Pre-emptive effect of dexamethasone and diclofenac sodium associated with codeine on pain, swelling, and trismus after third molar surgery: a split-mouth randomized triple-blind controlled clinical trial

Publication date: Available online 14 June 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Thiago César Lima, Elizabete Bagordakis, Saulo Gabriel Moreira Falci, Cássio Roberto Rocha dos Santos, Marcos Luciano Pimenta Pinheiro
PurposeTo compare the effect of dexamethasone 8 mg and diclofenac sodium 50 mg associated with codeine 50 mg on the control of pain, swelling, and trismus following the extraction of impacted third molars.MethodsFifteen healthy patients with a mean age of 22.8 (standard deviation 12.62) years received a single oral dose of either drug 1 h prior to each surgical procedure (left and right teeth). At 24, 48, and 72 h following surgery, swelling was determined using linear measurements on the face and trismus was determined by maximal mouth opening. Postoperative pain was self-recorded by the patients using a numerical rating scale at 24-h intervals for a period of 72 h. Data analysis involved descriptive statistics, and Shapiro-Wilk, Wilcoxon, and paired t tests (p < 0.05).ResultsDexamethasone controlled pain (p = 0.016) and edema (p = 0.08) better than diclofenac sodium associated with codeine, within 48 hours. No statistically significant differences were found between drugs in regard to trismus and consumption of rescue analgesics (acetaminophen).ConclusionThe results of this study suggest that pre-emptive administration of dexamethasone 8 mg showed better control of pain and swelling in bilateral extractions third impacted mandibular molars.



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