Abstract
This systematic review aimed to answer the following PICO question: Does the intramuscular
injection of dexamethasone result in less pain, swelling, and trismus after mandibular
third molar removal when compared to other routes of administration or a control group
(saline solution injection or no treatment)? An electronic search was conducted in
Virtual Health Library, PubMed, and Web of Science, through March 2018. Eligibility
criteria included clinical trials. The search strategy resulted in 331 studies. Following
the selection process, 15 articles were included in the systematic review; eight of
these were included in the meta-analysis. Most of the studies had an unclear risk
of bias (Cochrane Handbook assessment). Pain (mean difference (MD) −1.58, 95% confidence
interval (CI) −1.99 to −1.16) and oedema (MD −1.76, 95% CI −2.38 to −1.14) were lower
in the intramuscular dexamethasone group when compared to the control group. When
compared to the submucosal route, the intramuscular route was more effective only
for pain on the third postoperative day (MD −0.79, 95% CI −1.38 to −0.20). The results
suggest that the intramuscular injection of dexamethasone may be an alternative route
of administration, since it is effective at reducing pain and oedema when compared
to non-steroidal treatment and has similar results to the submucosal route.
Key words
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Article info
Publication history
Published online: October 13, 2018
Accepted:
September 27,
2018
Identification
Copyright
© 2018 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
