Intramasseteric versus pterygomandibular space dexamethasone injection for oedema and trismus after mandibular third molar surgery: a randomised split-mouth clinical trial
Abstract
Background: This study compared intramasseteric versus pterygomandibular space dexamethasone injection for postoperative oedema and trismus after mandibular third molar surgery.
Methods: This prospective, randomised, participant- and outcome assessor-blinded, active-comparator split-mouth clinical trial with sequential interventions was conducted at Afyonkarahisar Health Sciences University between April 28, 2023 and April 27, 2024. Twenty adults aged 18-25 years, classified as American Society of Anesthesiologists Physical Status I and requiring bilateral surgical extraction of comparable mandibular third molars, were enrolled. The two interventions were performed in randomised order at a three-week interval.
Results: All 20 participants completed both interventions. Operative time did not differ between injection sites (18.1 ± 2.8 vs. 18.1 ± 2.9 min; p = 1.000). Change in oedema was lower in the intramasseteric group on days 2 (4 [1-8] vs. 6 [4-12]; p < 0.001; difference between site-specific medians favouring intramasseteric injection, 2.0 mm) and 7 (0.5 [0-1] vs. 1 [0-3]; p = 0.006; difference between medians, 0.5 mm). Trismus was less severe on days 2 (10.4 ± 2.7 vs. 13.1 ± 3.2 mm; p = 0.006; mean difference, 2.7 mm; 95% CI, 0.9 to 4.5) and 7 (0.7 ± 0.8 vs. 1.2 ± 1.2 mm; p = 0.006; mean difference, 0.5 mm; 95% CI, 0.2 to 0.8). Between-group pain, salivary cortisol level, Oral Health Impact Profile-14 score, and analgesic consumption differences were nonsignificant.…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 20 participants or records.
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