Pre-emptive effect of dexamethasone injection and consumption on post-operative swelling, pain, and trismus after third molar surgery. A prospective, double blind and randomized study

Abstract

intravenous and experimental group II orally) with impacted lower third molars, average age 20.8 years with no local or systemic problems, with bilateral impacted lower third molars, were operated under local anesthesia. Group I was given 4 mg IV and group II was given 8 mg orally of dexamethasone 1 h before procedure. The choice of which side to operate first and the amount of concentration of medication to use was made randomly and double-blindly. Post-operative pain was evaluated using a visual analog scale (VAS) and the degree of swelling was evaluated through facial reference points' variation. The presence of trismus was analyzed through measurement of the interincisal distance (IID).These assessments were obtained before the operation and 24 h, 48 h and 7th POD.Results: No significant difference was found in facial swelling and trismus between IV 4 mg injection and oral 8 mg consumption after lower third molar surgery (student t test P > 0.05). The visual analogue scale scores for pain assessment showed no significant difference between IV injection and oral route of dexamethasone (student t test P > 0.05). Conclusion:Patients can be administered 8 mg oral dexamethasone is as effective as 4 mg intra venous route without much difference in final outcome at any given point of time.

Efficacy of intravenous, intramassetric, and submucosal routes of dexamethasone administration after impacted third molar surgery: A randomized, comparative clinical study

“…Since maxillofacial region is richly vascularized and has areas of loose connective tissue, the inflammatory responses tend to be significant. [16] Corticosteroids are well-known adjuvant to surgery for suppressing tissue mediators of inflammation, thereby reducing transudation of fluids and lessening edema. Dexamethasone is a highly selective, long-acting, synthetic corticosteroid, which has potent anti-inflammatory action.…”

Efectividad antiinflamatoria de la dexametasona más complejo b en la cirugía de terceras molares inferiores. Un ensayo clínico controlado aleatorizado paralelo a doble ciego

“…Como cualquier procedimiento quirúrgico maxilofacial, los pacientes pueden experimentar complicaciones postoperatorias inflamatorias indeseables, algunas de las cuales pueden prevenirse o minimizarse mediante el cumplimiento de las instrucciones postoperatorias, la aplicación simultánea de crioterapia y la administración precisa de medicamentos apropiados 1,[7][8][9][10]13,15,16,18,19 . Debido a esto, actualmente se utilizan medicamentos para reducir estas complicaciones, y entre ellos se incluyen los corticosteroides, que han mostrado buenos efectos inmunosupresores, antinflamatorios y analgésicos 1,[7][8][9][10][11]13,[15][16][17][18][19][20][21][22][23] .…”

“…La dexametasona, un miembro de la familia de los corticosteroides y análogo de la prenidsolona, ha demostrado ser eficaz en el alivio del dolor, la hinchazón y otras complicaciones indeseables después de la cirugía de tercer molar 1,[7][8][9][10][11][12][13]15,16,19,24 . Recientemente se ha prestado atención a la administración de dexametasona intramuscular en el manejo de complicaciones quirúrgicas 7,10,12,21,23 y también por vía oral 12,13,15,16,18,23 , submucosa 8,10 e intravenosa 18,19 . Sin embargo, no existe evidencia sobre el uso de dexametasona más complejo B en la reducción de estas complicaciones.…”

Application of corticosteroids in dentistry

“…Najizraženiji efekat KS imaju u prva 24h posle operacije, ali se ordiniraju do 3 dana posle operacije, iako sa nešto manjim dejstvom. Postoje brojne studije koje sugerišu na vreme i put administracije KS u hirurgiji donjeg impaktiranog umnjaka, kao i različite kombinacije KS sa drugim medikamentima u cilju smanjenja morbiditeta posle ovakvih intervencija [33][34][35][36][37] .…”