Effect of addition of steroids to local anesthesia on surgical extraction of impacted lower wisdom tooth.

Completed

• Conditions: Impacted teeth,

• Registration Number: CTRI/2021/08/035560
• Lead Sponsor: Poorna P

Brief Summary

Surgical extraction of impacted third molars is a routine minor oral surgical procedure carried out

usually under local anesthesia and is associated with postoperative sequelae including swelling, pain,

trismus, infection, bleeding, and paraesthesia.

Diligent administration of local anesthetic agent will help in achieving pain-free surgical extraction

while also reducing the risk of paresthesia and trismus post-operatively. An increased depth and

duration of action of local anesthetic agent is desirable to minimize the trauma experienced by the

patient intra-operatively and in achieving the pain-free transition from the waning anesthesia to analgesic

medication in the post-operative period respectively.

The goodness of Bupivacaine being a potent, long-acting local anesthetic with low tissue toxicity is

nullified by the undeniable fact that it is the most cardiotoxic of them all, involving both electrical and

mechanical structures within the heart. Therefore a need exists to find an alternative to Bupivacaine

that has a comparable depth and duration of anesthesia.

Studies done in other disciplines of surgery and in vivo studies have shown that using corticosteroids

as adjuncts to local anesthetics have increased the duration of their action in supraclavicular brachial

plexus block, axillary block; sciatic nerve block in rats, and intercostal nerve block in sheep.

Adding corticosteroids would also have the added advantage of reduced swelling, pain, and trismus

owing to an attenuated inflammatory response.

Sizeable research in similar lines has not been done specifically to Oral and Maxillofacial Surgery.

Lignocaine is the gold standard drug of choice for local anesthesia in oral surgery when coupled

Dexamethasone forms a drug combination that deserves testing.

The current study aims to fill the void of insufficient research and test the effect of Dexamethasone

added to Lignocaine with Adrenaline on depth and duration of anesthesia, reduction in swelling,

trismus, pain, and improved mouth opening in patients undergoing impacted third molar surgeries.

Detailed Description

Not available

Study Timeline

• Study Start: 2021-08-16
• Study Completion: 2022-11-25
• Last Update Posted: 2023-05-19

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 70

Inclusion Criteria

• Subjects falling under ASA class 1 & 2.
• Subjects requiring surgical extraction of bilateral mandibular third molars in class II position B.
• Subjects with no acute inflammation, excessive caries, pain and pathology around the mandibular third molars Subjects who have signed the informed consent.

Exclusion Criteria

• Subjects with infection around third molars.
• Subjects with peptic ulcer.
• Subjects who are pregnant and lactating.
• Subject with diabetes mellitus, systemic endocrine disorders, hypertension, kidney diseases, blood clotting disorders, obesity.
• Subjects having an allergy to any of the drugs or materials to be used.
• Subjects who have used antibiotics in the past 2 weeks.
• Subjects who have used NSAIDs in the past 1 week.
• Subjects who could not cooperate Subjects who refused to take part in the study.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
the difference in time of onset and duration of local anesthesia.	1. baseline | 2.2-8 hours after the procedure

Secondary Outcome Measures

Name	Time	Method
the difference in pain, swelling, and mouth opening.	24 hours, 48 hours and 1 week

Trial Locations

Locations (1)

Manipal College of Dental Sciences, Mangalore; 🇮🇳 Kannada, KARNATAKA, India

Manipal College of Dental Sciences, Mangalore

🇮🇳Kannada, KARNATAKA, India

DrPoorna P

Principal investigator

9701362020

potharaju.poorna@gmail.com