Post-op edema, pain, trismus control by injecting corticosteroids containing dexamethasone or betamethasone into the pterygomandibular space before imapcted third molar surgery

Introduction and Aim: The aim of this study was to improve the patient's comfort in the healing process after the impacted third third molar surgery by using dexamethasone or betamethasone containing corticosteroids preoperatively. Materials and Methods: Informed consent was obtained from patients aged 18-50 years without any systemic disorder or continuous drug use. In our split-mouth study, two separate study groups and one control group were formed in different patients. In the same patient, 38 (left lower third molar tooth) or 48 (right lower third molar tooth) impacted tooth side was determined as the study group and the other side as the control group. There was at least two weeks between the two surgical procedures. Thus, it was assured that corticosteroid did not systemically affect the control group. After anesthesia, 8 mg / 2 ml dexamethasone or betamethasone was injected into the pterygomandibular space on the side of the study group. The control group received 2 ml saline injections after anesthesia into the pterygomandibular space as placebo. In both conditions, patients underwent the same and routine standard surgical procedure. Measurements were performed in each patient to evaluate edema by USG on the same day before surgery, 3. day post-op and 7. day post-op. Mouth opening measurement and VAS pain scale were evaluated immediately before and after the surgery, postoperative 3. and 7. days. Results: VAS scores measured after surgery showed less pain in patients treated with dexamethasone and betamethasone. USG measurements showed less edema. However, the amount of trismus after surgery decreased in patients treated with dexamethasone and betamethasone. Conclusion: Post-op pain, edema, and trismus decreased in the study group as a result of less inflammatory events than the control group. Key words: Impacted third molar, Mandibular third molar, Dexamethasone, Betamethasone, Pterygomandibular Space.