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Mystery revealed on efficacy of intravenous dexamethasone vs methylprednisolone on post-operative sequelae after 3rd molar surgery

Background: Owing to its potent mode of action and lengthy half-life, dexamethasone has been used in oral surgery for many years. Several dexamethasone delivery methods for third molar surgery have been proposed. Dexamethasone administration has been a source of debate, with studies being unable to agree on the best effective method for reducing post-extraction complications. Aim:  To carry out comparative evaluation of effect of intravenous 8 mg Dexamethasone and 40 mg Methylprednisolone on pain, swelling and trismus post-operatively after mandibular impacted 3rd molar surgery. Methods and Materials: The study used a split mouth technique, in which the impacted mandibular 3rd molars were extracted one at a time, separated by at least 21 days. Following surgical removal of an impacted mandibular third molar, the patient was given 8mg Dexamethasone intravenously at the first appointment. The surgical removal of the mandibular third molar on the contralateral side was performed on the same patient at the second session after 21 days, and 40 mg Methylprednisolone was administered intravenously post-operatively. Results: For the 2nd, 5th, and 7th day postoperative evaluations, patients showed decreased swelling with the Dexamethasone protocol compared to the Methylprednisolone protocol. There was a statistically significant difference between the two groups.