This randomized clinical trial aims to evaluate the effectiveness of dexamethasone injection in reducing postoperative pain after surgical removal of impacted mandibular third molars. Patients are divided into two groups: one receiving standard local anesthesia, and the other receiving an additional dexamethasone injection postoperatively. Pain levels are assessed using the Visual Analogue Scale (VAS) at 24, 48, and 72 hours after surgery. The study is conducted at 28 Military Dental Centre, Lahore.

Impacted mandibular third molar surgery is commonly associated with postoperative pain, which can affect patient comfort and recovery. Corticosteroids such as dexamethasone have anti-inflammatory properties and may reduce postoperative pain and swelling.

This randomized clinical trial is designed to compare postoperative pain levels in patients undergoing third molar surgery with and without the administration of dexamethasone. Patients are randomly allocated into two groups. Group 1 receives standard inferior alveolar nerve block using 2% lignocaine with epinephrine. Group 2 receives an additional 1 ml (8 mg) dexamethasone injection in the buccal vestibule after completion of surgery.

Pain is assessed using the Visual Analogue Scale (VAS) at 24, 48, and 72 hours postoperatively. All patients are prescribed the same postoperative analgesic regimen. The primary outcome is the difference in mean pain scores between the two groups. Data analysis is performed using SPSS, and statistical significance is set at p < 0.05.

Inclusion Criteria:

• Patients aged 20 to 40 years
• Patients with at least one impacted mandibular third molar (Class A or B, Class I or II) including mesioangular, horizontal, vertical, or distoangular impactions according to Pell and Gregory classification confirmed by panoramic radiograph
• Patients with no systemic disease (e.g., diabetes mellitus, hypertension, ischemic heart disease)
• Patients of either gender

Exclusion Criteria:

• Patients who have used analgesics or related drugs within 15 days prior to surgery
• Pregnant patients
• Patients with known allergy to corticosteroids
• Patients with tooth associated with cyst, tumor, or trauma

This is an open-label study. Participants and investigators are aware of the assigned interventions, as one group receives dexamethasone while the control group receives standard postoperative care without dexamethasone.