Latt Maung Maung, Kiattavorncharoen Sirichai, Boonsiriseth Kiatanant, Pairuchvej Verasak, Wongsirichat Natthamet
Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
Insein General Hospital, Yangon, Myanmar.
J Dent Anesth Pain Med. 2016 Jun;16(2):95-102. doi: 10.17245/jdapm.2016.16.2.95. Epub 2016 Jun 30.
Surgery on the lower impacted third molar usually involves trauma in the highly vascularized loose connective tissue area, leading to inflammatory sequelae including postoperative pain, swelling, and general oral dysfunction during the immediate post-operative phase. This study aimed to investigate the effectiveness of preoperative injection of a single dose of 8 mg dexamethasone for postoperative pain control in lower third molar surgery.
A controlled, randomized, split-mouth, prospective study involving lower third molar surgery was performed in 31 patients. The randomized sampling group was preoperatively injected, after local anesthesia, with a single dose of dexamethasone (8 mg in 2 ml) through the pterygomandibular space; 2 ml of normal saline (with no dexamethasone) was injected as a placebo.
The pain VAS score was significantly different on the day of the operation compared to the first post-operative day (P = 0.00 and 0.01, respectively), but it was not significantly different on the third and seventh postoperative day between the control and study groups. There was a significant reduction in swelling on the second postoperative day, and a difference between the second postoperative day and baseline value in the study group (P < 0.05). Trismus was highly significantly different on the second postoperative day and between baseline and second postoperative day between the groups (P = 0.04 and 0.02, respectively). Descriptive statistics and independent-samples t- test were used to assess the significance of differences.
Injection of 8 mg dexamethasone into the pterygomandibular space effectively reduced the postoperative pain and other postoperative sequalae.
下颌阻生第三磨牙手术通常会在血管丰富的疏松结缔组织区域造成创伤，导致术后早期出现包括疼痛、肿胀和口腔功能障碍等炎症后遗症。本研究旨在探讨术前注射单剂量8毫克地塞米松对下颌第三磨牙手术术后疼痛控制的有效性。
对31例患者进行了一项涉及下颌第三磨牙手术的对照、随机、双侧对照、前瞻性研究。随机抽样组在局部麻醉后，通过翼下颌间隙术前注射单剂量地塞米松（2毫升含8毫克）；注射2毫升生理盐水（不含地塞米松）作为安慰剂。
与术后第一天相比，手术当天疼痛视觉模拟评分（VAS）有显著差异（分别为P = 0.00和0.01），但对照组和研究组术后第三天和第七天无显著差异。术后第二天肿胀明显减轻，研究组术后第二天与基线值有差异（P < 0.05）。两组术后第二天张口受限情况以及基线与术后第二天之间有高度显著差异（分别为P = 0.04和0.02）。采用描述性统计和独立样本t检验评估差异的显著性。
向翼下颌间隙注射8毫克地塞米松可有效减轻术后疼痛和其他术后后遗症。
