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Effect of submucosal and intramuscular dexamethasone on postoperative sequelae after third molar surgery: comparative study.
MedLine Citation:
PMID:  21035237     Owner:  NLM     Status:  In-Data-Review    
We compared the effects of dexamethasone sodium phosphate given submucosally and intramuscularly on postoperative complications after removal of impacted lower third molars in a preliminary randomised prospective clinical trial. Thirty patients, each of whom required removal of a single impacted mandibular third molar under local anaesthesia, were randomly allocated to one of 3 groups of 10 each. The 2 experimental groups were given dexamethasone 4mg submucosally or intramuscularly, and the control group had no steroid. Facial swelling and maximal interincisal distance were measured by an independent examiner at baseline (preoperatively), and at 1, 3, and 7 days postoperatively. Pain was measured by counting the number of rescue analgesic tablets taken, and from the patients' response to a visual analogue scale (VAS). The mean age of the 16 men and 14 women was 27 years (range 20-48). Both dexamethasone groups showed significant reductions in swelling (p<0.001) and in pain (p<0.05) compared with the control group at all intervals. Submucosal dexamethasone resulted in significantly less trismus than controls on day 1 postoperatively (p=0.04), but there were no significant differences among the groups at the other times. The effects of the two routes of dexamethasone were comparable for all variables. There were no cases of alveolar osteitis or wound infection. Dexamethasone 4mg given submucosally is an effective way of minimising swelling, trismus, and pain after removal of impacted lower third molars, and is comparable with the intramuscular route. It offers a simple, safe, painless, non-invasive, and cost-effective treatment in moderate and severe cases.
Omer Waleed Majid; Waseem Khalid Mahmood
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Publication Detail:
Type:  Journal Article     Date:  2010-10-29
Journal Detail:
Title:  The British journal of oral & maxillofacial surgery     Volume:  49     ISSN:  1532-1940     ISO Abbreviation:  Br J Oral Maxillofac Surg     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8405235     Medline TA:  Br J Oral Maxillofac Surg     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  647-52     Citation Subset:  D; IM    
Copyright Information:
Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Mosul, Mosul, Nineveh, Iraq.
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