A Double-blind Comparison of Dexamethasone and Placebo after Third Molar Surgery

Introduction:The surgical removal of third molar teeth can result in considerable pain, swelling, dysfunction and hyperthermia. The factors contributing to postoperative pain, edema, and trismus are complex, but many of the contributing factors are related to the inflammatory process. Meticulous surgical techniques will minimize the sequelae of inflammation but will not prevent them. Pharmacologic strategies for minimizing the clinical manifestations of surgical trauma are often directed toward blocking the formation or inhibiting the effects of biochemical mediators of acute inflammation. Corticosteroids have been suggested for the treatment of many inflammatory diseases and for the reduction of inflammatory sequelae of surgical procedures, including the removal of third molar teeth. Objetives: The purpose of this double-blind study was to evaluate and to compare a prototype glucocorticoid, dexamethasone, with placebo for suppression of swelling due to the surgical removal of third molars. Methods: Thirty patients were randomly divided into 2 groups: one of the groups received 8 mg dexamethasone (Decalonaâ), and the other group received placebo, one hour prior to each procedure, either dexamethasone or placebo was administered intramuscularly. The effect of treatment was evaluated using three methods: subjectively, anatomical references measurements, and digital photos by computerized method. Results: The statistical results showed that postoperative edema was significantly reduced in the group receiving corticosteroids. Conclusions: We concluded that short term corticosteroid administration may be a valuable means of reducing excessive inflammatory response after surgical procedures. Therefore, prophylactic steroid treatment is recommended in third molar surgery when a pronounced postoperative reaction can be expected.