Does Etoricoxib or Dexamethasone Control Inflammatory Pain, Edema, and Trismus After Impacted Third Molar Surgery? a Double-Blind, Split-Mouth Randomized Clinical Trial

Abstract Purpose:This double-blind, split-mouth randomized clinical trial investigated whether etoricoxib or dexamethasone is effective to control postoperative pain, edema, and trismus after extraction of impacted mandibular third molars. Methods: Twenty-eight patients received a single dose of dexamethasone (4 mg) (G1) or etoricoxib (120 mg) (G2) before surgery and were examined for the presence of pain, edema, and trismus for 72 h. Pain was evaluated by the Visual Analogue Scale (VAS) and total administration of rescue analgesic medication (paracetamol, 500 mg tablets). Edema was quantified by the VAS and five facial measures, whereas trismus was assessed by measuring the maximum opening of the mouth. Twenty-eight patients in need of impacted third molar surgery met the eligibility criteria. Results: Patients in G2 used rescue analgesic medication 12 h after surgery and reported minimal pain experience in the VAS (0.335 cm), suggesting that postoperative pain was significantly controlled with the administration of etoricoxib (P < 0.0001). Patients who received dexamethasone experienced pain levels 3.6-fold greater in the VAS (1.21 cm) and used the rescue analgesic medication more frequently, with a mean of 3.4 tablets. While the facial measures showed no significant differences between the groups concerning edema, self-assessed VAS data indicated that G1 patients experienced edema more frequently. There were significant differences regarding the control of trismus between the groups (P> 0.05). Conclusion: Our findings indicated that etoricoxib (120 mg) was significantly more effective in controlling postoperative pain than dexamethasone (4 mg) and that both drugs were comparable for the control of edema and trismus.