Controlling postoperative pain after third molar extraction with a dexamethasone and articaine injection: a double-blind randomized controlled trial

Objectives: To evaluate the benefits of submucosal administration of a dexamethasone and articaine mixture on postoperative pain after mandibular third molar extraction. Method and materials: This was a double-blind randomized controlled pilot trial of consecutive patients requiring surgical removal of mandibular third molars. Immediately post extraction, the surgeon administered a submucosal injection. The surgeon was masked to the content of the injection, which contained either a mixture of 10 mg dexamethasone and 68 mg articaine (“study group”) or the same volume of saline only (“control group”). Pain severity was assessed by questionnaire (postoperative symptom severity [PoSSe] scale) 7 days after the procedure. Results: Sixty subjects were enrolled. Patients in the study group had significantly lower PoSSe pain intensity scores than subjects in the control group (P = .004). The combined postoperative PoSSe pain score was significantly lower in the study group than in the control group (P = .016). There was no significant difference in pain duration between the two groups (P = .237). Conclusion: Submucosal injection of dexamethasone/articaine solution after surgical extraction of mandibular third molars is effective in reducing pain intensity. (Quintessence Int 2023;54:24–32; doi: 10.3290/j.qi.b3479957)