Single-shot Intra-masseteric Dexamethasone for Reducing Pain, Swelling, and Trismus Following Third Molar Surgery: A Randomized Controlled Trial at Silvassa

Abstract

Background:
Surgical removal of impacted mandibular third molars often leads to postoperative pain, swelling, and trismus, affecting recovery and comfort. Dexamethasone, a potent corticosteroid with anti-inflammatory and anti-edematous properties, is effective, though the ideal route and site for optimal therapeutic outcomes remain under investigation.
Aim:
To evaluate the efficacy of a single dose of intramuscular dexamethasone injection into the masseter muscle in reducing postoperative pain, swelling, and trismus following surgical extraction of impacted lower third molars.
Method:
A randomized controlled clinical trial was conducted on 40 patients (20 males and 20 females) undergoing surgical extraction of impacted mandibular third molars at NAMO Medical & Research Institute, Silvassa (DNH). Participants were randomly assigned into two groups: Group A received 8 mg dexamethasone intramuscularly into the masseter muscle following local anesthesia and prior to surgery, while Group B served as the control without dexamethasone. Postoperative pain visual analog scale (VAS), swelling (facial measurements), and trismus (interincisal distance) were assessed preoperatively and at 24, 48, and 72 hours postoperatively.
Data were analyzed using paired and unpaired t-tests, and two-way analysis of variance (ANOVA), with probability (p < 0.05) considered statistically significant.
Results:
Group A demonstrated a significant reduction in postoperative pain, swelling, and trismus at all evaluation intervals compared to Group B (p< 0.05).
Conclusion:
A single intramassetric dose of 8 mg dexamethasone administered before surgical extraction of impacted lower third molars effectively minimizes postoperative pain, swelling, and trismus, enhancing patient comfort and recovery without adverse effects.