Effect of submucosal dexamethasone injection after third molar surgery – A randomized controlled trial

Background: The post surgical sequeale following surgical removal of impacted third molars such as pain, swelling and trismus can cause distress to the patients and affect the quality of life. Many clinicians have attempted to reduce these sequelae by using NSAIDs and Corticosteroids like dexamethasone and methylprednisolone. Recently studies have been conducted to test the efficacy of local submucosal injection of corticosteroids. Aim: To evaluate the effects of submucosal injection of dexamethasone on postoperative discomfort after third molar surgery. Methods and Material: 60 patients requiring surgical removal of impacted mandibular third molar were randomly divided into two groups of 30 each - 1ml placebo for control group and 4 mg of dexamethasone sodium phosphate 1 ml for test group injected submucosally followed by oral administration of ibuprofen 400 mg postoperatively for each group. Each subject was evaluated on 2nd and 7th postoperative days. Trismus and facial edema was recorded as the difference between preoperative and postoperative values. Postoperative pain was evaluated by the number of analgesic tablets consumed and using a 8-point visual analog scale (VAS). Statistical Analysis: Data was analyzed by Student t- test / Mann Whitney test, Chi-square test and Friedmann test. Results: Increase in mouth opening was seen in group B on 2nd and 7th day respectively (p<0.00) as compared to group B. Swelling had decreased in both groups on 7th day (p <0.000) as compared to day 2. Similarly, pain also reduced in both groups on 7th post-operative day (p< 0.034). Conclusion: Submucosal injection of dexamethasone locally reduces swelling, trismus and also pain and can be used routinely in 3rd molar surgeries without any adverse effects.