The use of Dexamethasone (DXM) injection, particularly in the submucosal route proved effective in lessening the postoperative sequelae (i.e., pain, inflammation and trismus) following impacted mandibular third molars surgery, delineated a study in ‘The Journal of the American Dental Association’. Hossam Waleed Almadhoon and researchers compared the effects of various DXM routes and dosages on reducing postoperative sequelae after the surgery of impacted mandibular third molars.

After the search of five databases, 34 eligible randomized controlled trials were included. Eight studies had a low risk of bias (ROB) and 5 had high ROB with 21 having some challenges, as evaluated by the Cochrane ROB 2 tool. Network meta-analyses were performed (P < .05), and the P-score was used to grade comparisons of DXM doses and the routes of administration. Low to very low certainty in most comparisons was found as assessed by the Confidence in Network Meta-Analysis tool.

As per the outcomes, many DXM routes and dose combinations were superior to placebo in decreasing the postoperative sequelae 1 day following the surgery. In comparison with the 4 mg twin-mix or 8 mg intramuscular injection, DXM 4 mg submucosal injection significantly alleviated pain after 3 days of extraction.

Hence, it looks as if DXM 4 mg submucosal injection or admixed with local anaesthetic is useful in lowering the postoperative sequelae following the surgery. It should be noted that there were no remarkable differences found between the examined DXM route and the comparison of doses.