Effect of submucosal dexamethasone injection on pain and swelling after immediate implant placement: a randomized clinical trial.

Corticosteroids are often used to suppress inflammation associated with oral surgery, and submucosal injection of dexamethasone results in a quicker onset of action and slower absorption than systemic administration. The present study aimed to examine the impact of a single submucosal dexamethasone injection on pain and swelling following implant placement. A total of 60 patients with at least 1 nonrestorable tooth were randomly divided into 2 equal groups and underwent tooth extraction followed by immediate implant placement. Immediately after place¬ment of the implant, suturing of the incision, and irrigation, the intervention group received a submucosal injection of 4 mg of dexamethasone, while the control group received a submucosal injection of normal saline as a placebo. The patients' self-reported pain and swelling levels were as¬sessed 2, 4, and 7 days after surgery. Pain was measured using a 10-cm visual analog scale in which 0 denoted no pain and 10 denoted the highest possible level of pain. Swelling was evaluated using a 6-point scale in which 0 denoted that the patient did not notice any swelling and 5 denoted visibly present swelling that restricted mouth opening. Patient satisfaction was evaluated 7 days after surgery using an 11-point scale where 0 denoted extremely dissatisfied and 10 denoted very satisfied. The Mann- Whitney U test was used to compare the differences in pain, swelling, and overall satisfaction between the groups over time. A value of P < 0.05 was considered statistically significant. Postoperative pain was significantly lower in the dexamethasone group than in the placebo group both 2 days (P = 0.015) and 4 days (P = 0.002) after surgery. Additionally, the dexamethasone group reported signifi¬cantly less postoperative swelling than the control group both 4 days (P = 0.004) and 7 days (P = 0.007) after sur¬gery. No statistically significant differences were observed in overall patient satisfaction (P = 0.079). Submucosal administration of dexamethasone following implant surgery led to significant decreases in postoperative pain and swell¬ing. However, the corticosteroid injection did not produce a statistically significant increase in patients' overall level of satisfaction after surgery.