A comparative study on the efficacy of submucosal injection of dexamethasone versus methylprednisolone in reducing post operative sequelae following third molar surgery

Publication date: Available online 8 June 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Daniel Lim, Wei Cheong Ngeow
PurposeTo compare the efficacy of pre-operative submucosal injection of 4mg dexamethasone and 40mg methylprednisolone in reducing post-operative sequalae following surgical removal of impacted mandibular third molar.MethodsSixty five patients who required surgical removal of impacted mandibular third molar Class 2 or Position B (Pell & Gregory Classification) were included in this prospective, randomized, and double-blinded study. Patients were randomly assigned to three groups: dexamethasone, methylprednisolone or placebo control. Surgery was performed under local anesthesia. Baseline measurements were done pre-operatively and subsequent assessment were made on post-operative day 1, 2, 5 and 7 to measure post-operative facial swelling using 2 linear measurements, inter-incisal mouth opening width, and visual analog scale for pain. The amount of analgesic consumed was recorded. Wound healing was also assessed on post operative day 7. Descriptive and multivariate statistics were computed and the significance was set at P < 0.05.ResultsBoth methylprednisolone and dexamethasone significantly reduced swelling and trismus (Kruskal-Wallis test: P<0.05), while the methylprednisolone group experienced significantly less pain (Kruskal-Wallis test: P< 0.05) and consumed less analgesic (Chi-square test: P < 0.05) during the early post-operative days.ConclusionThe finding suggests that a single pre-operative dose of dexamethasone or methylprednisolone was equally effective in reducing post-operative swelling and trismus. Pain control by these corticosteroids, however, was variable.



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