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在减少阻生第三磨牙手术后的后遗症方面,咬肌内注射地塞米松比三角肌内注射更好吗?一项随机临床研究。

IS Intra-masseteric Dexamethasone Better than Intra-deltoid Injection in Reducing Post-operative Sequelae Following Impacted Third Molar Surgery?: A Randomized Clinical Study.

作者信息

Gupta Arpit, Mohanty Sujata, Sharma Pankaj, Chaudhary Zainab, Verma Anjali, Hemavathy S

机构信息

Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, MAMC Campus, Bahadur Shah Zafar Marg, New Delhi, 110002 India.

出版信息

J Maxillofac Oral Surg. 2024 Oct;23(5):1226-1233. doi: 10.1007/s12663-024-02308-z. Epub 2024 Aug 13.

Abstract

AIM

The post-operative sequelae of third molar surgical extractions need to be controlled in order to reduce patient morbidity. Dexamethasone is a well-researched drug which has established its merit as an anti-inflammatory agent. The aim of this randomized clinical study was to compare the patient-centric outcomes after pre-emptive intramuscular injection of dexamethasone into the masseter and deltoid, respectively.

MATERIALS AND METHODS

The outcomes measured were pain, facial swelling and mouth-opening postoperatively on Day 1, 3 and 7. The subjects were randomly divided into two groups. Group 1 received an intra-oral injection of 8 mg of dexamethasone into the masseter muscle and a placebo injection of distilled-water into the deltoid muscle 2 h before surgical removal of impacted mandibular third molar. Group 2 received an intra-oral placebo injection of distilled-water into masseter muscle and an 8 mg injection of dexamethasone into deltoid muscle.

RESULTS

On comparison, Group 1 patients experienced statistically significant less pain (VAS score on day 1, 3, and 7), facial swelling (day 1, 3), and restricted mouth-opening (day 1, 3).

CONCLUSION

The study concluded that pre-emptive dexamethasone injection, at masseter or deltoid, is helpful in reducing post-operative sequelae of mandibular third molar extraction. However, the immediate post-operative outcomes were found to be better mitigated when the injection was administered locally into masseter muscle.

摘要

目的

为降低患者术后发病率,需控制第三磨牙外科拔除术后的后遗症。地塞米松是一种经过充分研究的药物,已确立其作为抗炎药的功效。本随机临床研究的目的是比较分别在咬肌和三角肌进行地塞米松肌肉注射预处理后以患者为中心的结局。

材料与方法

测量的结局指标为术后第1、3和7天的疼痛、面部肿胀和张口度。将受试者随机分为两组。第1组在手术拔除下颌阻生第三磨牙前2小时,于咬肌内注射8毫克地塞米松,并于三角肌内注射蒸馏水作为安慰剂。第2组在咬肌内注射蒸馏水作为安慰剂,并于三角肌内注射8毫克地塞米松。

结果

相比之下,第1组患者在疼痛(第1、3和7天的视觉模拟评分)、面部肿胀(第1、3天)和张口受限(第1、3天)方面的统计学差异显著更小。

结论

该研究得出结论,在咬肌或三角肌进行地塞米松预处理注射有助于减少下颌第三磨牙拔除术后的后遗症。然而,发现当注射剂局部注射到咬肌中时,术后即刻结局能得到更好的缓解。

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本文引用的文献

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Current thinking in lower third molar surgery.下颌第三磨牙手术的当前思路。
Br J Oral Maxillofac Surg. 2022 Apr;60(3):257-265. doi: 10.1016/j.bjoms.2021.06.016. Epub 2021 Jul 30.
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