Efficacy of various routes of dexamethasone administration in reducing postoperative sequelae following impacted third molar surgery

Abstract

Aim: To compare the efficacy of intravenous (IV), intramassetric (IM) submucosal (SM) routes & oral routes of dexamethasone administration post impacted third molar removal surgery. Type of Study: Prospective randomized comparative clinical study. Materials and Method: This prospective comparative study included 60 patients with Class II and position B type of impaction (according to Pell and Gregory's classification). Patients were randomly divided into 4 groups. Group A, B, C & D patients received 8mg dexamethasone immediately post-surgical tooth removal via the IV, SM and IM route & oral respectively. Assessment of swelling, mouth opening and pain was done at intervals of 1st, 3rd and 7th post-op days. Results: The average age of the patients was 27 years. The mean time taken was 20 mins 40 seconds. The IV group showed minimal swelling and better pain control on the 3rd post op day (statistically significant). All 4 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; IM and SM routes are also comparably effective although oral route had the best patient acceptance.

Comparison of Submucosal With Intramuscular or Intravenous Administration of Dexamethasone for Third Molar Surgeries: A Systematic Review and Meta-Analysis

“…A total of 29 articles were screened by their full texts of which 16 were excluded with reasons. Finally, 13 articles were included in the review (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32).…”

“…However, the dose of dexamethasone was the same in the intervention and comparative arms of each trial. Three of the included trials were three-arm trials comparing the SM route with both IV and IM routes (23,25,32). Eight studies reported the use of chlorhexidine mouthwash postoperatively (22,24,(27)(28)(29)(30)(31)(32).…”

Injeção submucosa de dexametasona em cirurgia de remoção de terceiro molar reduz dor e edema pós-operatório? Uma revisão

“…Contudo, houveram contextos em que a injeção intravenosa apresentou efeito significativamente maior no controle de dor e edema por um maior período de tempo, apesar do tempo mais demorado para início de ação, porém, também foi constatado que a via submucosa foi eficaz e teve melhor aceitação pelos pacientes, como é citado por Vivek et al, (2020).…”

Does Mandibular Gonial Angle Influence the Eruption Pattern of the Lower Third Molar? A Three-Dimensional Study

“…To use radiologic data for scientific analysis, a specific informed consent form was signed by all patients. Inclusion criteria were the following: (1) patients aged 18 to 32 years; (2) no previous orthodontic treatment; (3) presence of unilateral or bilateral M3M (3.8 and/or 4.8); (4) extension of the CBCT scans from the nasal bones to the chin; (5) high resolution images without metal artifacts and/or movement; (6) presence of central incisors, first and second molars without altered angulation in both dental arches; (7) dental arches in centric occlusion during scans acquisition; (8) completed root apexification (stage H) [25]. Patients with history of mandibular trauma, facial malformations, craniofacial syndromes, systemic diseases, osteometabolic disorders, parathyroid diseases, or incomplete radiological exams were excluded.…”

“…The lower third molars (M3M) are the most frequent impacted teeth with indication to surgical removal [1,2]. The surgical treatment of the M3M always represents a challenge for oral surgeons, considering difficulties and possible risks of this procedure [3]. Surgical removal of the lower third molars is strictly related to anatomical factors and operative abilities of the surgeon [4].…”