ASSESSMENT OF POSTOPERATIVE MORBIDITY IN ORAL SURGERY PATIENTS RECEIVING CORTICOSTEROIDS VERSUS NO CORTICOSTEROID THERAPY

Abstract

Background: Postoperative pain, facial oedema, and trismus are common sequelae of oral surgical procedures that may adversely affect patient recovery and quality of life. Corticosteroids have been widely advocated for their anti inflammatory properties; however, evidence regarding their routine perioperative use remains variable across different oral surgical settings. Aim: To compare postoperative morbidity in patients undergoing elective oral surgical procedures with and without perioperative corticosteroid therapy Materials and Methods: A randomized controlled trial was conducted between April 2025 and March 2026 at two oral and maxillofacial surgery units. Ninety patients aged 18–45 years undergoing elective oral surgical procedures were randomly allocated to receive either intravenous dexamethasone (8 mg) administered 30 minutes preoperatively (corticosteroid group; n = 45) or no corticosteroid therapy (control group; n = 45). Primary outcome measures included facial oedema, pain intensity assessed using the Visual Analog Scale (VAS), and mouth opening. Secondary outcomes included analgesic consumption, quality of life, return to a normal diet, and postoperative adverse events. Outcome assessments were performed at baseline and at 24 hours, 72 hours, and 7 days postoperatively. Statistical analysis was performed using mixed-model repeated-measures Analysis of Covariance (ANCOVA), independent-samples t-tests, and chi-square tests, with statistical significance set at p < 0.05. Results: Of the 90 enrolled participants, approximately 97% completed the follow-up protocol. Baseline demographic and clinical characteristics were comparable between groups. At 72 hours postoperatively, the corticosteroid group demonstrated significantly lower facial oedema (6.8 ± 2.1 mm vs. 11.6 ± 3.4 mm; p < 0.001), lower pain scores (VAS: 2.4 ± 0.9 vs. 4.2 ± 1.2; p < 0.001), and greater mouth opening (44.6 ± 4.8 mm vs. 38.3 ± 5.2 mm; p < 0.001) than the control group. Analgesic consumption during the first 72 hours was significantly reduced in the corticosteroid group (3.2 ± 1.1 vs. 5.1 ± 1.4 tablets; p < 0.001). Patients receiving corticosteroids also exhibited superior quality-of-life scores (78.4 ± 7.6 vs. 65.3 ± 9.1; p < 0.001) and returned to a normal diet earlier (3.1 ± 0.9 vs. 4.8 ± 1.2 days; p < 0.001). Wound infection and alveolar osteitis occurred less frequently in the corticosteroid group, whereas mild transient hyperglycaemia (4.4%) and gastrointestinal discomfort (6.7%) were observed only among corticosteroid recipients. No serious adverse events were reported. Conclusion: Perioperative administration of intravenous dexamethasone significantly reduced postoperative morbidity following elective oral surgical procedures by decreasing facial oedema, pain, trismus, and analgesic requirements while improving quality of life and accelerating functional recovery. The therapy was well tolerated, with only minor transient adverse effects and no serious complications. These findings support the judicious use of perioperative corticosteroids as an effective adjunct in the management of postoperative morbidity in oral surgery.