Mystery revealed on efficacy of intravenous dexamethasone vs methylprednisolone on post-operative sequelae after 3rd molar surgery (original) (raw)
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Journal of Health Sciences & Research
Aims and objectives: To understand the benefits of dexamethasone and compare the effects of submucosal vs intramuscular (IM) administration of dexamethasone in reducing postoperative sequelae following impacted mandibular third molar surgery. Materials and methods: The study was conducted on 90 patients, who were divided into three groups of 30 each. The two experimental groups were given dexamethasone 4 mg submucosally or intramuscularly (preoperatively), and the control group did not receive any form of corticosteroid. Measurements of facial swelling and maximal interincisal distance were made preoperatively and on the 1st, 3rd, and 7th postoperative days. Pain was evaluated from patients' response to visual analog scale and recording the number of rescue analgesic tablets taken at the end of the 7th postoperative day. Results: Both dexamethasone groups showed a significant reduction in pain, swelling, and trismus as compared with the control group at all intervals. There was a statistically significant reduction in magnitude of swelling in the submucosal dexamethasone group as compared with the IM dexamethasone group on the 1st postoperative day, but there was no significant difference among two experimental groups at other times and their effects were comparable for all variables. Conclusion: Dexamethasone 4 mg is an effective therapeutic strategy for reducing postoperative sequelae following surgical removal of impacted third molars and submucosal dexamethasone is an effective alternative to dexamethasone given systemically.
Egyptian dental journal, 2021
Introduction: Corticosteroids are considered anti-inflammatory which considered the essential roles, as well as it reduces edema. Aim: To compare the efficacy of dexamethasone injection submucosally, intra-masseteric and intra-muscular on post-operative swelling, mouth opening and pain following removal of mandibular impacted third molars. Type of Study: prospective randomized comparative clinical study. Methods: The current study included forty-five patients with impacted mandibular third molars were selected to underwent surgical removal of mandibular third molars. Group I, comprised of fifteen patients who received pre-operative sub-mucosal 8 mg dexamethasone injection, Group II, comprised of fifteen patients who received pre-operative Intra-masseteric 8 mg dexamethasone injection and Group III, taking intramuscular dexamethasone injection, Postoperative assessment included: mouth opening, swelling as well as pain at the following intervals; 1 st , 3 rd and 7 th day post-operative. Results: our study showed no statistically significant difference between mean MMO as well as VAS in Group I and II; both showed statistically significant higher mean MMO and VAS than Group III. Significant reduction in pain and swelling in both sub-mucosal, intra-masseteric and intramuscular but a greater immediate effect on trismus was seen in sub-mucosal and intramasseteric routes Conclusion: preoperative administration of dexamethasone has greater post-operative effects. Dexamethasone injected preoperatively was safe and simple effective method to reduce postoperative complications such pain, swelling and trismus.
Oral Surgery, 2018
Aim: To demonstrate the preventative therapeutic effect of preoperative and post-operative intravenous 8 mg of dexamethasone on post-operative pain, swelling and trismus after the surgical extraction of mandibular third molars. Materials and methods: A randomised clinical trial was conducted on of 100 healthy participants (group I pre-operative and group II postoperative) with unilateral impacted lower third molars, average age 27.7 AE 9.7 years with no local or systemic problems were operated under local anaesthesia. Group I received 8 mg intravenous 1 hour preoperatively and group II received 8 mg intravenous dose of dexamethasone at the end of procedure. Post-operative pain was evaluated using a visual analogue scale (VAS) and the degree of swelling was evaluated through facial reference point variation. The presence of trismus was analysed through measurement of the inter-incisal distance (IID). These assessments were obtained before the operation and 48 hour and 7 th post-operative day. Results: No significant differences were observed in facial swelling and trismus among pre-operative and post-operative IV 8 mg doses after the surgery (student t-test; P > 0.05). The visual analogue scale scores for pain assessment showed no clinically or statistically significant differences in both groups (student t test; P > 0.05). Conclusions: Pre-operative administration of 8 mg intravenous dexamethasone is as effective as 8 mg IV post-operative dexamethasone with no clinically or statistically significant differences in the final outcomes of the third molar surgery. Clinical Significance This study demonstrates that the steroids can be used pre-operatively and post-operatively for the third molar surgery safely without any statistical difference. However, the steroids should be used judiciously and its use depends on the case selection and preference of the practitioner.
SVOA Dentistry, 2021
Aim: To evaluate the efficacy and post operative effect of Dexamethasone to decreases the swelling and trismus after surgical extraction of mandibular 3 rd molars. Material and method: In this study 294 adult patients underwent surgical extraction lower third molar under local anesthesia at OMFS dept of Update dental college for last 2 years. These patients were divided into two groups. Group-A patients were given post operative orally steroids. Group-B Patients were not given any steroids at the end of the surgical procedure. Evaluation of pain, trismus, swelling preoperatively, 3 rd and at 7 th days post operative day. Result: On 7 th post-operative day, those who received dexamethasone orally showed better results such as greater reduction of pain, trismus and swelling in compared to those who didn't receive dexamethasone. Conclusion: This study concludes that, administration of dexamethasone is more effective after surgical extraction to reduce unfavorable swelling, trismus which improves and enhance patients comfort and facial appearance in shorter duration.
