He Feng, Ming Panpan, Zhu Hong, Zhu Wenqing
Department of Oral Special Consultation, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China.
State Key Laboratory Cultivation Base of Research, Prevention and Treatment for Oral Diseases, Nanjing, People's Republic of China.
BMC Oral Health. 2025 Jul 2;25(1):1012. doi: 10.1186/s12903-025-06355-x.
Tooth implant treatment is frequently accompanied by postoperative pain and swelling. While dexamethasone is known to mitigate these symptoms, the optimal administration method remains unclear. This study compared the effects of different administration methods of dexamethasone on alleviating pain and swelling after flap implantation surgery.
Patients with dentition defects requiring implant treatment were grouped according to whether dexamethasone was administered via submucosal injection during the surgery or orally after the surgery. Pain and swelling levels were measured and recorded within 72 h post-operation, along with potential influencing factors including gender, age, number of implants, duration of surgery, oral hygiene status, preoperative anxiety level, and pain sensitivity score using Pain Sensitivity Questionnaire (PSQ). The differences in pain and swelling between the two groups at different time points were compared, and Pearson correlation and multiple linear regression analyses were conducted on the potential influencing factors.
While pain and swelling scores in the submucosal injection group were consistently lower than in the oral group at all time points, these intergroup differences did not reach statistical significance (P > 0.05). However, significant time effects were observed within each group (P < 0.05), with swelling reduction occurring earlier in the submucosal injection group (24 h vs 48 h). Correlation and regression analyses showed that higher scores in PSQ-total and preoperative anxiety level, as well as a greater number of implants, were associated with higher pain levels, while postoperative swelling was significantly greater in females than in males.
Intraoperative submucosal dexamethasone was associated with earlier swelling reduction compared to oral administration, though both methods showed comparable pain control. These findings suggest a potential clinical advantage for the intraoperative route that warrants further investigation.
This study was registered on Chinese Clinical Trial Registry, and the trial registration number is ChiCTR2500098816. Registered March 13, 2025- Retrospectively registered, https://www.chictr.org.cn/bin/project/edit?pid=257854 .
牙齿种植治疗术后常伴有疼痛和肿胀。虽然已知地塞米松可减轻这些症状，但其最佳给药方式仍不明确。本研究比较了地塞米松不同给药方式对减轻瓣植入术后疼痛和肿胀的效果。
将需要种植治疗的牙列缺损患者，根据术中是否通过黏膜下注射给予地塞米松或术后口服地塞米松进行分组。在术后72小时内测量并记录疼痛和肿胀程度，以及潜在影响因素，包括性别、年龄、种植体数量、手术时长、口腔卫生状况、术前焦虑水平，以及使用疼痛敏感性问卷（PSQ）得出的疼痛敏感性评分。比较两组在不同时间点的疼痛和肿胀差异，并对潜在影响因素进行Pearson相关性分析和多元线性回归分析。
虽然黏膜下注射组在所有时间点的疼痛和肿胀评分始终低于口服组，但这些组间差异未达到统计学意义（P>0.05）。然而，每组内均观察到显著的时间效应（P<0.05），黏膜下注射组肿胀减轻出现得更早（24小时对48小时）。相关性和回归分析表明，PSQ总分和术前焦虑水平得分较高，以及种植体数量较多，与较高的疼痛水平相关，而术后女性的肿胀明显大于男性。
与口服给药相比，术中黏膜下地塞米松与肿胀减轻更早相关，尽管两种方法在疼痛控制方面表现相当。这些发现表明术中给药途径具有潜在的临床优势，值得进一步研究。
本研究在中国临床试验注册中心注册，试验注册号为ChiCTR2500098816。2025年3月13日注册——回顾性注册，https://www.chictr.org.cn/bin/project/edit?pid=257854 。
