Effectivness of submucosal, oral and intramuscular routs of dexamethasone administration in trismus, swelling and pain reduction after the third lower molar surgery

Abstract

Background/Aim. Surgical extraction of impacted lower third molars is inevitably followed by postoperative occurrence of trismus, swelling and pain sensations in some degree. Corticosteroids (dexamethasone particularly) are commonly used drugs in the prevention of these complications. The aim of this study was to determine the effectiveness of dexamethasone in prevention of postoperative complications, edema, trismus and pain, after the surgical extraction of impacted lower third molars, depending on the method of its administration. Methods. This prospective study involved 30 healthy patients, 18 years and older, of both sexes, with fully impacted lower third molar - class I or II and position B or C, according to Pell and Gregory classification system and vertical position according to Winter classification. All patients were randomly divided into three groups depending on the way dexamethasone was administered: ORAL - dexamethasone in the form oral tablets, in a dose of 4 mg, (Dexason? tab. 0,5 mg, Galenika, Srbija) one hour before the surgery; SUBMUCOSAL - dexamethasone solution in a dose of 4 mg (Dexason? amp 4 mg/mL, Galenika, Srbija) submucosally in the area of buccal sulcus, after the inferior alveolar nerve block anesthesia and additional anesthesia for the buccal nerve; INTRAMUSCULAR - dexamethasone solution in a dose of 4mg (Dexason? amp 4 mg/mL, Galenika, Srbija) intramuscularly, into the area of the deltoid muscle, right before the intervention. Preoperatively and at every control visit (1st, 2nd and 7th day postoperatively) interincisal distance, the degree of edema and the level of pain with the use of Visual-analogue scale (VAS), were measured. On the 7th postoperative day, a total number of analgesics taken by the patients was recorded.Results. In postoperative period, there was no statistically significant difference between the examined groups in term of effectiveness in swelling, trismus and pain reduction (p ? 0.05).Conclusion.There is no significant difference of dexamethasone effectiveness in postoperative trismus, swelling and pain reduction after the third lower molar surgery, regarding the route of administration - oral, intramuscular or local submucosal.