.aspx
Bamgbose BO, Akinwande JA, Adeyemo WL, Ladeinde AL,
Arotiba GT, Ogunlewe MO. Effects of co-administered
dexamethasone and diclofenac potassium on pain, swelling
and trismus following third molar surgery. Head Face Med
[Internet]. 2005 ;1(1):11. Available from: https://head-facemed.biomedcentral. com/articles/10.1186/1746-160X-1-11
Ricciotti E, FitzGerald GA. Prostaglandins and Inflammation.
Arterioscler Thromb Vasc Biol [Internet]. 2011 ;31(5)
:986–1000. https://doi.org/10.1161/ ATVBAHA.110. 207449
Antunes AA, Avelar RL, Martins Neto EC, Frota R, Dias E.
Effect of two routes of administration of dexamethasone on
pain, edema, and trismus in impacted lower third molar
surgery. Oral Maxillofac Surg [Internet]. 2011 ;15(4):217–23.
Available from: http://link.springer.com/10.1007/s10006-011-
-9
Gholami M, Anbiaee N, Abad SB, Asadi M. What Are the
Effects of Methylprednisolone Injection Into the Masseter
and Gluteal Muscle on Pain, Edema, and Trismus After
Impacted Lower Third Molar Surgery? A Randomized Clinical
Trial. Journal of Oral and Maxillofacial Surgery. 2021 Sep
;79(9):1829-36.
Falci SGM, Lima TC, Martins CC, Santos CRR dos, Pinheiro
MLP. Preemptive Effect of Dexamethasone in Third-Molar
Surgery: A Meta-Analysis. Anesth Prog [Internet]. 2017 Sep
;64(3):136–43. https://doi.org/10.2344/anpr-64-05-08
Lima CAA, Favarini VT, Torres AM, da Silva RA, Sato FRL.
Oral dexamethasone decreases postoperative pain, swelling,
and trismus more than diclofenac following third molar
removal: a randomized controlled clinical trial. Oral Maxillofac
Surg [Internet]. 2017;21(3):321–6. Available from:
http://link.springer.com/10.1007/s10006-017-0635-0
Sabhlok S. Randomized Controlled Trial to Evaluate the
Efficacy of Oral Dexamethasone and Intramuscular
Dexamethasone in Mandibular Third Molar Surgeries. J Clin
DIAGNOSTIC Res [Internet]. 2015;DOI : 10.7860/JCDR/2015
/13930.6813
Ngeow WC, Lim D. Do Corticosteroids Still Have a Role in
the Management of Third Molar Surgery? Adv Ther [Internet].
;33(7):1105–39. Available from: http://link.springer.
com/10.1007/s12325-016-0357-y
Grossi GB, Maiorana C, Garramone RA, Borgonovo A,
Beretta M, Farronato D, et al. Effect of Submucosal Injection
of Dexamethasone on Postoperative Discomfort After Third
Molar Surgery: A Prospective Study. J Oral Maxillofac Surg
[Internet]. 2007;65(11):2218–26. Availablefrom:
https://linkinghub.elsevier.com/retrieve/pii/S027823910602
Sanari AA, Alsolami BA, Abdel-Alim HM, Al-Ghamdi MY,
Meisha DE. Effect of smoking on patient-reported
postoperative complications following minor oral surgical
procedures. Saudi Dent J [Internet]. 2020;32(7):357–63.
Available from: https://linkinghub.elsevier.com/retrieve/
pii/S1013905219306339
Al-Delayme RM. The effect of cigarette smoking on the
severity of pain, swelling and trismus after the surgical
extraction of impacted mandibular third molar. J Clin Exp
Dent. 2013;5(3):e117-21. DOI: 10.4317/jced.50979
Falci SGM, Lima TC, Martins CC, Santos CRR dos, Pinheiro
MLP. Preemptive Effect of Dexamethasone in Third-Molar
Surgery: A Meta-Analysis. Anesth Prog [Internet]. 2017
;64(3):136–43. Available from: https://meridian.allenpress
.com/anesthesia-progress/article/64/3/136/25009/PreemptiveEffect-of-Dexamethasone-in-ThirdMolar
Latt MM, Kiattavorncharoen S, Boonsiriseth K, Pairuchvej
V, Wongsirichat N. The efficacy of dexamethasone injection
on postoperative pain in lower third molar surgery. J Dent
Anesth Pain Med [Internet]. 2016;16(2):95. Available from:
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Saeed Ullah Shah, Nameera Agha, Abhishek Lal, Rahima Yousofi, Resham Nadeem, Naseer Ahmed
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0