Comparison Study On The Swelling And Pain Reduction And Satisfaction After Impacted Lower Third Molar Extraction Under Local Anesthesia With Ropivacaine Combined With Dexamethasone

Objective: Facial swelling and pain are the most common sequelae after surgical removal of lower impacted third molars.These postoperative sequelae can make the patients discomfort and compromises quality of life.The aim of this study was to evaluate the degree of the facial swelling and pain relief after lower impacted third molars extracted under local anesthesia with ropivacaine,combined with submucosal injection of dexamethasone,as well as the satisfaction of the patients in regard to the treatment.Methods: Thirty patients with lower impacted third molars were selected,average aged23.17±2.61.All the cases were treated in Hospital of Stomatology,China Medical University from July 2020 to December 2020.The patients were randomly divided into3 groups,the submucosal injection group,the perineurotic group and the control group.The patients in the submucosal injection group received local block anesthesia of inferior alveolar nerve,lingual nerve,and buccal nerve with 5.96 mg/ml ropivacaine mesylate,combined with submucosal injection of 4 mg(0.8ml)dexamethasone(after anesthesia,before surgery).The patients in the perineurotic group received local block anesthesia of inferior alveolar nerve,lingual nerve,and buccal nerve with 5.96 mg/ml ropivacaine mesylate and 4 mg dexamethasone,combined with submucosal injection of0.8ml physiological saline(after anesthesia,before surgery).While the patient in the control group received local block anesthesia with 5.96 mg/ml ropivacaine,combined with submucosal injection of 0.8ml physiological saline(after anesthesia,before surgery).The lower impacted third molars were extracted.The facial swelling was measured before operation,immediately after operation,48 hours after operation,and 7days after operation.Pian was evaluated at 2h,4h,8h,12 h,24h after operation,with VAS pain score.After suture removal,the patient satisfaction scores were analysed.Results: 30 lower impacted third molars were successfully surgical removed,with no complications occurred,such as infection,postoperative bleeding,nerve damage or dry socket.Compared to preoperative,the average of facial swelling 48 hours postoperative in submucosal injection group was significantly less severe than that of perineurotic group and control group.The VAS scores evaluated postoperative were lower than 3 in three groups.The average of satisfaction scores to swelling reduction and the average of overall satisfaction in submucosal injection group was significantly higher than that of perineurotic group and control group.Conclusion: Surgical removal of the impacted lower third molars under local block anesthesia with ropivacaine mesylate and submucosal injection of dexamethasone can be considered as an effective therapeutic strategy to reduce postoperative swelling and make the patients more satisfied.Surgical removal of the impacted lower third molars under local block anesthesia with ropivacaine mesylate and dexamethasone can be considered as an effective therapeutic strategy to reduce postoperative pain and make the patients more satisfied.