Route-Based Evaluation Of Preoperative Dexamethasone Administration For Mandibular Third Molar Removal: A Quasi-Experimental Analysis

Abstract

Introduction:

Dexamethasone is widely used to minimize postoperative pain, swelling, and trismus following third molar surgery; however, the optimal route of administration remains debated.

Objective:

To compare the clinical effectiveness of submucosal, intramuscular, and intravenous administration of dexamethasone in reducing postoperative complications after mandibular third molar extraction.

Methods:

This randomized controlled study was conducted at a private hospital in Multan from January to June 2024 after obtaining IRB approval. Thirty patients indicated for surgical removal of impacted mandibular third molars were randomly assigned to two groups (n = 15). Group A received 8 mg dexamethasone via the submucosal route at the surgical site, while Group B received the same dose through the systemic route (intramuscular or intravenous). Postoperative pain (VAS), facial swelling (linear measurement), and mouth opening (interincisal distance) were evaluated at 24 hours, 48 hours, and 7 days postoperatively. Data were analyzed using SPSS 26 with significance set at p < 0.05.

Results:

The mean age of participants was 26.8 ± 5.7 years, with an equal gender distribution. Both groups showed statistically significant reductions in postoperative pain, swelling, and trismus (p < 0.05). The submucosal group exhibited superior outcomes in pain and facial swelling reduction, particularly within the first 48 hours, though differences were not statistically significant.

Conclusion:

All routes of dexamethasone administration effectively reduced postoperative discomfort following third molar surgery. The submucosal route provided a slight clinical advantage, likely due to its localized anti-inflammatory effect, making it a practical and minimally invasive alternative for routine use.