Comparison of preemptive etoricoxib and dexamethasone in third molar surgery – a randomized controlled clinical trial of patient-reported and clinical outcomes

Objectives To compare preemptive single-dose etoricoxib and dexamethasone on postoperative patient satisfaction (pPS) and clinical parameters following the impacted mandibular third molar (IMTM) extraction. Materials and Methods A parallel-group, triple-blinded, controlled clinical study included a total of 90 patients ( n = 30), randomized to receive: etoricoxib 90 mg, dexamethasone 4 mg, or no premedication (control group) 1 h before surgery. Paracetamol 500 mg was prescribed as rescue medication (RM). Check-ups were scheduled at 24 h, 48 h, and day 7 post-surgery. At each time point, pPS was assessed using the 5-point Likert scale. RM parameters, swelling, trismus, and the occurrence of adverse events were also recorded, and patients were instructed to rate the perceived pain on Visual Analogue Scale. Results In all the follow-up periods, data indicated significantly higher pPS scores in the preemptive medication groups when compared to the control group ( p < 0.05). Both regimens delayed the first RM intake when compared to controls. In the etoricoxib group, a significantly lower total RM consumption was observed ( p < 0.05). Dexamethasone significantly decreased swelling at each check-up and increased mouth opening at day 7 after the surgery ( p < 0.05). Conclusions Preemptive etoricoxib and dexamethasone elevate pPS after IMTM surgery. Etoricoxib improves RM parameters, while dexamethasone ameliorates the patient’s postoperative functional ability. Clinical Relevance Preemptive etoricoxib and dexamethasone use may decrease patients’ discomfort following the impacted mandibular third molar extraction. Trial registration ClinicalTrials.gov Identifier: NCT05791721. Date of Registration: 28/03/2023 (retrospectively registered).