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Objective: The aim of this study is to evaluate the effectiveness of submucosal 8 mg (2 mL) dexamethasone (DEX) on postoperative pain, swelling, chewing efficiency, trismus, healing, and discomfort after periodontal flap surgery (PFS)., Methods: In this randomized controlled split-mouth study, 25 patients underwent PFS in the mandible, whereby postoperative, submucosal DEX was injected to the surgical field to the test group and submucosal normal saline was applied to the control group. Pain was evaluated using the Visual Analogue Scale (VAS) and the 101-point numeric rate scale in the first 8 h after PFS and on the 2nd, 3rd, 4th, and 7th days, whereas swelling, chewing efficiency, trismus, healing, discomfort and analgesic consumption were evaluated preoperatively on the 1st, 2nd and 7th days., Results: In the intergroup evaluation, the VAS-7th hour value of the test group was lower than the control group(p < 0.05). On the 1st day, it was observed that there was less swelling and more chewing efficiency in the test group than in the control group(p < 0.05). When time-dependent changes were examined, the decrease in mouth opening due to trismus in the control group was greater than that in the test group on the 1st and the 2nd days compared to the preoperative period(p < 0.05). Finally, postoperative healing, discomfort, and analgesic consumption were similar between groups., Conclusion: Within the limits of this study, the submucosal DEX may be an effective protocol in the management of pain, swelling, and trismus after PFS., Clinical Relevance: Our findings shed light on the possible effects of DEX after PFS., Trial Registration: This study was registered on ClinicalTrials.gov (NCT06119893)., Competing Interests: Declarations. Ethical approval: This clinical study was approved by the human subjects ethics board of the Clinical Research Ethics Committee of Van Yuzuncu Yil University (Decision number: 13.07.2021/08). The present study was conducted in accordance with the Helsinki Declaration of 1975, as revised in 2013. This study was registered on ClinicalTrials.gov (NCT06119893). Competing interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Aim: To establish the effects of submucosal tramadol, dexamethasone and articaine on the success of inferior alveolar nerve blocks (IANB) during root canal treatment of mandibular molars with symptomatic irreversible pulpitis (SIP). Methodology: In this randomized double‐blind, controlled clinical trial, 120 patients with the diagnosis of SIP in their mandibular first or second molars were included and randomly divided into four groups (n = 30). The control group received normal saline and three experimental groups received a single dose of dexamethasone (8 mg/2 mL), or tramadol (100 mg/2 mL) or articaine (4% / 2 mL). The pre‐operative pain levels of the patients were measured with the Heft‐Parker visual analogue scale (HP VAS). All patients received standard IANB of 4% articaine with 1:200000 epinephrine. Following the observation of lip numbness, submucosal injections were administered into the mucobuccal fold adjacent to the mandibular molars. After 15 min, standard root canal treatment was initiated, and the pain intensity levels recorded from the access cavity preparation to pulp extirpation were measured with HP VAS. The duration of the anaesthesia was also evaluated. The experimental groups were compared using one‐way ANOVA or Kruskal–Wallis H‐test. The groups that were significantly different were compared pairwise using the Tukey Multiple Comparison test. The Chi‐square test was used to compare the categorical variables. Results: The submucosal administration of articaine significantly increased the success rate to 63% in comparison with the control group that received submucosal saline (p <.05). The success rate of pulpal anaesthesia was 37% in the control group, 57% in the tramadol group and 47% in the dexamethasone group, with no significant difference in the success rate among these groups. In the dexamethasone group, the duration of the anaesthetic effect of IANB was significantly longer than those in the other groups (p <.001). Conclusions: In patients with SIP, pre‐operative submucosal administration of articaine increased the success rate of IANB, while administration of dexamethasone increased the duration of anaesthesia. These agents can be used in cases where effective anaesthesia cannot be obtained during root canal treatments. [ABSTRACT FROM AUTHOR]