Preemptive use of dexamethasone in periodontal surgery

Objectives: evaluate the efficacy of dexamethasone on postoperative pain control in periodontal surgery. Methods: fifty-seven patients presenting moderate or severe chronic periodontitis, at least one site with probing depth > 5mm and persisting bleeding on probing and/or suppuration after nonsurgical therapy were enrolled in this parallel-group, randomized and double-blind clinical trial. The patients received open flap debridement surgery with hand and ultrasonic instrumentation. Each patient was randomly assigned to one of the following drug regimen one hour before surgery: Group (G) 1 - 4 mg dexamethasone, and another 4 mg dose 8 hours after first ingestion; G2- 8 mg dexamethasone; G3- placebo. Pain intensity was evaluated every hour for the first 8 hours (h) using the Visual Analogue Scale (VAS). Results: except for the 2nd hour, G2 exhibited less postoperative pain than G3 for all time periods. Pain scores in G2 were statistically significant lower than G1 at 1h (p=0.034), 5h (p=0.03), 6h (p=0.04), 7h (p=0.005) and 8h (p=0.01)(Kruskall Wallis test). Rescue medication (paracetamol 750mg) intake in G2 was lower than in G1 and G3 (p=0.002 - Anova). Conclusions: within the limits of this study, it was concluded that preemptive medication with 8 mg of dexamethasone was effective for the management of postoperative pain following open flap debridement surgery. Financial Support: Fundação Araucária 07/2010