title: A randomized clinical trial to compare the efficacy of submucosal aprotinin injection and intravenous dexamethasone in reducing pain and swelling after third molar surgery: a prospective study.
abstract: OBJECTIVE
  The purpose of this study was to compare two different groups of drugs, aprotinin and dexamethasone for its efficacy in reducing post operative swelling and pain after third molar surgery.
  
  
  METHODS
  Fifty consecutive patients requiring surgical removal of single mandibular third molar (class II position B) under local anesthesia were randomly divided into two groups, each group consisting of 25 patients. One group was administered 8 mg dexamethasone through intravenous route pre-operatively. The other group received 1 ml of Aprotinin through submucosal route in operating area after the onset of local anesthesia. Swelling was assessed by measuring facial contours at baseline and at 1st, 3rd and 7th post-operative days. Pain was measured on the 1st, 3rd and 7th post-operative days using visual analog scale. Based on statistical analysis (paired t test and Wilcoxon's signed ranking test), the results showed statistically significant difference in post operative swelling and pain on 3rd postoperative day in dexamethasone group as compared to aprotinin group.
  
  
  RESULTS
  The results of present study showed a similar reduction in the severity of pain and swelling at the aprotinin and dexamethasone sites on 1st and 7th postoperative day. It was also noticed that the aprotinin promoted a greater reduction of swelling and pain on 3rd postoperative day.
  
  
  CONCLUSIONS
  It appeared that, benefits of aprotinin against the risks of dexamethasone and its efficacy in controlling pain and swelling after third molar surgery makes aprotinin to be a valuable alternative to dexamethasone.
authors.affiliation: PB's Indian Academy of Craniofacial Research (PBIACR), Gangashri Nilaya, Basaveshwara Nagar, Shahapur, Yadgir, 585223 Karnataka India ; Department of Oral and Maxillofacial Surgery, Navodaya Dental College and Hospital, Raichur, Karnataka India.
authors.forename: Gururaj
authors.initials: G
authors.lastname: Arakeri
authors.affiliation: Department of Oral Maxillofacial Surgery, Bapuji Dental College and Hospital, Davangere, Karnataka India.
authors.forename: Kirthi Kumar
authors.initials: KK
authors.lastname: Rai
authors.affiliation: Department of Oral Maxillofacial Surgery, Bapuji Dental College and Hospital, Davangere, Karnataka India.
authors.forename: H R
authors.initials: HR
authors.lastname: Shivakumar
authors.affiliation: Department of Oral Maxillofacial Surgery, Bapuji Dental College and Hospital, Davangere, Karnataka India.
authors.forename: Bhushan
authors.initials: B
authors.lastname: Jayade
keywords: Aprotinin; Dexamethasone; Pain; Submucosal injection; Swelling; Third molar