Intramasseteric versus pterygomandibular space dexamethasone injection for oedema and trismus after mandibular third molar surgery: a randomised split-mouth clinical trial

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Pektaş M. Y., Topal O.

BMC ORAL HEALTH, cilt.26, ss.1-7, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 26
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1186/s12903-026-09953-5
  • Dergi Adı: BMC ORAL HEALTH
  • Derginin Tarandığı İndeksler: Natural Science Collection (ProQuest), Biological Science Database (ProQuest), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Scopus, Science Citation Index Expanded (SCI-EXPANDED), CINAHL, EMBASE, MEDLINE, Directory of Open Access Journals
  • Sayfa Sayıları: ss.1-7
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Kütahya Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Abstract

Background This study compared intramasseteric versus pterygomandibular space dexamethasone injection for

postoperative oedema and trismus after mandibular third molar surgery.

Methods This prospective, randomised, participant- and outcome assessor-blinded, active-comparator split-mouth

clinical trial with sequential interventions was conducted at Afyonkarahisar Health Sciences University between

April 28, 2023 and April 27, 2024. Twenty adults aged 18–25 years, classified as American Society of Anesthesiologists

Physical Status I and requiring bilateral surgical extraction of comparable mandibular third molars, were enrolled. The

two interventions were performed in randomised order at a three-week interval.

Results All 20 participants completed both interventions. Operative time did not differ between injection sites

(18.1 ± 2.8 vs. 18.1 ± 2.9 min; p

=

1.000). Change in oedema was lower in the intramasseteric group on days 2 (4 [1–8]

vs. 6 [4–12]; p < 0.001; difference between site-specific medians favouring intramasseteric injection, 2.0 mm) and 7

(0.5 [0–1] vs. 1 [0–3]; p

=

0.006; difference between medians, 0.5 mm). Trismus was less severe on days 2 (10.4 ± 2.7 vs.

13.1 ± 3.2 mm; p

=

0.006; mean difference, 2.7 mm; 95% CI, 0.9 to 4.5) and 7 (0.7 ± 0.8 vs. 1.2 ± 1.2 mm; p

=

0.006; mean

difference, 0.5 mm; 95% CI, 0.2 to 0.8). Between-group pain, salivary cortisol level, Oral Health Impact Profile-14 score,

and analgesic consumption differences were nonsignificant.

Conclusions Intramasseteric injection was associated with lower oedema and trismus severity. Patient-reported

recovery outcomes did not differ significantly between the injection sites. The clinical relevance of these differences

remains uncertain.

Trial registration ClinicalTrials.gov NCT06604286; first submitted 17 September 2024 and first posted 19 September

2024 (retrospectively registered).

Keywords Dexamethasone, Third molar, Trismus, Oedema, Split-mouth study, Oral surgery