Effect of submucosal administration of dexamethasone on postoperative discomfort after third molar surgery.

Aim: To compare the impact of submucosal dexamethasone (4 mg) administered after the onset of local anesthesia on postoperative discomfort after third molar surgery and compare the parameters with a control group that did not receive the drug.

Methods: A total of 60 patients indicated for surgical removal of impacted mandibular third molars (mesioangular, Class II or III, and position B or C) were randomly divided into two groups of 30 patients each. After the onset of local anesthesia, the first group (Group A) received a submucosal injection of 4 mg dexamethasone adjacent to the surgical site, and the control group (Group B) received no drug. Pain, swelling, and trismus were recorded at follow-up visits on the 1^st, 2^nd, and 7^th postoperative days. Assessment of postoperative discomfort was performed by evaluating responses through a modified postoperative symptom severity scale questionnaire, which was administered to the patients on the 7^th postoperative day.

Results: The difference in subjective pain values and the mean number of analgesics consumed was not significant between the groups. The difference in postoperative swelling was statistically significant on the 1^st, 2^nd (P < 0.0001), and 7^th postoperative days (P = 0.0152). The difference in postoperative trismus was highly significant on 1^st and 2^nd postoperative days (P < 0.0001). The difference in the mean total quality of life (QOL) score, Eating, Appearance, Daily activity subscale (P < 0.0001), and Social Isolation subscale (P = 0.0002) was statistically significant between both groups.

Conclusion: It was found that the administration of submucosal dexamethasone resulted in significantly lesser postoperative swelling and trismus and better QOL outcomes.