The Effectiveness of Using a Single Postoperative Intramuscular Dexamethasone Injection on Patients with Surgical Extraction of Lower Third Molar: Split Mouth Technique

Background: Surgical removal of the lower third molar is one of the most common challenges in oral surgery. Their removal is associated with postoperative sequelae like pain, facial swelling, and trismus. All these sequelae are normal physiological responses of the body to tissue injury associated with surgical extraction. The pharmacological management is by analgesics, anti-inflammatory agents, and opioids perioperatively. One of the most used drugs is dexamethasone. Objective: Evaluating the effectiveness of using a single immediate postoperative intramuscular dexamethasone injection on pain, swelling, trismus, and tissue healing in the first seven days. Methods: A split-mouth technique was used on 16 patients with bilateral, similar impacted mandibular third molars that were extracted; one side was given an 8mg intramuscular injection of dexamethasone (study group), and the other side wasn’t given an injection (control group), and comparisons of the two sides were done in the following seven days. Results: 6 patients were excluded (not meeting criteria), so only 10 were left. All records showed a decrease in pain scores (significant only on the 1st and 2nd days), a decrease in swelling (not significant) measurements, and a decrease in limitation of mouth opening (significant only on the 1st day), while there were close healing scores for both groups. Conclusions: The use of a single immediate postoperative intramuscular dexamethasone injection showed a decrease in pain scores, a reduction in trismus, and a lessening in swelling but had trivial or no effect on healing at the operation site.