EFFECT OF ORAL OR INTRA-ALVEOLAR DEXAMETHASONE ADMINISTRATION ON POSTOPERATIVE QUALITY OF LIFE FOLLOWING SURGICAL EXTRACTION OF IMPACTED MANDIBULAR THIRD MOLARS

Abstract

Surgical removal of impacted mandibular third molars (IMTMs) is a frequently performed procedure in oral and maxillofacial surgery practice. Presently, Quality of life (QoL) assessment is now regarded as an important tool for assessing clinical care outcomes. Immediate postoperative complications following surgical removal of impacted mandibular third molar such as pain, trismus, swelling and difficulty in swallowing often impact negatively on the patients’ QoL, leading to loss of productivity and the global cumulative cost that runs into billions of dollars("Economic aspects of mandibular third molar surgery," 2010).

The objective of this study was to compare the effect of oral or topical dexamethasone on quality of life following surgical removal of impacted mandibular third molars.

Ethical approval was obtained and patients 18 years and above who required surgical removal of the impacted mandibular third molar were randomly allocated into 3 groups. Group 1 received oral dexamethasone 30 minutes before surgery and then 8 hourly for 24 hours and Group 2 received intra-alveolar dexamethasone 4mg respectively, both groups also received postoperative antibiotics and analgesics.  Patients in group 3 received no dexamethasone but were only given post-operative antibiotics and analgesics. All patients had preoperative evaluation of their QoL using OHIP-14 questionnaires. Data obtained was analyzed using SPSS version 25.

One hundred and eighty-six patients, 71(38.2%) males and 115(61.8%) females with Mean±SD of 30.1±6.9 completed the postoperative review. The mean QoL was worst (higher scores) among the groups on postoperative day 1. Group 2 patients had the best overall QoL score on POD 7 as compared with groups 1 and 3, with statistical significance (p=0.0001).

The present study shows that intra-alveolar application of dexamethasone following the surgical removal of IMTMs showed the least deterioration in the patients’ quality of life in the immediate postoperative period and particularly POD 1 and POD