Effectiveness of Intra-Socket Application of Dexamethasone- and Hyaluronic Acid-Soaked Gelfoam in Mandibular Third Molar Surgery

Abstract Background Extraction of impacted mandibular third molars are commonly associated with postoperative pain, facial swelling, and trismus. Local intra-socket drug delivery provides targeted therapy with minimal systemic drug exposure. This study compared the efficacy of dexamethasone and hyaluronic acid–soaked gelfoams in reducing postoperative sequelae. Materials and Methods A prospective randomized controlled study was conducted on 54 patients who underwent surgical extraction of impacted mandibular third molars. Participants were allocated into three groups (n = 18 each): Group A (control, normal saline-soaked gelfoam), Group B (dexamethasone-soaked gelfoam), and Group C (hyaluronic acid-soaked gelfoam). Facial swelling (linear measurements), interincisal mouth opening, and pain were recorded preoperatively and on postoperative days 3 and 7 using the Visual Analog Scale (VAS). Data were analyzed using one-way and repeated-measures ANOVA (p < 0.05). Results All fifty-four participants completed the study. Baseline parameters were comparable across groups (p = 0.88, p = 0.06, p = 0.17). Facial swelling showed no significant intergroup differences on day 3 (p = 0.71) or day 7 (p = 0.74). Mouth opening differed significantly on day 3 (p = 0.021) and day 7 (p = 0.049) showed better preservation in the dexamethasone group. Pain scores showed no significant differences (p = 0.57, p = 0.82), although lower mean values were observed in the intervention groups. Antibiotic (p = 0.124) and analgesic consumption (p = 0.154) were comparable. Conclusion Intra-socket dexamethasone demonstrated superior efficacy in preserving mouth opening, whereas both dexamethasone and hyaluronic acid showed favorable trends in pain reduction.