Efficacy of Dexamethasone in Reducing Postoperative Symptoms of the Surgical Extraction of Impacted Third Molars

Sangita Kalita; Rohit Goyal; Hem Kumar; Divya Yadav; Lakhan Talreja; Pooja Jaiswal

doi:10.7759/cureus.72035

Efficacy of Dexamethasone in Reducing Postoperative Symptoms of the Surgical Extraction of Impacted Third Molars

Cureus. 2024 Oct 21;16(10):e72035. doi: 10.7759/cureus.72035. eCollection 2024 Oct.

Authors

Sangita Kalita¹, Rohit Goyal¹, Hem Kumar¹, Divya Yadav¹, Lakhan Talreja¹, Pooja Jaiswal²

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Maharaja Ganga Singh Dental College and Research Centre, Sri Ganganagar, IND.
² Department of Oral and Maxillofacial Surgery, Surendera Dental College and Research Institute, Sri Ganganagar, IND.

Abstract

Introduction: Among anti-inflammatory medications, dexamethasone has an extended half-life and strong effects, particularly in oral surgical procedures. Administering dexamethasone helps reduce discomfort and inflammation and enhances recovery by minimizing postoperative complications. This study aimed to assess the effectiveness of dexamethasone administered before and after surgery in reducing postoperative pain and swelling and relieving mouth opening following the surgical removal of impacted third molars.

Material and methods: An observational, prospective cohort study was conducted on 60 patients who had already been administered with dexamethasone pre- and postoperatively and were divided into two non-randomized groups. The first group had received 8 mg of dexamethasone intramuscularly one hour before the surgical removal of impacted third molars, while the second group had received the same dose immediately after surgery. The observer evaluated pain, swelling, and mouth opening in both groups at baseline (preoperative) and on the second and seventh days after the surgical extraction of impacted third molars.

Results: In terms of swelling, the second postoperative day showed a significant difference between the two groups (p<0.05). Group 2 exhibited more pronounced swelling (140.34±10.11 mm) than group 1 (127.50±13.29 mm), with a p-value of 0.006. Pain evaluation on the second day revealed that group 2 experienced notably higher levels of discomfort (3.60±0.99) than group 1 (3.33±0.98), with a p-value of 0.0463. While there was no significant variation in mouth opening before the operation (p=0.288), the second postoperative day showed a marked difference. Group 1 demonstrated a significantly less reduction in mouth opening (45.69±6.06 mm) than group 2 (38.69±4.40 mm), with a p-value of 0.001.

Conclusion: The study has shown that administering dexamethasone before surgery led to better management of swelling, pain, and mouth opening after the procedure, compared to giving it postoperatively. These results supported the current clinical practice of utilizing corticosteroids prior to surgery to enhance patient outcomes following third molar extraction.

Keywords: dexamethasone; impaction; mouth opening; pain; swelling; third molar.