The Efficacy of Preemptive Submucosal Dexamethasone at Temporalis Muscle and Medial Pterygoid Muscle in Preventing Trismus Following Mandibular Third Molar Surgery: A Comparative Split mouth Study

Abstract

Introduction

The profound antiinflammatory properties of dexamethasone alleviated trismus with reducing the production of chemical mediators, edema, and pain. Similarly, preemptive submucosal injection of dexamethasone for the treatment of surgery-induced edema was regarded as a safe, effective, and uncomplicated method of pain management. To evaluate postoperative complications, submucosal dexamethasone was compared to placebo in the temporalis and medial pterygoid muscles of the same patient at 2-week intervals after surgery on the patient's third mandibular molars.

Materials and Methods

Thirty patients (20-40 years old, mean age: 25) with bilateral class II position B/C soft tissue-covered impactions participated in a randomised, triple-blind study. Using the sequentially-numbered, opaque/unclear, tightly sealed envelopes (SNOSE) technique, Subject/patients were randomly assigned/allocated to either the D (right/left side) or P (right/left side) research groups. Patients who had undergone bilateral procedures separated by two weeks recorded with pain, swelling, and mouth opening periodically.

Results

The comparison between Groups D & P focused on assessing Swelling, Mouth opening & Pain scores. GroupD exhibited superior outcomes in terms of reduced swelling, improved mouth opening, & decreased pain compared to GroupP. Statistical tests, including the Friedman examination/test, Mann WhitneyU examination/test, and Repeated Measure ANOVA, were employed to analyze/examine the variations/differences between groups at various time frame. The statistical examination/analysis confirmed that Group D consistently outperformed Group P in the aspects of swelling reduction, enhanced mouth opening, and postoperative pain relief.

Conclusion

By conclusion, preoperative administration of steroids reduces postoperative trismus and improves patient outcomes. Dexamethasone administered submucosally reduces swelling and restores mouth opening. The benefits of multiple postoperative dosages must be confirmed in studies with larger sample sizes.