Abstract

Aim: To compare the effectiveness of five day versus one day perioperative dose of corticosteroids in mandibular fractures operated via an intraoral approach. Materials and method: This is a prospective, randomized, controlled, double blind clinical study involving 144 subjects from (2011-2015) who underwent Open reduction and internal fixation (ORIF) via intraoral approach for simple, non-comminuted, fractures of mandible. The subjects were randomly assigned into 2 groups of 72 each by lottery method. Patients in Group A (control group) were administered a tapering dose of Dexamethasone 8mg IV over 5days while patients in Group B (test group) received one preoperative and one postoperative dose of intravenous (IV) Dexamethasone. Both groups were administered 1st dose of 8mg Dexamethasone simultaneously. Both the groups were followed up on the 1st day, 3rd day, 1st week post operatively and were evaluated for pain (VAS on 10cm scale), swelling, paraesthesia, nausea and vomiting and any other adverse effects. Results: Postoperatively swelling at 48hours was higher in test group by 7.5% which was statistically significant (p = 0.001). Paraesthesia was also 10% higher in test group but wound dehiscence was higher in control group by 7.5%. The test group also recorded lower incidence of infection clinically as well as radiographically. Conclusion: 5 day steroid regimen and 1 day regimen were equally effective in increasing patients comfort by reducing swelling. However, 1 day regimen was significantly satisfactory with regard to healing and long term outcomes while being cost effective at the same time.