The Effect of Submucous Dexamethasone Injection on the Post-Operative Sequelae After Impacted Third Molar Surgery

Background:Different method were attempted by many researchers to reduce postoperative inflammatory response following surgical extraction of lower wisdom teeth because this is a very common procedure and is usually associated with pain, difficulty in mouth opening and swelling. Aims: To assess the effect of sub mucosal injection of 4mg/1ml dexamethasone on reduction of postoperative pain, facial swelling and trismus following the surgical extraction of impacted lower wisdom teeth.

Materials and Method:forty patients were selected to be included in this randomized clinical study with a total number of 42 impacted mandibular third molars, they divided randomly into two groups, control and study group of twenty patients for each, patients in the study group received 4mg/1 ml submucos injection of dexamethas one, while patients in the control group received placebo (normal saline) five minutes after local anesthesia administration, and surgical removal of impacted teeth was done after further five minutes. evaluation of mouth opening and swelling was done as a baseline and on the second and seventh post-operative days after surgery, while pain was scored daily until the 7 th postoperative day by the patient according to numerical rating scale. Assessment of trismus was done by measuring the maximum interincisal distance swelling was evaluated by measuring the distance between five selected points. Every one of these factors in addition to the time of surgery were compared between the two groups.

Results:Study group showed less limitation in mouth opening than control group but there was no statistically significant difference between them however study group showed a significant reduction in pain scores on the first and the second post-operative days and a significant improvement of swelling compared with the control group at the 48 hour follow up.

Conclusion:Submucosal injection of dexamethasone was effective in minimizing facial swelling, Pain and trismus after surgical extraction of mandibular third molar.