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European Journal of Oral and Maxillofacial Surgery 2019 December;3(3):55-8

DOI: 10.23736/S2532-3466.19.00177-2


language: English

Effect of dexamethasone using two doses to evaluate postoperative trismus in the patients after impacted mandibular third molar extraction

Rozi AFSAR 1, Tahir U. KHAN 2 , Muhammad ISHFAQ 1, Sana WAZIR 2, Syed A. SHAH 1, Muhammad FAROOQ 3

1 Peshawar Dental College and Hospital, Peshawar, Pakistan; 2 Lady Reading Hospital, Peshawar, Pakistan; 3 Bannu Medical College, Bannu, Pakistan

BACKGROUND: Removal of the mandibular third molar is one of the most frequent surgical procedures for dental or oral and maxillofacial surgeons. In addition to pain and swelling, trismus is the commonest complication for the patients. The objective of this study was to compare the outcome of 4mg and 8mg oral dexamethasone preoperatively for decrease in trismus, following impacted mandibular third molar surgery.
METHODS: This was randomized controlled clinical trial of 100 patients which were divided into two groups by using random number table, with patients arriving at even numbers in group A and patients arriving at odd numbers in group B. Maximum inter incisal opening for each patient was recorded preoperatively. Group A received a 4-mg dexamethasone tablet one hour before the procedure and group B received a 8-mg dexamethasone tablet one hour before the procedure. All the patients were advised to use a mouthwash chlorhexidine 0.2% before giving local anesthesia. In the postoperative period, a non-steroidal anti-inflammatory drug (paracetamol 500 mg; one tablet every 6 hours for 4 days) was prescribed. The outcome of both treatment modalities in term of decrease in postoperative trismus at day 2 was measured, because edema is usually maximal from 12 to 48 hours after surgical removal of impacted mandibular third molar.
RESULTS: According to our study, the average age of patients was 30.29±7.9357 years with minimum and maximum ages 20 and 50 years respectively. Gender distribution was almost equal in this study; there were 49 male patients and 51 female patients. After treatment the average maximum interincisal mouth opening distance was significantly higher in group B as compared to group A (36±3.928 mm vs. 26.04±3.097 mm; P=0.000).
CONCLUSIONS: According to this study, we conclude that the dosage of 8 mg of dexamethasone was statistically more significant in reducing the trismus compared to 4 mg (P=0.000).

KEY WORDS: Impacted tooth; Tooth extraction; Trismus; Dexamethasone

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