Is the Efficacy of Dexamethasone Dependent upon the Route of Administration for Postoperative Sequelae after Third Molar Surgery?


Authors : Ankur Rathaur; Devang Dwivedi; Vivek singh Chauhan; Akash Tiwari; Rupesh Srivastava; Francis John Alapatt; Ayushi Agarwal

Volume/Issue : Volume 8 - 2023, Issue 7 - July

Google Scholar : https://bit.ly/3TmGbDi

Scribd : https://tinyurl.com/9d26au6t

DOI : https://doi.org/10.5281/zenodo.8265105

Abstract : Background: Administration of corticosteroids at the time of surgical removal of mandibular third molar is a practice that oral surgeons often follow. However, the need for the steroid and the most apt route of administration is still a subject of study. Purpose: The present study aimed to evaluate the effect of four different routes of administration of dexamethasone (8mg) on postoperative pain, swelling, and trismus after third molar surgery. Study design, setting, sample: It was a single-centered randomized controlled clinical trial conducted on 75 patients. All the selected patients were chosen based on specific inclusion criteria and each of them underwent a single-sided mandibular third molar extraction. There were five groups with fifteen patients in each. Group 1 was control where no steroid was administered. The rest of the four groups were provided with local injection of dexamethasone or peroral tablet or regional injection of dexamethasone on deltoid muscle or intravenous dexamethasone injection. The study variables were facial swelling, trismus, and pain. All these variables were assessed preoperatively, on postoperative day 1,5, and 7. Results: Trismus (interincisal mouth opening) had set in the most in the control group which sustained until postoperative day 7. The least trismus was seen in the group with local submucosal dexamethasone injection. Similarly, swelling was highest in the control group. The least effected group was the one with intravenous dexamethasone injection. In terms of pain, the most effective route was the local dexamethasone injection. Conclusion: Trismus and pain were best controlled with local injection, while swelling was best controlled by the intravenous route.

Keywords : Dexamethasone, Molar, Pain, Route, Swelling, Trismus.

Background: Administration of corticosteroids at the time of surgical removal of mandibular third molar is a practice that oral surgeons often follow. However, the need for the steroid and the most apt route of administration is still a subject of study. Purpose: The present study aimed to evaluate the effect of four different routes of administration of dexamethasone (8mg) on postoperative pain, swelling, and trismus after third molar surgery. Study design, setting, sample: It was a single-centered randomized controlled clinical trial conducted on 75 patients. All the selected patients were chosen based on specific inclusion criteria and each of them underwent a single-sided mandibular third molar extraction. There were five groups with fifteen patients in each. Group 1 was control where no steroid was administered. The rest of the four groups were provided with local injection of dexamethasone or peroral tablet or regional injection of dexamethasone on deltoid muscle or intravenous dexamethasone injection. The study variables were facial swelling, trismus, and pain. All these variables were assessed preoperatively, on postoperative day 1,5, and 7. Results: Trismus (interincisal mouth opening) had set in the most in the control group which sustained until postoperative day 7. The least trismus was seen in the group with local submucosal dexamethasone injection. Similarly, swelling was highest in the control group. The least effected group was the one with intravenous dexamethasone injection. In terms of pain, the most effective route was the local dexamethasone injection. Conclusion: Trismus and pain were best controlled with local injection, while swelling was best controlled by the intravenous route.

Keywords : Dexamethasone, Molar, Pain, Route, Swelling, Trismus.

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