Egyptian dental journal, 2019
Purpose: The aim of the current study was to compare the efficacy of dexamethasone injection submucosally, intra-masseteric and intramuscular in surgical removal of mandibular third molars on post-operative swelling, mouth opening and pain. Patients and Methods: forty five patients with impacted mandibular third molars were selected to undergo surgical removal of mandibular third molars. Patients were randomly divided into three groups of fifteen each. Group I, taking sub-mucosal dexamethasone injection, Group II, taking Intra-masseteric dexamethasone injection and Group III, taking intramuscular dexamethasone injection, all patients were injected pre-operatively Assessment of swelling, mouth opening, and pain was done at intervals of 1st, 3rd, and 7th post-operative days. Results: our study showed no statistically significant difference between mean MMO as well as VAS in Group I and II; both showed statistically significant higher mean MMO and VAS than Group III. Significant reduction in pain and swelling in both sub-mucosal, intra-masseteric and intra-muscular but a greater immediate effect on trismus was seen in sub-mucosal and intramasseteric routes Conclusion: It can be concluded that pre-operative dexamethasone injection is an effective pharmacological agent to reduce post-surgical third molar removal sequelae such as pain, swelling and trismus.
INTERNATIONAL JOURNAL OF SCIENTIFIC RESEARCH
Introduction: The surgical removal of impacted mandibular third molars is an invasive procedure that involves extensive tissue trauma and a considerable postoperative inflammatory response. Although the inflammatory process is necessary for healing when exacerbated it may cause pain, swelling and limited mouth opening. Corticosteroids are among the most widely employed pre-operative medication administered for the control of such complications. Objective: To compare the effects of single dose of pre-operative Injection Dexamethasone versus Injection Methylprednisolone via Intramuscular or Submucosal route for controlling the post-operative pain, swelling and limited mouth opening in the removal of impacted mandibular third molars. Material and Method:. The present study was conducted on 40 healthy adult patients with bilaterally symmetrical impacted mandibular third molar, reporting to the Department of oral and Maxillofacial Surgery of Guru Nanak Dev Dental College and Research Ins...
Journal of Dental and Craniofacial Research
Objective of this study was aimed to compare the therapeutic effects of 8 mg dexamethasone intramuscular administered pre-operatively vs post-operatively after the surgical extraction of impacted mandibular third molars, in Al-Qurayyat, Saudi Arabia, population. One hundred and fifty patients who visited the Department of Oral and Maxillofacial Surgery of Gurayat specialized dental center, Al-Qurayyat, Saudi Arabia, were included in the study. The study was conducted from February 2018 to August 2018. 150 patients constituted the study and were randomly divided into two groups. Group A received 8 mg dexamethasone (intramuscular) 1hr pre-operatively. Group B received 8 mg dexamethasone (intramuscular) immediately after the surgery. According to the gender there were 81(54%) males and 69 (46%) females, in both the groups combined. Males to females' ratio was 1.17: 1 in this study. Post-operative 1 st and 3 rd day follow-up showed that there was a significant difference between the two groups in terms of swelling and mouth opening (P=0.000). Overall, Group A showed much better results as far as the post-operative swelling and mouth opening was concerned. There was no statistical difference in the scores when the post-operative pain was evaluated on 1 st , 3 rd and 7 th day (P=0.679, P=0.755, P=0.202). The depth, angulation and the position of the tooth did not affect the study in terms of significance (P=0.626, P=0.874, P=1.000). It was concluded that preoperative administration of single dose of dexamethasone intramuscularly was more effective than the postoperative period, in reducing the swelling and trismus.
National Journal of Maxillofacial Surgery, 2020
Objectives: A randomized prospective double-blind study was conducted to determine the efficacy of sub-mucosal local infiltration vs. intravenous dexamethasone in reducing postoperative pain, swelling and trismus after surgical removal of impacted mandibular third molars. Materials and Methods: Forty five patients were included in the study and were randomly divided into three groups. Each group consisted of 15 patients for which the first and second groups were given 8 mg of dexamethasone intrlesionally & intravenously respectively, at 30 minutes prior to surgery; the third group served as control. Duration of facial swelling was evaluated subjectively by the patients themselves. Severity of postoperative pain was quantified by counting the number of analgesics taken by the patients during and after surgery (six subsequent days). Postoperative trismus was determined by measuring the maximum incisal opening before surgery and on the seventh day. Results: Results showed that duration of postoperative edema was almost the same in the three test groups. During surgery, the intravenous dexamethasone group showed a significantly lesser pain than the other two groups; the intralesional dexamethasone group showed less marked pain than the control group. Additionally, patients who had taken steroids had a marked increase in the incisal opening postoperatively over the control group. Trismus was significantly reduced in the methylprednisolone group as compared to the dexamethasone group. Conclusion: It is concluded that both preoperative local infiltration and intravenous administration of dexamethasone significantly reduced postoperative pain and trismus after surgical removal of mandibular third molars. An intravenous dexamethasone is more effective in reducing postoperative inflammatory sequelae than its intralesional route.
Nepal Journal of Health Sciences
Introduction: Third molar surgery is one of the most common procedures performed by dental surgeons in clinical practice, where postoperative sequelae like pain, trismus, and swelling are often encountered. Thus, in this study, we compared medications employed to reduce such complications. Objective: To compare the effect of two different doses (4 and 8 mg) of dexamethasone in the control of swelling and trismus after the surgical extraction of mandibular impacted third molars. Methods: An experimental study consisted of twenty-seven (27) healthy adult patients of both genders with bilateral impacted lower third molars, where surgical extraction was indicated, 4 mg and 8 mg of dexamethasone were given orally to the patients 1 hour before the surgical procedure at both the surgeries. The swelling was recorded by measuring the length of 3 facial planes using a measuring tape. Trismus was evaluated by measuring the maximum interincisal distance. Recording of facial swelling and maximum...