Dexamethasone and Diclofenac sodium in patients undergoing surgical removal of impacted mandibular third molars: A double-blind randomized control trial

Abstract Introduction: Postoperative use of medications is usually recommended to relieve pain and inflammations following surgical removal of the impacted teeth, although, despite adequate measures, complications still persist. The present trial analyzed and compared the effect of Dexamethasone and Diclofenac sodium administered preoperatively on complications, including neural pain perceptions in patients undergoing surgical extractions for impacted mandibular third molars. Materials and Methods: The present, double-blind, randomized control trial comprised 90 healthy, adult patients, aged between 18 and 45 years, who were advised surgical removal of impacted mandibular third molars. The selected patients were randomly assigned to three groups using the simple randomized sampling and were administered 2 cc of normal saline (in controls) and 75 mg of Diclofenac sodium along with 8 mg of Dexamethasone in different groups as a single preoperative, intramuscular (IM) injection before procedure, while the various clinical indicators such as pain, swelling (edema), and trismus were assessed preoperatively and subsequently, on the 2 nd and 7 th postoperative days. Again, the Chi-square test was used to test the association between the variables studied, whereas the one-way analysis of variance was used to compare the means of independent groups to determine whether they were significantly different from each other. P < 0.05 was considered statistically significant. Results: Severe pain was reported in the maximum patients in control Group (Group A) followed by Group C and Group B on the 2 nd and 7 th postoperative days. Furthermore, maximum mouth opening was recorded on the 7 th postoperative day in Group C wherein patients were administered Dexamethasone, while the normal facial contours were restored in all three groups with minimal to no swelling reported in different groups on the 7 th postoperative day. Conclusion: Based on the results obtained in the present trial, it can be concluded that a single preoperative dose of either Dexamethasone and Diclofenac sodium might not benefit patients significantly when administered through the IM route. The following core competencies are addressed in this article: Practice-based learning and Improvement, Patient Care and Procedural Skills, Systems-Based Practice, and Medical Knowledge.