Effect of Submucosal Injection of Dexamethasone on Postoperative Discomfort After Third Molar Surgery: A Prospective Study

Purpose

The purpose of this study was to evaluate the effect of submucosal administration of dexamethasone sodium phosphate on discomfort after mandibular third molar surgery.

Patients and Methods

Sixty-one consecutive patients requiring surgical removal of a single mandibular impacted third molar under local anesthesia were randomly placed into 3 groups. After the onset of local anesthesia, the experimental groups received dexamethasone at 2 different doses (4 or 8 mg) as submucosal injection, and the control group received no drug. Standardized surgical and analgesic protocols were followed. Maximum interincisal distance and facial contours were measured at baseline and at postsurgery days 2 and 7. Pain was objectively measured by counting the number of analgesic tablets required. The patients’ perception of the severity of symptoms was assessed with a follow-up questionnaire (PoSSe scale).

Results

On the second postoperative day, facial edema showed a statistically significant reduction in both dexamethasone 4-mg and dexamethasone 8-mg groups compared with the control group, but no statistically significant differences were observed between the 2 dosage regimens of dexamethasone. By contrast, there was no statistically significant difference between all groups when postoperative swelling was evaluated at day 7 (P > .50). The treatment group had a limited and nonsignificant effect on pain and trismus when compared with the control group at the 2 times of evaluation.

Conclusions

Parenteral use of dexamethasone 4 mg, given as an intraoral injection at the time of surgery, is effective in the prevention of postoperative edema. Increasing the dose to 8 mg provides no further benefit.