Background: Administration of corticosteroids at the
time of surgical removal of mandibular third molar is a
practice that oral surgeons often follow. However, the
need for the steroid and the most apt route of
administration is still a subject of study.
Purpose: The present study aimed to evaluate the effect of
four different routes of administration of dexamethasone
(8mg) on postoperative pain, swelling, and trismus after
third molar surgery.
Study design, setting, sample: It was a single-centered
randomized controlled clinical trial conducted on 75
patients. All the selected patients were chosen based on
specific inclusion criteria and each of them underwent a
single-sided mandibular third molar extraction. There
were five groups with fifteen patients in each. Group 1
was control where no steroid was administered. The rest
of the four groups were provided with local injection of
dexamethasone or peroral tablet or regional injection of
dexamethasone on deltoid muscle or intravenous
dexamethasone injection. The study variables were facial
swelling, trismus, and pain. All these variables were
assessed preoperatively, on postoperative day 1,5, and 7.
Results: Trismus (interincisal mouth opening) had set in
the most in the control group which sustained until
postoperative day 7. The least trismus was seen in the
group with local submucosal dexamethasone injection.
Similarly, swelling was highest in the control group. The
least effected group was the one with intravenous
dexamethasone injection. In terms of pain, the most
effective route was the local dexamethasone injection.
Conclusion: Trismus and pain were best controlled with
local injection, while swelling was best controlled by the
Keywords : Dexamethasone, Molar, Pain, Route, Swelling, Trismus.