COMPARISON OF POST-OPERATIVE SEQUELAE OF INTRA-SPACE INJECTION OF TWIN MIX VERSUS INTRAORAL-SUBMUCOSAL, INTRAMUSCULAR , INTRAVENOUS AND PER-ORAL ADMINISTRATION OF DEXAMETHASONE AFTER REMOVAL OF IMPACTED MANDIBULAR THIRD MOLAR.

Aim- This study compares the post-operative sequelae of intra-space injection of Twin mix versus intraoral-submucosal, intramuscular, intravenous and per-oral administration of dexamethasone on impacted mandibular third molars. Materials & method- A randomized prospective study including a sample size of 60 patients were divided into 6 groups. Group I: (Control group) No steroid was administered before the surgical procedure. Group II: (Intra-space injection of Twin mix) 1.8 ml 2 % lignocaine with 1:200,000 epinephrine+1 ml 4 mg dexamethasone administered in the pterygomandibular space before the surgical procedure. Group III: (Submucosal dexamethasone) 1 ml of 4 mg dexamethasone administered in the buccal mucosa intraorally immediately before the surgical procedure. Group IV: (Intramuscular dexamethasone) 1 ml of 4 mg dexamethasone administered in the deltoid muscle immediately before the surgical procedure. Group V: (Intravenous dexamethasone) 1 ml of 4 mg dexamethasone administered in a vein in the forearm immediately before the surgical procedure. Group VI: (Per-oral dexamethasone) 4 mg per-oral dexamethasone 1 h before the procedure. Result- all the groups were followed up on 1st, 3rd and 7th day. There was statistically significant difference between group II and the control group for pain and swelling. Conclusion- Steroid groups appeared to have a better clinical outcome with improved quality of life post-operatively when compared to the non-steroid study group. Intra-space injection of dexamethasone in pterygomandibular space as Twin mix was found to have similar clinical effects as conventional methods of administering steroids via intraoral-submucosal, intramuscular, intravenous and per-oral routes. Keywords- Twin Mix, Dexamethasone, Post-operative sequelae, Impacted, Third molar