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地塞米松肺泡内给药对下颌阻生第三磨牙拔除后肿胀、牙关紧闭和疼痛的影响:一项随机、双盲临床试验。

Effect of the intra-alveolar administration of dexamethasone on swelling, trismus, and pain after impacted lower third molar extraction: a randomized, double-blind clinical trial.

机构信息

Avenida dos Portugueses, s/n, Cidade Universitária Dom Delgado CEP 65085-580, São Luís, MA, Brazil

出版信息

Med Oral Patol Oral Cir Bucal. 2022 Jan 1;27(1):e51-e58. doi: 10.4317/medoral.24894.

Abstract

BACKGROUND

To evaluate the efficacy of intra-alveolar administration of dexamethasone 4 mg in the control of edema, trismus, and pain resulting from the extraction of impacted lower third molars and the drug permeability through the oral mucosa by in silico prediction.

MATERIAL AND METHODS

The randomized, double-blind, split-mouth clinical trial included patients who had both impacted lower third molars in equivalent positions. Hemiarches were divided into control side when dexamethasone was administered orally and experimental side when dexamethasone was administered using the intra-alveolar route. Patients were evaluated considering edema, trismus, and pain. The permeability of dexamethasone through the oral mucosa was assessed by in silico prediction. Student's t-test was selected for comparative analysis of edema and trismus, and the chi-square test analyzed the distribution of postoperative pain between the sides.

RESULTS

There were no significant differences between the routes of administration in measuring symptoms between the pre and postoperative times (p>0.05). In silico prediction suggested that dexamethasone molecular characteristics facilitate intra-alveolar administration.

CONCLUSIONS

Intra-alveolar administration had similar efficacy to oral administration in controlling symptoms of post-surgical inflammation of impacted lower third molars.

摘要

背景

通过计算机预测,评估肺泡内给予地塞米松 4mg 对控制下颌阻生第三磨牙拔除术后水肿、牙关紧闭和疼痛的疗效,并评估药物经口腔黏膜的渗透性。

材料与方法

本随机、双盲、分侧临床研究纳入了具有相同位置下颌阻生第三磨牙的患者。将半口牙弓分为接受地塞米松口服给药的对照组和接受肺泡内给药的实验组。根据水肿、牙关紧闭和疼痛情况对患者进行评估。通过计算机预测评估地塞米松经口腔黏膜的渗透性。采用 Student's t 检验比较水肿和牙关紧闭的测量值,采用卡方检验分析两侧术后疼痛的分布。

结果

两种给药途径在术前和术后各时间点的症状测量值之间无显著差异(p>0.05)。计算机预测表明,地塞米松的分子特征有利于肺泡内给药。

结论

肺泡内给药在控制下颌阻生第三磨牙拔除术后炎症症状方面与口服给药具有相似的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/289c/8719784/3f9949ab7ac6/medoral-27-e51-g001.jpg

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