Decreased post-operative pain using a sublingual injection of dexamethasone (8 mg) in lower third molar surgery

Abstract

BackgroundEvery patient who undergoes mandibular third molar surgery is concerned about post-operative pain. Indeed, previous researchers have used various methods to treat such pain. This study aimed to assess the effectiveness of sublingual injection of dexamethasone (8 mg) to treat post-operative pain after mandibular third molar surgery.MethodThis was a randomized, double-blind, split-mouth, clinical trial, involving 48 healthy patients who required surgical removal of two mandibular third molars with similar bilateral positions. All operations were performed by the same experienced surgeon. The patients were randomized into a study group (8 mg dexamethasone injection) and a placebo group (normal saline injection). Both interventions were injected into the sublingual space immediately after local anesthesia, 30 min before the first incision. The study group received an 8 mg dexamethasone injection, while the placebo group received a normal saline injection. The wash period between the patients' two operations was 3 to 4 weeks. Pain was assessed by recording the number of analgesic tablets (rescue drug) consumed, as well as by noting the patients' responses to the visual analog scale (VAS) on the first, second, and third days after surgery.ResultsThe study group differed significantly from the placebo group in terms of VAS score and analgesic consumption.ConclusionDexamethasone (8 mg), injected sublingually, significantly eased post-operative pain after surgical removal of the mandibular third molar.

Dexamethasone Injection Into Pterygomandibular Space Versus Sublingual Space on Post-Operative Sequalae of Lower Third Molar Intervention

“…Corticosteroids have been shown to reduce level of lymphokine, prostaglandin, serotonin, bradykinin, cortisol, migratory inhibiting factor, and β-endorphin and are believed to decrease post-operative facial swelling and limited mouth opening [17-18]. Many previous literatures proved that pre-operative dexamethasone injection had benefit in reducing post-operative complication in lower third molar intervention.…”

“…Patient will be measured for post-operative pain, swelling and limit mouth opening on the day before intervention and on second and seventh day post-operatively with same technique as the pre-operative one by same examiner: 1) Post-operative pain assessment by visual analogue scale (VAS) scores [20-22] and the number of analgesic tablets required; 2) Facial swelling [17-18] was measured by facial contour by using three lines along the length of the face from the reference point, lateral corner of eye to angle of mandible, corner of mouth to border of earlobe, soft tissue pogonion to border of earlobe (Fig. 2); and 3) Limited mouth opening [17-18] was measured along the distance between incisal edge of maxillary and mandibular incisor (inter-incisal distance).…”

“…The previous study of Latt et al [17] studied the efficacy of dexamethasone injection versus the saline injection (control group) on post-operative pain in lower third molar intervention. The previous study of Gozali et al [18] also mentioned the decreased post-operative pain using 8-mg dexamethasone injection into sublingual space (SLS) compared with the saline group in lower third molar intervention.…”

Dexamethasone treatment for bilateral lingual nerve injury following orotracheal intubation

“…Therefore, dexamethasone 10 mg was administered, leading to reduction of paresthesia in the tongue. Dexamethasone has an anti-inflammatory action, which is effective against neuroinflammation and reduction of post-operative pain [ 10 11 ]. Moreover, in a pre-clinical study, dexamethasone was shown to effectively aid functional recovery after nerve injury [ 12 ].…”

Evaluation of Dexamethasone Injection into the Pterygomandibular Space in Impacted Lower Third Molar Surgery

“…Today, there is consensus that regaining pain free function after lower 3 rd molar surgery is an essential element, so Dx has been introduced due to its pure glucocorticoid effects, no mineralocorticoid effects, and the least effects on leukocyte chemotaxis. (7) Many studies, (8)(9)(10)(11)(12)(13) reported submucosal, intraalveolar, intravenous, intramuscular and oral use of CS. Injection of CS into Pm is preferred in decreasing trismus, swelling, and pain at the operative site, reducing the postoperative discomfort, and confirm the effectiveness of locally administered CS in 3 rd molar surgery.…”