Anti-Inflammatory Effectiveness of Oral Dexamethasone 4 mg on Mandibular Third Molar Surgeries: A Split-Mouth Randomized Clinical Trial

J Oral Maxillofac Surg. 2021 May;79(5):981-988. doi: 10.1016/j.joms.2021.01.003. Epub 2021 Jan 12.

Abstract

Purpose: This study aimed to evaluate the anti-inflammatory effect of oral dexamethasone 4 mg in a single dose preemptively administered to reduce pain, swelling, and trismus following mandibular third molar surgeries.

Methods: A split-mouth randomized clinical trial was performed including 22 participants undergoing surgical removal of bilateral and symmetrically positioned third molars. A total of 44 teeth were allocated by simple randomization to either the test or nonintervention/control side. Oral dexamethasone 4 mg was administered on the test side an hour before the surgery. All of the participants were unaware of the medication studied, and only 1 surgeon, blinded to the medication intake, performed all of the procedures. Anti-inflammatory effect was evaluated using the clinical parameters of mouth opening, swelling, and rescue analgesic medication intake to control pain. The statistical analysis was blinded to the allocation groups, and a significance value P < .05 was adopted for all the tests.

Results: Dexamethasone reduced the mean of rescue analgesic medication intake by 5 times (P = .002). Facial swelling was lower on the test side by 72h postsurgery in comparison with the control side (P = .036). No significant difference in mouth opening was found between the groups.

Conclusions: Preemptive use of oral dexamethasone 4 mg proved to be effective in controlling pain and reducing the need for rescue medication and had a beneficial effect in reducing swelling during a short postoperative period.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Dexamethasone / therapeutic use
  • Edema / drug therapy
  • Edema / prevention & control
  • Humans
  • Molar, Third* / surgery
  • Pain Measurement
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / prevention & control
  • Tooth Extraction
  • Tooth, Impacted*
  • Trismus / drug therapy
  • Trismus / etiology
  • Trismus / prevention & control

Substances

  • Anti-Inflammatory Agents
  • Dexamethasone