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Volume 6 Issue 1 (January, 2018)

Original Articles

Efficacy of Use of Single Dose Submucosal Injection of Dexamethasone in Impacted Mandibular Third Molar Surgery
Manish Sahore, Monica Parmar

Purpose: The purpose of this preliminary randomized prospective clinical trial was to evaluate and compare the effect of single dose perioperative administration of dexamethasone sodium phosphate by submucosal and intramuscular route on postoperative discomfort after mandibular third molar surgery. Materials and Methods: This is a prospective randomized clinical trial. We prospectively evaluated 40 patients requiring surgical removal of single mandibular impacted third molar under local anesthesia by randomly allocating them to three groups: submucosal dexamethasone group, intramuscular dexamethasone group and no dexamethasone (control) after onset of local anesthesia. Maximum inter-incisal distance and facial contours were measured at baseline and at post surgery days 2, 5 and 7. Subjects completed a questionnaire assessing postoperative pain intensity using Visual Analogue Scale. Results: On 2nd postoperative day facial edema showed a significant reduction in submucosal group as compared with the intramuscular and control group. On 5th postoperative day, there was no significant change between the submucosal and intramuscular group, but both groups showed significant difference in comparison to control group. There was no significant difference in edema on the 7th postoperative day between all the three groups. The submucosal group had a limited and nonsignificant affect on pain when compared with intramuscular group on 2nd postoperative day but showed a marked reduction in pain on 5th postoperative day when compared with intramuscular group and control group. On 7th postoperative day there was non-significant affect on pain between submucosal and intramuscular groups. The comparison of mean value of trismus on 2nd and 5th postoperative days between submucosal and intramuscular groups is significant, showing less decrease in interincisal opening in submucosal group. On the 7th postoperative day the mean value of trismus in all the three groups is non-significant. Conclusions: Parenteral use of dexamethasone 8mg as a single submucosal injection at site of surgery peri-operatively is effective in the reduction of postoperative sequalae in terms of pain, swelling and edema after mandibular impacted third molar surgery.

 
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