Effect of different administration methods of dexamethasone on postoperative pain and swelling following implant flap surgery: A randomized controlled trial of patient-centered outcomes.

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

TRIAL REGISTRATION

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 .