Efficiency of Dexamethasone & Articaine Injections for Controlling Post-operative Pain

Objective: The purpose of this study was to evaluate the effect of submucosal administration of solution of Dexamethasone Sodium Phosphate and Articaine on early and late pain after mandibular third molar extraction surgery.

Methods: This is a double-blind RCT study. 60 consecutive patients requiring surgical removal of a single mandibular impacted third molar under local anesthesia were randomly placed into 2 groups. All extractions were performed by the same surgeon. After the conclusion of the procedure, the experimental group received 10mg Dexamethasone and 72 mcg Articaine as submucosal injection and the control group received same volume of Saline injection.The surgeon and the patients were blinded to the contents of the injection. The patients’ perception of the severity of pain was assessed with a follow-up questionnaire, 7 days after the procedure (PoSSe scale).

Results: Patients in the experimental group present significantly lower PoSSe score that the patients in the experimental group (p<0.05). Pain duration was much shorter in the experimental group as well as need for analgesics.

Conclusions: The use of Dexamethasone/Articaine solution, given as an intraoral injection after the surgical extraction of third lower molars, is effective in the prevention of early and late postoperative pain. Further research with larger cohorts and possibly stratifying the study groups according to Pell & Gregory classification may lead to deeper understanding of the benefits of this treatment.