Dexamethasone injection into the pterygomandibular space in lower third molar surgery

Area of Science:

• Oral and Maxillofacial Surgery
• Pharmacology
• Anesthesiology

Background:

• Lower third molar extraction often results in significant postoperative sequelae, including pain, swelling, and limited mouth opening.
• Managing these complications is crucial for patient comfort and recovery.
• Intra-articular injections of corticosteroids have shown potential in reducing inflammation and pain in various surgical contexts.

Purpose of the Study:

• To evaluate the efficacy of an 8mg dexamethasone injection into the pterygomandibular space for mitigating postoperative sequelae following lower third molar surgery.
• To compare the effects of dexamethasone versus a normal saline placebo on facial swelling, mouth opening, pain, and analgesic consumption.

Main Methods:

• A prospective, randomized, controlled, split-mouth study involving 62 lower third molar extractions in 31 patients.
• The study group received an 8mg dexamethasone injection in the pterygomandibular space, while the control group received normal saline.
• Postoperative assessments included facial swelling, mouth opening, visual analogue scale (VAS) pain scores, and analgesic consumption.

Main Results:

• Dexamethasone significantly reduced facial swelling on postoperative day 2.
• Patients receiving dexamethasone demonstrated significantly greater mouth opening on postoperative day 2.
• VAS pain scores were significantly lower in the dexamethasone group on the day of surgery and the first postoperative day.

Conclusions:

• An 8mg dexamethasone injection into the pterygomandibular space is effective in reducing postoperative swelling and pain after impacted lower third molar extraction.
• This intervention also helps alleviate the limitation of mouth opening, improving patient outcomes.
• Targeted corticosteroid injection offers a viable strategy for managing common complications associated with third molar surgery.