USE OF PREOPERATIVE SUBMUCOSAL DEXAMETHASONE IN THIRD MOLAR SURGERY: A STEP TOWARDS IMPROVEMENT IN QUALITY OF LIFE
DOI:
https://doi.org/10.33279/jkcd.v15i04.870Keywords:
Dexamethasone; Third Molar Surgery; Swelling; Trismus; Quality of Life.Abstract
Objectives: To determine the efficacy of pre-operative submucosal administration of dexamethasone in surgery of impacted third molar (M3) teeth.
Materials and Methods: Prospective, randomized controlled trial was conducted at Armed Forces Institute of Dentistry, CMH Rawalpindi, from April 2023 to October 2023. A total 130 patients were enrolled in study and divided into two groups by simple randomization method. Group A was control group injected placebo and group B was case group injected 4mg dexamethasone immediately after induction of anesthesia through submucosal route. Efficacy was measured in terms of reduction in trismus, pain and inflammation in post-operative time. SPSS version 24 was used for data entry and analysis of variables.
Results: The mean pain score in Group A was 31.29 ± 6.04, while in Group B it was 25.32 ± 3.49, with Group B showing significantly lower pain levels than Group A (p < 0.001). The mean swelling measured 4.63 ± 1.22 mm in Group A and 3.16 ± 0.72 mm in Group B, indicating signifi cantly less swelling in Group B (p < 0.001). Similarly, the mean trismus was 26.17 ± 3.63 mm in Group A compared to 21.15 ± 2.44 mm in Group B.
Conclusion: Administering 4mg of dexamethasone through the submucosal route prior to mandibular third molar surgery can effectively reduce post-operative pain, swelling, and trismus.
References
Sreesha S, Ummar M, Sooraj S, Aslam S, Roshni A, Jabir K. Postoperative pain, edema and trismus following third molar surgery–A comparitive study between submucosal and intravenous dexamethasone. J Family Med Prim Care. 2020 May;9(5):2454.
Gümrükçü Z. The effects of piezosurgery and submucosal dexamethasone injection on post-operative complications after third molar surgery. JStomatol Oral Maxillofac Surg. 2019 Jun 1;120(3):182-7.
Erdil A, Akbulut N, Altan A, Demirsoy MS. Comparison of the effect of therapeutic elastic bandage, submucosal dexamethasone, or dexketoprofentrometamol on inflammatory symptoms and quality of life following third molar surgery: a randomized clinical trial. Clin Oral Investig. 2021 Apr;25:1849-57.
Desai Y, Ebenezer V, Balakrishnan R. Effect of Pre-Operative Use of Dexamethasone in Management of Inflammatory Complications in Surgical Removal of Third Molar–A Review Article. JPharmacSci Res. 2023 Mar 1;15(3):1047-8.
Shibl M, Ali K, Burns L. Effectiveness of pre-operative oral corticosteroids in reducing pain, trismus and oedema following lower third molar extractions: a systematic review. British Dent J. 2021 Jul 8:1-8.
Hiriyanna NM, Degala S. Objective and subjective comparison of submucosal and intravenous routes of single-dose preoperative dexamethasone for mandibular third molar surgery—a prospective randomized observer-blind study. Oral Maxillofac Surg. 2021 Jun;25:207-13.
Urechescu H, Tudor A, Costan VV, Talpos S, Pricop M. The role of submucosal dexamethasone injection in reducing complications after lower third molar surgery. Romanian J Oral Rehabil. 2022 Jan;14(1):169-74.
Ayub K, Fazal M. The Effectiveness of Submucosal Administration of Methylprednisolone and Dexamethasone in Comparison to Placebo after Third Molar Surgery: A Double Blinded, Parallel Arm Randomized Clinical Trial. Pak J Med Res. 2022;61(4):154-9.
Gümrükçü Z. The effects of piezosurgery and submucosal dexamethasone injection on postoperative complications after third molar surgery. J Stomatol Oral Maxillofac Surg. 2019 Jun;120(3):182-87.
Selvido DI, Bhattarai BP, Niyomtham N, Riddhabhaya A, Vongsawan K, Pairuchvej V et al. Review of dexamethasone administration for management of complications in postoperative third molar surgery. J Korean Assoc Oral Maxillofac Surg. 2021;47(5):341-50.
Alexander RE, Throndson RR. A review of perioperative corticosteroids use in dentoalveolar surgery. Oral Surg Oral Med Oral Path Oral RadiolEndod. 2000;90(4):406–15.
Dionne RA, Gordon SM, Rowan J, Kent A, Brahim JS. Dexamethasone suppresses peripheral prostanoid levels without analgesia in a clinical model of acute inflammation. J Oral Maxillofac Surg. 2003;61(9):997–1003.
Shad S, Mahmud A, Shahnawaz A, Shah SMH, Farooq A, Mehmood S et al. Use of preoperative submucosal dexamethasone in third molar surgery: A step towards improvement in quality of life. J Ayub Med Coll Abbottabad. 2020;32(Suppl.1):607–11.
Ehsan A, Ali Bukhari SG, Ashar, Manzoor A, Junaid M. Effects of pre-operative submucosal dexamethasone injection on the postoperative swelling and trismus following surgical extraction of mandibular third molar. J Coll Physicians Surg Pak. 2014;24(7):489–92.
Warraich R, Shaheen A, Rana M, Faisal M, Gellrich NC, Rana M. Evaluation of postoperative discomfort following third molar surgery using submucosal dexamethasone – a randomized observer blind prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116(1):16–22.
Nair RB, Rahman NMM, Ummar M, Hafiz KAA, Issac JK, Sameer KM. Effect of submucosal injection of dexamethasone on postoperative discomfort after third molar surgery: A prospective study. J Contemp Dent Pract. 2013;14(3):401–4.
Mojsa IM, Pokroweicki R, Lipczynski K, Czerwonkta D, Szceklik K, Zaleska M. Effect of submucosaldexamehtasoneinjrction on postoperative pain, oedema and trismus following mandibular third molar surgery: a prespective randomized double-blind clinical trial. Int J Oral Maxillofac Surg. 2017;46(4):524–30.
Grossi GB, Maiorana C, Garranmone RA, Borgonovo A, Beretta M, Farronato D, et al. Effect of submucosal injection of Dexamethasone on postoperative discomfort after third molar surgery: A prosective study. J Oral Maxillofac Surg. 2007;65(11):2218–26.
Majid OW. Submucosal dexamethasone injection improves quality of life measures after third molar surgery: A comparative study. J Oral Maxillofac Surg. 2011;69(9):2289– 97.
Veras IC, Paiva CL, de OC, Silva EI, de A.Cavalcante AC et al. Submucosal dexamethasone injection in third molar removal surgery reduces postoperative pain and edema? A review. Res Society Develop. 2023;12(4):e29012435269.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Sarmad Suleman, Ali Akhtar khan, Usama Akhtar Khan, Ozair Shirazi, Sameen Naweed, Lubna Arshad Azam Raja
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- NonCommercial — You may not use the material for commercial purposes .
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
