Effect of Perioperative Steroid, Bupivacaine and Tetracycline on Post Operative Sequelae of Impacted Mandibular Third Molar Surgery

Mohit Mangla; Seema Aggarwal; Monis Raza; Swati Sharma

doi:10.21276/ujds.2023.9.4.5

Dr. Mohit Mangla Senior Consultant, Oral & Maxillofacial Surgery Advik Dent-o-Care, Delhi, India
Dr. Seema Aggarwal Senior Consultant, Oral & Maxillofacial Surgery Advik Dent-o-Care, Delhi, India
Dr. Monis Raza Assistant Professor, Department of Orthodontics, Institute of Dental Studies & Technologies, Ghaziabad, Uttar Pradesh
Dr. Swati Sharma Assistant Professor, Department of Orthodontics, Institute of Dental Studies & Technologies, Ghaziabad, Uttar Pradesh

DOI: https://doi.org/10.21276/ujds.2023.9.4.5

Keywords: Third molar, steroids, tetracycline

Abstract

Aim: To study the effectiveness of perioperative steroids, bupivacaine and intra-socket tetracycline on post-operative sequelae after impacted mandibular third molar surgery.

Materials and Methods: Twenty patients of age group 20-40 years were randomly selected who underwent extraction of non-carious impacted mandibular third molars. In group I (10 Patients): Dexamethasone 8 mg intravenously 1 hour before surgery was given and then intraoperative nerve block was given with 0.5% bupivacaine plus placement of tetracycline gel in the socket and post operatively NSAID after surgery was prescribed. Group II served as control (10 Patients) wherein intraoperative nerve block was given with 2% lignocaine with 1:80,000 adrenaline and post operatively antibiotics (Cap. Amoxicillin) along with NSAIDs (non-steroidal anti-inflammatory drugs) but no steroid and tetracycline were given.

Visual analogue scale (VAS) for Pain, swelling and mouth opening was assessed post- operatively on first, third and seventh day. Any other post-operative complications like alveolar osteitis and wound dehiscence were determined on seventh day. The data obtained were examined using Maan-Whitney U-test and Wilcoxon test for pain and independent t-test was applied for evaluating mouth opening and swelling via SPSS, version 20.

Results: Twenty patients were analyzed out of which each group included ten patients. The post-operative mean VAS score of group I at first post-surgery day was low as compared to group II, which was statistically highly significant (P= 0.001). Swelling and mouth opening were comparatively same in both groups which was not significant statistically (P> 0.005). There were no post-operative complications occurred in both groups.

Conclusion: The modified protocol for third molar surgery is as equally effective as standard method with an added advantages of: (1) no fear of antibiotic resistance development, (2) no excessive use of antibiotics and NSAIDS, (3) less patient discomfort both in terms of pain, swelling, trismus and in remembering large number of medicine that he/she has to take after surgery. Multicenter studies with more sample size are required to confirm its efficacy.

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