Comparison Of Efficacy Of Submucosal Injection Of Tramadol Vs Dexamethasone In Reducing Post Operative Sequelae In Impacted Mandibular Third Molar Extraction : A Prospective, Randomised, Placebo Controlled, A Triple Blind Study.

**Background:**Surgical removal of impacted mandibular third molars is frequently associated with postoperative sequelae such as pain, swelling, and trismus, which can significantly affect patient comfort and quality of life. Various pharmacological agents have been evaluated to minimize these outcomes. This study aims to compare the efficacy of submucosal injection of tramadol versus dexamethasone in controlling postoperative discomfort following third molar surgery.

Materials and Methods: A prospective, randomized, placebo-controlled, triple-blind clinical trial was conducted on 90 systemically healthy patients requiring mandibular third molar extraction. Patients were randomly allocated into three groups (n=30 each): Group A received 1 ml of tramadol (50 mg/ml), Group B received 1 ml of dexamethasone (4mg/ml), and Group C received 1 ml of normal saline (placebo) via submucosal injection immediately post-extraction. Standardized surgical protocol and postoperative care were maintained. Pain (measured using a Visual Analog Scale), facial swelling (measured using two-line facial measurement), and trismus (interincisal distance) were assessed on postoperative days 1, 3, and 7.