Altindal Dicle, Alsafadi Anas, Alshujaa Basem, Talmac Ahmet Cemil, Ege Bilal, Calisir Metin, Alpaslan Nazli Zeynep
Faculty of Dentistry, Department of Periodontology, Van Yuzuncu Yil University, Van, Turkey.
Special Dental Clinic, Istanbul, Turkey.
Clin Oral Investig. 2024 Dec 4;28(12):681. doi: 10.1007/s00784-024-06076-5.
The aim of this study is to evaluate the effectiveness of submucosal 8 mg (2 mL) dexamethasone (DEX) on postoperative pain, swelling, chewing efficiency, trismus, healing, and discomfort after periodontal flap surgery (PFS).
In this randomized controlled split-mouth study, 25 patients underwent PFS in the mandible, whereby postoperative, submucosal DEX was injected to the surgical field to the test group and submucosal normal saline was applied to the control group. Pain was evaluated using the Visual Analogue Scale (VAS) and the 101-point numeric rate scale in the first 8 h after PFS and on the 2nd, 3rd, 4th, and 7th days, whereas swelling, chewing efficiency, trismus, healing, discomfort and analgesic consumption were evaluated preoperatively on the 1st, 2nd and 7th days.
In the intergroup evaluation, the VAS-7th hour value of the test group was lower than the control group(p < 0.05). On the 1st day, it was observed that there was less swelling and more chewing efficiency in the test group than in the control group(p < 0.05). When time-dependent changes were examined, the decrease in mouth opening due to trismus in the control group was greater than that in the test group on the 1st and the 2nd days compared to the preoperative period(p < 0.05). Finally, postoperative healing, discomfort, and analgesic consumption were similar between groups.
Within the limits of this study, the submucosal DEX may be an effective protocol in the management of pain, swelling, and trismus after PFS.
Our findings shed light on the possible effects of DEX after PFS.
This study was registered on ClinicalTrials.gov (NCT06119893).
本研究旨在评估牙周翻瓣术（PFS）后黏膜下注射8mg（2mL）地塞米松（DEX）对术后疼痛、肿胀、咀嚼效率、牙关紧闭、愈合及不适的影响。
在这项随机对照的半口研究中，25例患者接受下颌骨的PFS，术后在试验组的手术区域黏膜下注射DEX，对照组则黏膜下注射生理盐水。在PFS后的前8小时以及第2、3、4和7天，使用视觉模拟量表（VAS）和101分数字评分量表评估疼痛，而在术前第1、2和7天评估肿胀、咀嚼效率、牙关紧闭、愈合、不适及镇痛药消耗情况。
组间评估中，试验组第7小时的VAS值低于对照组（p<0.05）。在第1天，观察到试验组的肿胀程度低于对照组，咀嚼效率高于对照组（p<0.05）。检查时间依赖性变化时，与术前相比，对照组在第1天和第2天因牙关紧闭导致的开口度下降幅度大于试验组（p<0.05）。最后，两组术后愈合、不适及镇痛药消耗情况相似。
在本研究范围内，黏膜下注射DEX可能是PFS后疼痛、肿胀和牙关紧闭管理的有效方案。
我们的研究结果揭示了PFS后DEX的可能作用。
本研究已在ClinicalTrials.gov（NCT06119893）注册。
