Effects of intra-space injection of Twin mix versus intraoral-submucosal, intramuscular, intravenous and per-oral administration of dexamethasone on post-operative sequelae after mandibular impacted third molar surgery: a preliminary clinical comparative study

Abstract

Steroid groups had a better clinical outcome with improved quality of life post-operatively when compared to the nonsteroid study group. Intra-space injection of dexamethasone in pterigomandibular space as Twin mix was found to have similar clinical effects as conventional methods of administering steroids via intraoral-submucosal, intramuscular, intravenous and per-oral routes. This, however, is a small study which would now benefit from larger numbers.

Evaluation of effects of two dexamethasone formulations in impacted third molar surgeries

“…However, it is a convenient, safe and lowcost route. Our study data showed that oral dexamethasone was effective to control pain and edema during the studied period, which is in line with other similar studies 6,7,11,12 . Submucosal dexamethasone injection had significant effect on edema in two previous studies and both have reported significant decrease of edema in the immediate postoperative period as compared to controls 1,13 .…”

“…An interesting observation in this group was the significant trismus decrease in the first postoperative day, which is similar to group B (oral route), fact which might be result of the higher concentration of dexamethasone obtained immediately at injury site. These results add more power to the concept that dexamethasone administered close to the surgical site is a valuable way to decrease edema and trismus 5,6,12,32 . Our results, regarding Levene and Shapiro-Wilks tests, have not shown statistically significant differences between groups with regard to postoperative pain, edema and trismus decrease after third molar extraction.…”

“…There is a broad discussion about the best drug to minimize postoperative discomfort in dentistry and among the best drugs of choice, dexamethasone is being evaluated by several scientific studies due to its efficacy to control inflammatory complications as compared to its non-use [5][6][7] . Meechan and Seymour 28 have studied different complications that appear after impacted third molar surgery and have concluded that the observation of such complications is important to comparatively evaluate the efficacy of several therapeutic measures.…”

“…This model is an advantage for the prospective evaluation of clinical pharmacology, since patients assure the quality of their own control. Some studies suggest the systemic use of corticosteroids for impacted third molar surgeries [5][6][7]12,13 . Markiewicz et al 4 in a meta-analysis have concluded that corticosteroids administered in the preoperative period were of great value to decrease postoperative inflammatory signs and symptoms.…”

“…Several professionals have emphasized the need for better controlling the postoperative inflammatory process of such surgical procedures, and different drugs have been proposed for such. Corticosteroids may inhibit the onset of inflammatory mediators synthesis and are considered potent drugs to control pain, edema and trismus [4][5][6][7] . Dexamethasone has been widely used in dentistry in different doses and administration routes to decrease postoperative discomfort and when used for a short period presents less interference with chemotaxis for leucocytes 8,9 .…”