A Prospective Study to Compare the Effects of Preemptive Piroxicam and Oral Dexamethasone on Edema, Trismus and Pain in Third Molar Surgery: A Randomized Controlled Trial

Introduction: Surgical extraction of impacted third molars is an increasingly common procedure but is associated with postoperative sequelae such as pain, swelling, and trismus. This study aims to compare the effects of preemptive piroxicam and oral dexamethasone on pain, swelling and trismus following third molar surgery. Materials and Methods: A prospective randomized study consisting of 31 patients requiring lower third molar surgery were selected. They were randomly allocated to two treatment groups, oral dexamethasone (8 mg) and oral piroxicam (20 mg). The overall analgesic efficacy and anti-inflammatory effect of the two drugs were assessed postoperatively after 24, 48, 72 h, and on day 7 for pain, swelling, and trismus. Results: The difference in the mean scores of piroxicam group and dexamethasone group was statistically significant with the dexamethasone group showing better analgesia at the end of 24 h, 48 h, and 72 h done using Mann–Whitney U test. The swelling was compared between the two groups using an independent t-test. These results were statistically significant and dexamethasone was more effective at return to normal preoperative measurements 1-week postsurgery. When the mouth opening at day 7 was compared with the preoperative values, subjects in the piroxicam group showed a decrease of 0.18 ± 0.13, and those in the dexamethasone group showed a decrease of 0.05 ± 0.13 showing that dexamethasone group was significantly closer to returning to normal mouth opening at the end of 1 week post-surgery using independent t-test. Conclusion: We can conclude that the use of 8 mg oral dexamethasone 1 h preoperatively leads to a more comfortable and pain-free period for patients who undergo wisdom teeth removal, within its limitations.