© 2017 Babcock University Medical Journal
1. INTRODUCTION
Surgical removal of mandibular third molar
is one of the most common surgical events in
1
medical practice . This is why, in spite of the
diversified demands of practice, many dental
surgeons will still need to face the problem of
1,2
removal of impacted mandibular third molars.
This invariably involves trauma to hard and soft
tissues. The greater the tissue injury is, the more
extensive the amount of tissue response and
2
inflammation in the surgical area.
This inflammation is regarded as a
protective reaction of vascular connective tissue to
damaging stimuli and it is associated with
vasodilatation, increased vascular permeability,
recruitment of inflammatory cells and the release of
3
inflammatory mediators from these cells.
The most important of these mediators are
2,3
the prostaglandins and the leukotrienes.
Ironically, this protective mechanism may bring
discomfort to patients and affect their quality of life
as a result of resultant pain, swelling and
4
trismus, otherwise called post-operative
5,6
complications. The factors affecting these
postoperative complications have been grouped
into patients' factors, tooth related factors and
6
operative factors.
Pain is the most commonly encountered
post-operative complication following mandibular
rd 5
3 molar surgery. Pain sensation is subjective and
can be influenced by different factors such as
4
patient age, sex, anxiety and surgical difficulty. In
this sense, longer operations are typically
associated with more pain, and the pain
furthermore increases with the difficulty of the
7
operation. Similarly, swelling may be particularly
significant when the duration of surgery is
8
prolonged and manipulation of tissues is extensive.
Trismus is defined as a limitation in maximum oral
aperture, and is caused by the swelling and pain
7
attributed to surgical trauma. It has been described
to be more intense on the first day after surgery
followed by gradual improvement and resolution
ABSTRACT
Objective: This study aimed to compare
the effects of administration of both preoperative
and postoperative dexamethasone with that of only
preoperative dexamethasone, and with that of a no
dexamethasone (control) on reduction of pain,
rd
trismus and swelling following lower impacted 3
molar surgery.
Methods: A prospective randomized
controlled double blinded study at the dental clinic
of Babcock University Teaching Hospital on 84
subjects that were divided into 3 groups. Group A
had both preoperative and postoperative
dexamethasone, while group B had only
preoperative dexamethasone and group C was a 'no
dexamethasone' group. Differential mean facial
swelling, mouth opening and pain scores were
compared within the three groups.
Results: The pattern of postoperative swelling,
pain and trismus showed a general decrease from
day 1 to 7, with group A showing the highest rate of
decrease. On postoperative day 1, there was a
difference between the swelling of groups A and C (p
=0.01) and groups B and C (p = 0.02) and also
between the pain scores of group A and group C (p =
0.01). On postoperative day 3, there was only a
difference between the swelling of groups A and C (p
= 0.02), but not in pain and trismus and no
difference was seen in all the measured variables on
postoperative day 7.
Conclusion: Administration of a combination of
both preoperative and postoperative
dexamethasone to reduce the postoperative
inflammatory sequelae that follows lower third
molar surgery gave better results than
administration of only a single preoperative dose.
Comparison Of The Effect Of Two-dose And One-dose
Dexamethasone On Post-inflammatory Complications
In Third Molar Surgery
1,2* 1,2 2 3 4 4 4
Adetayo AM , Oyedele TA , Ajimoko AO , Adetayo MO , Adeyemi MO, Somoye MS , Gbotolorun MO .
1
Department of Surgery, Benjamin Carson Snr School of medicine, Babcock University, Ilisan-Remo, Ogun State.
2
Dental Unit, Babcock University Teaching Hospital, Ilisan-Remo, Ogun State
3
Department of Biological Sciences, Babcock University High School, Ilisan-Remo, Ogun State
4
Oral & Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-araba, Surulere, Lagos State
*Corresponding author: Dr A dekunle Adetayo, Dental Unit, Department of Surgery, Babacock University,
Ilishan-Remo, Nigeria. E-mail: adekunleadetayo@yahoo.com