Submucosal against Intramuscular Administration of Dexamethasone in Treatment of Postoperative Edema after Odontectomy of Impacted Mandibular Third Molars

<b>Aim</b>: To clinically evaluate the efficacy of Dexamethasone depending on the method of administration in the treatment of postoperative complications following odontectomy of lower impacted third molars. <b>Materials and Methods</b>: At the Clinic for Oral Surgery at USKC "St. Panteleimon" in Skopje, North Macedonia, 45 patients, 20 to 40 years, indicated for odontectomy of lower impacted third molars, were included. 15 patients were treated with DXP (Dexamethasone), ampule of 4mg/1ml, applied submucosally (SM). Another 15 patients were treated with DXP administered intramuscularly (IM) into the deltoid muscle. No DXP was applied to the control group (CG). Edema was monitored by measuring three facial lines: tragus to labial commissure (Tr-Co), tragus to gnathion (Tr-Gn), and lateral eye canthus to angulus mandibulae (Cn-Am). The clinical effects in the three study groups were monitored at 24 hours (T1), 48 hours (T2), and 7 days (T3) post-op. <b>Results</b>: Cn-Am direction in T1, showed significantly larger edema in the CG vs the examined groups. In all time points there were no statistically significant differences between the examined groups (p>0.05). In T1 and T2, in the Tr-Co direction, the results showed the biggest reduction of the edema with a statistically significant difference (p=0.012) in IM vs SM application at T2. T3 showed least edema in the SM group. Tr-Gn direction, at T1, a significant difference in edema dimensions was found between the IM and CG (p=0.015), indicating a significantly smaller measured edema in the IM group. Identical findings were seen at T2. T3 showed better results in edema control in the SM vs. other groups. <b>Conclusion</b>: The intramuscular application technique of DXP was more effective than the submucosal technique across all measurement lines and time points in managing postoperative edema following surgical extraction of lower impacted third molars.