Sharma Divashree, Tripathi Geeta Mishra, Tiwari Rajnarayan, Mishra Ambrish
Department of Dentistry, Shyam Shah Medical College, Rewa, Madhya Pradesh, India.
Department of Pharmacology, Shyam Shah Medical College, Rewa, Madhya Pradesh, India.
Natl J Maxillofac Surg. 2024 May-Aug;15(2):288-294. doi: 10.4103/njms.njms_4_23. Epub 2024 Jul 24.
To compare the impact of submucosal dexamethasone (4 mg) administered after the onset of local anesthesia on postoperative discomfort after third molar surgery and compare the parameters with a control group that did not receive the drug.
A total of 60 patients indicated for surgical removal of impacted mandibular third molars (mesioangular, Class II or III, and position B or C) were randomly divided into two groups of 30 patients each. After the onset of local anesthesia, the first group (Group A) received a submucosal injection of 4 mg dexamethasone adjacent to the surgical site, and the control group (Group B) received no drug. Pain, swelling, and trismus were recorded at follow-up visits on the 1, 2, and 7 postoperative days. Assessment of postoperative discomfort was performed by evaluating responses through a modified postoperative symptom severity scale questionnaire, which was administered to the patients on the 7 postoperative day.
The difference in subjective pain values and the mean number of analgesics consumed was not significant between the groups. The difference in postoperative swelling was statistically significant on the 1, 2 ( < 0.0001), and 7 postoperative days ( = 0.0152). The difference in postoperative trismus was highly significant on 1 and 2 postoperative days ( < 0.0001). The difference in the mean total quality of life (QOL) score, Eating, Appearance, Daily activity subscale ( < 0.0001), and Social Isolation subscale ( = 0.0002) was statistically significant between both groups.
It was found that the administration of submucosal dexamethasone resulted in significantly lesser postoperative swelling and trismus and better QOL outcomes.
比较局部麻醉开始后给予黏膜下注射地塞米松（4毫克）对第三磨牙手术后术后不适的影响，并将各项参数与未接受该药物的对照组进行比较。
总共60例拟行下颌阻生第三磨牙（近中阻生、II类或III类，位置B或C）拔除术的患者被随机分为两组，每组30例。局部麻醉开始后，第一组（A组）在手术部位附近接受4毫克地塞米松的黏膜下注射，对照组（B组）不接受任何药物。在术后第1、2和7天的随访中记录疼痛、肿胀和张口受限情况。术后第7天通过改良的术后症状严重程度量表问卷评估患者的反应，以进行术后不适评估。
两组之间主观疼痛值和平均镇痛药消耗量的差异不显著。术后第1、2天（<0.0001）和第7天（=0.0152）的术后肿胀差异具有统计学意义。术后第1和2天的术后张口受限差异高度显著（<0.0001）。两组之间的平均总生活质量（QOL）评分、饮食、外观、日常活动子量表（<0.0001）和社交隔离子量表（=0.0002）的差异具有统计学意义。
发现黏膜下注射地塞米松可显著减轻术后肿胀和张口受限，并改善生活质量结果。
