title: Evaluation of postoperative discomfort following third molar surgery using submucosal dexamethasone - a randomized observer blind prospective study.
abstract: BACKGROUND
  Surgical removal of impacted lower third molar is still the most frequent procedure done by Oral and Maxillofacial surgeons and is often associated with pain, swelling and trismus. These postoperative sequelae can cause distress to the patient as a result of tissue trauma and affect the patient's quality of life after surgery. Use of antiseptic mouthwashes, drains, muscle relaxants, cryotherapy, antibiotics, corticosteroids and physiotherapy seems to decrease postoperative discomfort. Among them corticosteroids are well-known adjuncts to surgery for suppressing tissue mediators of inflammation, thereby reducing transudation of fluids and lessening edema. The rationale of this study is to determine the effectiveness of submucosal injection of dexamethasone in reducing postoperative discomfort after third molar surgery.
  
  
  METHODS
  100 patients requiring surgical removal of third molar under local anesthesia were randomly divided into 2 groups, group I receiving 4 mg dexamethasone as submucosal injection and the control group II received no steroid administration. Facial swelling was quantified by anatomical facial landmarks. Furthermore, pain and patient satisfaction, as well as neurological score and the degree of mouth opening were observed from each patient.
  
  
  RESULTS
  Patients receiving dexamethasone showed significant reduction in pain, swelling, trismus, a tendency to less neurological complaints and improved quality of life compared with the control group.
  
  
  CONCLUSIONS
  Submucosal injection of dexamethasone is more efficient to manage postoperative discomfort after removal of third molars compared to no steroid administration.
authors: Department of Oral and Maxillofacial Surgery, King Edward University, Lahore, Pakistan.
authors: Riaz
authors: R
authors: Warraich
authors: Muhammad
authors: M
authors: Faisal
authors: Madiha
authors: M
authors: Rana
authors: Anjum
authors: A
authors: Shaheen
authors: Nils-Claudius
authors: NC
authors: Gellrich
authors: Majeed
authors: M
authors: Rana
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D059925:Anatomic Landmarks; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007267:Injections / Q000379:methods; D008297:Male; D008334:Mandible / Q000601:surgery; D008964:Molar, Third / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D011862:Radiography, Panoramic; D016037:Single-Blind Method; D014081:Tooth Extraction / Q000009:adverse effects*; D014095:Tooth, Impacted / Q000601:surgery*
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone