The aim of the study is to compare the efficacy of intravenous (IV), intramassetric (IM), and submucosal (SM) routes of dexamethasone administration post-impacted third molar removal surgery. Materials and Methods: This prospective comparative study included 45 patients with Class II and position B type of impaction (according to Pell and Gregory's classification). Patients were randomly divided into three groups. Group A, B, C patients received 8mg dexamethasone immediately post-surgical tooth removal through the IV, SM, and IM route, respectively. Assessment of swelling, mouth opening, and pain was done at intervals of 1 st , 3 rd , and 7 th post-operative days. Results: The average age of the patients was 27 years. The average time taken was 20 min 40 s. The IV group showed minimal swelling and better pain control on the 3 rd post-operative day (statistically significant). All three routes showed comparable mouth opening results. Conclusion: IV administration of dexamethasone post-third molar surgery has been the traditional way because of its faster onset of action and increased efficacy; the IM and SM routes are also comparably effective and have their own advantages.

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Administration of local anesthetic drug that prevents pain during dental treatment is of absolute importance. Act of injecting local anesthetic should be nonpainful and atraumatic. The maxilla is very porous and highly vascular. Therefore, anesthesia of maxillary teeth can be accomplished more easily than with mandibular teeth. The aim of this study is to determine the anesthetic efficacy of the conventional technique of posterior superior alveolar (PSA) and greater palatine nerve(GP) block anesthesia as compared to the buccal and palatal technique in terms of pain during injection, after extraction, after 15mins of the procedure and quality of anesthesia during the extraction procedure. The study also intends to determine the incidence of positive aspiration in the infiltration technique. This randomized clinical study was carried out on 154 patients who reported to the Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences & Hospital Bangalore, requiring extraction of maxillary second and third molar teeth. The patients received anesthesia using the conventional nerve block technique and infiltration technique randomly on each side of the mouth. Patients were assessed for pain during the injection, after extraction, and after 15mins of the procedure with each technique using Visual Analog Scale (VAS). The patients were also assessed for pain using the Verbal Response Scale (VRS). The positive aspiration was assessed for each technique. During tooth extraction, quality of anesthesia was assessed using an eight-point category rating scale. The results obtained were analyzed using Chi-square test. It was concluded that the buccal infiltration technique is less painful for the patient as compared to the posterior superior alveolar nerve block. This technique has a lower frequency of positive aspiration as compared with the PSA nerve block. However, the PSA nerve block technique provides better-quality of anesthesia. It can be concluded that the infiltration technique appears to be a successful alternative with additional advantages, as compared to the nerve block technique.