| Summary: | Background: Third molar or wisdom tooth removal is the most recorded surgery in all maxillofacial clinics globally. Post-operative complications can range from crucial complications such as damage to inferior alveolar nerve, infection, fracture of mandible, dry socket to frequent complains like pain, edema and swelling which can disturb the daily routine of patients.
Objective: To compare effect of submucosal administration of dexamethasone 8mg and methylprednisolone 40 mg with placebo (saline) one hour prior to third molar surgery in reducing the post operation sequelae after the third molar removal surgery.
Study type, settings & duration: This double blinded, parallel arm randomized clinical trial was carried out in Oral and Maxillofacial Ward of Islamic International Dental College, Islamabad from January to June 2019.
Methodology: The trial was registered in Australian and New Zealand international trial registry. The sample size was calculated by WHO calculator. A VAS variance was stated as 3 for drugs and 14 for intergroup. Errors were set as alpha =0.05 and beta=0.2. A total sample size was calculated to be 90 patients. A total of ninety patients were included and were divided into three groups. Each group had thirty patients. Group A was given submucosal dexamethasone 8 mg (2ml) before the start of the procedure and after injection of local anesthesia. Group B was given 40 mg (2ml) subcutaneous methyl prednisolone and group C was just given local anesthesia and saline injection (2ml) and served as placebo group. Trismus and mouth opening were evaluated using the Vernier calipers and distance between upper central and lower central incisor tooth was measured. Swelling was evaluated using a tape measure method. Three readings were taken in each patient for three reference points: A. Tragus to external angle of the eye, B. Tragus to lateral angle of the mouth, C. External angle of the eye to gonion. Pain was evaluated by using visual analogue scale from 1 to 10 and number of analgesics consumed by the patient on post op days. Data was analyzed using SPSS and is represented in form of tables.
Results: Submucosal injection of dexamethasone was significantly better in control of swelling at 24 and 48 hours post operatively than methylprednisolone and placebo. Dexamethasone was significantly better at control of trismus than methylprednisolone and placebo at 24 and 72 hours postoperatively.
Conclusion: Submucosal injection of dexamethasone can be given pre operatively in third molar impactions patients to control post op sequel like swelling, trismus and pain.
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