Evaluation of Dexamethasone Irrigation in Third Molar Surgery and Reduction in Pain and Post-Operative Edema – A Split Mouth Study

Abstract

Background: Disimpaction of third molars is a routine procedure performed by the oral and maxillofacial surgeon. This procedure embraces keen expertise from the surgeon to facilitate a smooth post-operative sequela. The study employs the use of diluted dexamethasone locally as intraoperative irrigation solution compared to saline being the gold standard. Aim: The study aims to evaluate the use of dexamethasone irrigation in third molar surgery and observe the reduction of postoperative pain and edema. Materials and Methods: The study consisted of 20 participants with bilateral impacted horizontal mandibular impacted teeth postion B class 2 (Pell and Gregory) who has received diluted dexamethasone with saline solution on one side(Group D) and plain saline (Group C) on one side. The first surgery was followed by the second tooth removal surgery after minimum of 15 days. The post-operative edema at both the surgeries was measured after 48 hours. The post-operative pain measurement was carried out using the VAS score at 8,16,24,48 hours post operatively. Patients were asked to maintain a 4 part diary post operatively for the same.

Results: A total of 12 males and 8 females were included in the study with a mean age of 27.35 years. The average swelling on the side receiving plain saline solution as irrigant was 10.29±0.81cm and that in the dexamethasone group 9.96±0.68cm with p=0.171. The average pain score at 8,16,24,48 hour period was found to be 5.75, 4.5, 2.7, 2.2 in Group C and 5, 2.75, 2.25, 1.6 in group D respectively with a respective p values of: p= 0.78, p=0.000, p=0.184 and p= 0.009 repectively. Conclusion: Intraoperative dexamethasone irrigation provides significant reduction of the postoperative pain and helps in managing the post-operative sequale of the disimpaction of teeth. Further research could facilitate the routine use of dexamethasone in clinical practice.