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Background <p>Surgical removal of impacted mandibular third molars is a common procedure often associated with postoperative pain, swelling, and trismus. Corticosteroids such as dexamethasone are frequently used to mitigate these sequelae. This study aims to compare the efficacy of intra-masseteric (IM) and submucosal (SM) routes of dexamethasone administration in reducing postoperative discomfort.</p> Materials and Methods <p>A prospective split-mouth randomized controlled trial was conducted on 15 patients with bilateral impacted mandibular third molars. Group A received 8&#xa0;mg dexamethasone IM, and Group B received it SM, both 1&#xa0;h preoperatively. Pain (VAS), swelling (thread method), and mouth opening (interincisal distance) were assessed on days 1, 3, 7, and 14 postoperatively.</p> Results <p>Both groups showed significant reduction in pain, swelling, and trismus over time. Although pain scores did not significantly differ between groups at any time point, Group B (SM) demonstrated significantly better mouth opening on days 1, 3, and 7 and significantly lower swelling scores on days 3, 7, and 14 compared to Group A (IM). No major complications were observed.</p> Conclusion <p>Submucosal dexamethasone administration offers a simpler, effective, and minimally invasive alternative to the intra-masseteric route for managing postoperative sequelae in third molar surgery.</p>

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Dexamethasone Dynamics: A Split-Mouth Trial of Two Routes of Delivery in Third Molar Surgery

  • 期刊论文

  • 发表日期：

    2026年5月7日

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  • Sania Khalid,
  • Amit Gupta,
  • Shayan Ghosh,
  • Snehil Shrivastava,
  • Siddharth Rawat,
  • Aviral Verma

摘要

Background

Surgical removal of impacted mandibular third molars is a common procedure often associated with postoperative pain, swelling, and trismus. Corticosteroids such as dexamethasone are frequently used to mitigate these sequelae. This study aims to compare the efficacy of intra-masseteric (IM) and submucosal (SM) routes of dexamethasone administration in reducing postoperative discomfort.

Materials and Methods

A prospective split-mouth randomized controlled trial was conducted on 15 patients with bilateral impacted mandibular third molars. Group A received 8 mg dexamethasone IM, and Group B received it SM, both 1 h preoperatively. Pain (VAS), swelling (thread method), and mouth opening (interincisal distance) were assessed on days 1, 3, 7, and 14 postoperatively.

Results

Both groups showed significant reduction in pain, swelling, and trismus over time. Although pain scores did not significantly differ between groups at any time point, Group B (SM) demonstrated significantly better mouth opening on days 1, 3, and 7 and significantly lower swelling scores on days 3, 7, and 14 compared to Group A (IM). No major complications were observed.

Conclusion

Submucosal dexamethasone administration offers a simpler, effective, and minimally invasive alternative to the intra-masseteric route for managing postoperative sequelae in third molar surgery.