Analgesic and Anti-Inflammatory Effects of Articaine and Perineural Dexamethasone for Mandibular Third Molar Surgery:...

We aimed to investigate the effectiveness of articaine and perineural dexamethasone (DX) in reducing postoperative sequelae such as swelling and maximum mouth opening that are harming the quality of life of patients after impacted mandibular third molar (IMTM) surgery.

We implemented a randomized clinical trial composed of patients undergoing IMTM extraction. The predictor variable was the treatment group. The patients were randomly assigned to 1 of 3 groups: Group A was administered 3.6 mL of articaine mixed with 2 mL of saline solution; group B, 3.6 mL of articaine and 1 mL of DX (4-mg/mL solution) with 1 mL of saline solution; and group C, 3.6 mL of articaine with 2 mL of DX (8-mg/mL solution). The primary outcome variables were swelling (determined by anatomic facial landmarks), pain, and maximum mouth opening. Other variables comprised the duration of surgery, number of analgesics taken in the postoperative period, hygiene, and petechiae.

The sample was composed of 60 patients (20 per treatment group), with a mean age of 25.18 ± 5.22 years; 53.3% were women. Postoperative swelling was significantly reduced in groups B and C (P < .05). Maximum mouth opening was significantly increased in groups B and C (P < .05).

The results of this study suggest that combining DX with articaine improves the management of discomfort after IMTM surgery. The use of articaine via a mandibular block was not associated with neural damage in our study.