Do immediate intramuscular co-administration of diclofenac and dexamethasone or extraoral ice pack application have any influence on pain perception and oral health related quality of life (OHRQoL) following trans-alveolar extraction of impacted mandibular third molars? A comparative study in a Saudi Arabian sub-population

Pain perception and QoL are fundamental enquiries patients wants to know regarding trans-alveolar extraction of lower third molar. The current study hopes to compare the influence of co-administration of diclofenac+dexamethasone and icepack on pain and QoL after trans-alveolar surgery of lower third molar. This was a prospective study of patients referred for trans-alveolar extraction of mandibular third molar teeth under local anesthesia. Patients were randomly assigned into Group A (co-administered IM Dexamethasone 8 mg and IM Diclofenac 75 mg in office) and Group B (ice packs extra-orally). Assessment of pain was carried out using the numerical pain rating scale. Validated Arabic version of the 16 item United Kingdom Oral Health Related Quality of Life measure (UK-OHRQoL) was used to evaluate the QoL pre and on the POD's. A total of 78 patients equally distributed into Groups A and B were the study participants. The mean age was 31.6 ± 6.4 years (Group A: 32.5 ± 5.5 and Group B: 30.8 ± 7.2, range 20–48years). The M:F ratio was 1:1.1. Better pain reduction was observed in Group A which became significant (p = 0.019) on POD 3. Domain scores was better in the Group A patients at the body function level (p = 0.016) and personal level (p = 0.013) at POD 1 and body function level (p = 0.044) at POD 3. Overall QoL scores was also better in the Group A with significant difference (p = 0.025) on POD 1. Pain perception, domain and overall QoL scores continues to improves throughout the review period with better improvement in the Group A.