Comparison Of The Effect Of Two-dose And One-dose Dexamethasone On Post-inflammatory Complications In Third Molar Surgery

Abstract
Objective: This study aimed to compare the effects of administration of both preoperative and postoperative dexamethasone with that of only preoperative dexamethasone, and with that of a no dexamethasone (control) on reduction of pain, trismus and swelling following lower impacted 3rd molar surgery. Methods: A prospective randomized controlled double blinded study at the dental clinic of Babcock University Teaching Hospital on 84 subjects that were divided into 3 groups. Group A had both preoperative and postoperative dexamethasone, while group B had only preoperative dexamethasone and group C was a 'no dexamethasone' group. Differential mean facial swelling, mouth opening and pain scores were compared within the three groups. Results: The pattern of postoperative swelling, pain and trismus showed a general decrease from day 1 to 7, with group A showing the highest rate of decrease. On postoperative day 1, there was a difference between the swelling of groups A and C (p =0.01) and groups B and C (p = 0.02) and also between the pain scores of group A and group C (p = 0.01). On postoperative day 3, there was only a difference between the swelling of groups A and C (p = 0.02), but not in pain and trismus and no difference was seen in all the measured variables on postoperative day 7. Conclusion: Administration of a combination of both preoperative and post operative dexamethasone to reduce the postoperative inflammatory sequelae that follows lower third molar surgery gave better results than administration of only a single preoperative dose.