Anti-oedematous and anti-in ammatory protocol in surgery of lower third molars: preliminary results of a prospective randomized double blind study

Aim: The aim of this clinical study is to evaluate and compare the relative ef cacy of two different dosages of dexamethasone, i.e. 2 and 4 mg injected submucosally to reduce postoperative discomfort, e.g. trismus and oedema after mandibular third molar surgery. Methods: A prospective randomized double blind study is still being conducted on 150 patients requiring surgical removal of an impacted third molar. Selected patients are divided randomly into three groups of 50 patients each: group I (literature’s gold standard) patients received one regimen single dose of 4 mg dexamethasone submucosally, group II (test) received one regimen single dose of 2 mg dexamethasone submucosally, and group III (control group), no dexamethasone was given but only received injection of normal saline submucosally. The drug was administered after the wound closure through silk sutures. Baseline measures were done pre-operatively as inter-incisal mouth opening width and three linear measurements for facial swelling. Each patient was instructed to assume 1 gr paracetamol exclusively. For pain assessing patients were required to take note on a survey form through an VAS scale and the paracetamol capsules amount. The postoperative sequelae were assessed using the same linear measurements on the second and seventh postoperative day. The sutures were removed on the seventh day post-surgery. Results: As compared to group III, group I showed statistically signi cant reduction in trismus and swelling whereas no statistically signi cant difference were found between the group II and group III. The statistical analysis showed that the dexamethasone treatment is more effective on the male gender. Conclusions: It can be concluded that dexamethasone is effective in curtailing the postoperative oedema and trismus of lower third molar surgery but have negligible analgesic effect, though keeping in mind that is still a work in progress because the sample size is yet to be reached. As no statistically signi cant di- erence is found between both the group II (2 mg) and control group, so within the con nes of our study, it may be concluded that 4 mg dexamethasone can be given safely to reduce the postoperative edema after the third molar surgery. Due to the gender pattern that has emerged from our statistical analysis, further high-quality study are needed to con rm this findings.