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Effect of submucosal and intramuscular dexamethasone on postoperative sequelae after third molar surgery: comparative
Omer Waleed Majid1, Waseem Khalid Mahmood
1Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Mosul, Nineveh, Iraq. omerw_majid@yahoo.co.uk
The British Journal of Oral & Maxillofacial Surgery
|November 2, 2010
Summary
Submucosal or intramuscular dexamethasone effectively reduces swelling and pain after impacted lower third molar removal. Both administration routes offer comparable benefits, with submucosal dexamethasone showing promise for minimizing trismus.
Area of Science:
- Oral and Maxillofacial Surgery
- Pharmacology
- Clinical Trials
Background:
- Postoperative complications like swelling, pain, and trismus are common after impacted lower third molar extraction.
- Corticosteroids, such as dexamethasone, are often used to manage these complications.
- The optimal route of administration for dexamethasone in this context requires further investigation.
Purpose of the Study:
- To compare the efficacy of submucosal versus intramuscular dexamethasone sodium phosphate in managing postoperative complications following impacted lower third molar removal.
- To evaluate the impact of these administration routes on facial swelling, maximal interincisal distance, pain, and trismus.
Main Methods:
- A preliminary randomized prospective clinical trial involving 30 patients undergoing impacted lower third molar removal.
- Patients were allocated to three groups: submucosal dexamethasone (4 mg), intramuscular dexamethasone (4 mg), or control (no steroid).
- Measurements included facial swelling, maximal interincisal distance, pain (analgesic tablet count and VAS), and trismus at various postoperative intervals.
Main Results:
- Both dexamethasone groups demonstrated significant reductions in swelling (p<0.001) and pain (p<0.05) compared to the control group.
- Submucosal dexamethasone showed a significant reduction in trismus on postoperative day 1 (p=0.04) compared to controls.
- The effects of submucosal and intramuscular dexamethasone were comparable across all measured variables, with no cases of alveolar osteitis or wound infection.
Conclusions:
- Dexamethasone 4 mg administered submucosally is an effective and comparable alternative to the intramuscular route for minimizing swelling, trismus, and pain after impacted lower third molar surgery.
- Submucosal dexamethasone offers a safe, painless, non-invasive, and cost-effective treatment option, particularly for moderate to severe cases.