Single-Dose of Submucosal Injection of Dexamethasone Affects the Post Operative Quality of Life After Third Molar Surgery

Abstract

Introduction: Third molar surgery (TMS) became a routine, safe office procedure with generally predictable outcomes and relative low cost. It affects quality of life (QOL) of patients by causing considerable pain, swelling and trismus; by changing what people eat, their speech in the first few days after surgery. The purpose of the present study was to improve QOL of patient after lower TMS by injecting single dose 8 mg submucosal dexamethasone.

Materials and methods: Forty healthy adult subjects of either gender underwent surgical removal of the lower impacted third molar under local anaesthesia and after being randomly assigned to receive either 8 mg dexamethasone submucosal injection or normal saline injection in proximity to surgical site.

Statistical analysis used: Chi-square test, Mann-Whitney U test (Z), t student and unpaired t test, and Fisher extract test were used for calculation of data.

Results: Facial swelling, trismus showed significant reduction immediate postoperative day in dexamethasone groups. Patient perception postoperative pain on VAS score was not significant. PoSSe statistics, only three out of seven subscales showed a statistically significant difference between groups viz., Eating subscale, Appearance subscale, Sickness subscale but over all improvement in QOL was observed.

Conclusions: Submucosal dexamethasone effectively reduces postoperative sequelae and improves postoperative QOL after TMS.

Keywords: Corticosteroid in oral surgery; Post operative sequelae; Quality of life; Submucosal Injection of dexamethasone; Third Molar; Third Molar Surgery.

Fig. 1

Objective data in 2nd and 7th PODs; Significant recovery of Trismus and swelling was observed in DXG on 2nd POD which gradually resolved to baseline on 7th POD

Fig. 2

VAS score reported by subjects from 1st to 7th POD

Fig. 3

Eating subscale. a Percent subjects responded, operation affect on enjoyment of food in 1st postoperative week. b Percent of subjects were unable to open mouth normally in 1st postoperative week because of operation

Fig. 4

Speech subscale. a Percent of subjects who reported many days in a 1st postoperative week voice affected because of the operation. b On the worst day, percent of subjects were speech affected by the operation

Fig. 5

Sensation subscale. Percent of subjects who felt tingling and numbness of lips or tongue because of operation within a week

Fig. 6

Appearance subscale. Percent of subjects who reported many days bruise and swollen face and/or neck because of the operation

Fig. 7

Pain subscale. a Percent of subjects who experienced pain within a week after the operation. b Percent of subjects who responded pain controlled by pain killers up to 1st post-operative week

Fig. 8

Sickness subscale. a Percent of subjects who reported vomiting or feeling nauseated in 1st postoperative week. b On the worst day of the last week, percent of subjects felt many times vomiting or nausea

Fig. 9

Interference with daily activities subscale. a Percent of subjects could not carry out work/housework and other daily activities in 1st postoperative week. b Percent of subjects who reported with affect of leisure activities including sports, hobbies and social life in 1st postoperative week. c Percent of subjects who reported affected your life due to the pain in 1st postoperative week