Comparison of the effect of dexamethasone, ketoprofen and cold Compress on Postoperative quality of life following impacted lower third molar surgery: A randomized clinical trial

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Abstract Objectives: To evaluate and compare the effect of dexamethasone, ketoprofen and cold compress on the quality of life (QoL) following surgical removal of impacted lower third molar (ILTM). Materials and Methods: Eligible patients requiring ILTM extraction with modified Pederson difficulty index score of 5-6 were recruited. The patients were randomly allocated into Group A, B and C. The group A and C patients received pre-operatively, 100mg of ketoprofen and 8mg of dexamethasone per-oral respectively. Subjects in group B applied a pre-standardized ice pack over the angle of the mandible for 6 hours postoperatively. The QoL questionnaire was administered on postoperative day 1, 2 and 7. Results: In total, seventy-eight subjects completed the study: 46 (59%) were male and had a mean age of 27.8 ± 4.9 years. The groups were similar sociodemographically. The overall QoL and appearance domain score was significantly better in patients on oral dexamethasonein postoperative day 1 compared to other groups. Conclusions: Oral dexamethasone demonstrates better improvement in postoperative QoL and appearance on day 1 following ILTM surgery compared to ice packs and ketoprofen. Although ice packs are readily available, can be used repeatedly and are a low-cost option, more research is necessitated to determine its optimum therapeutic use in outpatient setting that will produce a result superior to a single dose of oral dexamethasone. Clinical Relevance: Oral dexamethasone is superior to ice pack compress and ketoprofen in improving the postoperative QoL in ILTM surgery.

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