BACKGROUND: Surgery on the lower impacted third molar usually involves trauma in the highly vascularized loose connective tissue area, leading to inflammatory sequelae including postoperative pain, swelling, and general oral dysfunction during the immediate post-operative phase. This study aimed to investigate the effectiveness of preoperative injection of a single dose of 8 mg dexamethasone for postoperative pain control in lower third molar surgery. METHODS: A controlled, randomized, split-mouth, prospective study involving lower third molar surgery was performed in 31 patients. The randomized sampling group was preoperatively injected, after local anesthesia, with a single dose of dexamethasone (8 mg in 2 ml) through the pterygomandibular space; 2 ml of normal saline (with no dexamethasone) was injected as a placebo. RESULTS: The pain VAS score was significantly different on the day of the operation compared to the first post-operative day (P = 0.00 and 0.01, respectively), but it was not significantly different on the third and seventh postoperative day between the control and study groups. There was a significant reduction in swelling on the second postoperative day, and a difference between the second postoperative day and baseline value in the study group (P < 0.05). Trismus was highly significantly different on the second postoperative day and between baseline and second postoperative day between the groups (P = 0.04 and 0.02, respectively). Descriptive statistics and independent-samples t- test were used to assess the significance of differences. CONCLUSIONS: Injection of 8 mg dexamethasone into the pterygomandibular space effectively reduced the postoperative pain and other postoperative sequalae.
Anesthesia, Local ; Connective Tissue ; Dexamethasone* ; Humans ; Molar, Third* ; Pain, Postoperative* ; Prospective Studies ; Tooth, Impacted ; Trismus

BACKGROUND: Surgery on the lower impacted third molar usually involves trauma in the highly vascularized loose connective tissue area, leading to inflammatory sequelae including postoperative pain, swelling, and general oral dysfunction during the immediate post-operative phase. This study aimed to investigate the effectiveness of preoperative injection of a single dose of 8 mg dexamethasone for postoperative pain control in lower third molar surgery. METHODS: A controlled, randomized, split-mouth, prospective study involving lower third molar surgery was performed in 31 patients. The randomized sampling group was preoperatively injected, after local anesthesia, with a single dose of dexamethasone (8 mg in 2 ml) through the pterygomandibular space; 2 ml of normal saline (with no dexamethasone) was injected as a placebo. RESULTS: The pain VAS score was significantly different on the day of the operation compared to the first post-operative day (P = 0.00 and 0.01, respectively), but it was not significantly different on the third and seventh postoperative day between the control and study groups. There was a significant reduction in swelling on the second postoperative day, and a difference between the second postoperative day and baseline value in the study group (P < 0.05). Trismus was highly significantly different on the second postoperative day and between baseline and second postoperative day between the groups (P = 0.04 and 0.02, respectively). Descriptive statistics and independent-samples t- test were used to assess the significance of differences. CONCLUSIONS: Injection of 8 mg dexamethasone into the pterygomandibular space effectively reduced the postoperative pain and other postoperative sequalae.
Anesthesia, Local ; Connective Tissue ; Dexamethasone* ; Humans ; Molar, Third* ; Pain, Postoperative* ; Prospective Studies ; Tooth, Impacted ; Trismus

There has been significant magnitude of problems of diabetes in Myanmar, according to the estimates of International Diabetes Federation (IDF) and the recent National Survey on the prevalence of diabetes. There has been a wide gap of equity between the urban and rural healthcare delivery for diabetes. Myanmar Diabetes Care Model (MMDCM) aims to deliver equitable diabetes care throughout the country, to stem the tide of rising burden of diabetes and also to facilitate to achieve the targets of the Global Action Plan for the Prevention and Control of NCDs (2013-2020). It is aimed to deliver standard of care for diabetes through the health system strengthening at all level. MMDCM was developed based on the available health system, resources and the country's need. Implementation for the model was also discussed.