Extraction of impacted lower third molars induces trauma within a highly vascularised area characterized by loose connective tissue, triggering a cascade of inflammatory after-effects, including postoperative discomfort, edema, restricted mouth opening, and widespread oral impairment throughout the healing period. An encompassing technique to extend anesthesia and curb the unavoidable postoperative aftermath in minor oral surgical interventions remains insufficiently investigated. To determine the effectiveness of dexamethasone incorporated into local anesthetic solutions for lengthening anesthetic depth and duration while diminishing postoperative morbidity following the surgical removal of impacted third molars. A prospective, controlled, randomized, split-mouth, double-blind investigation of lower third molar surgery was conducted on 35 subjects. The experimental cohort (Group I) was administered 8 mg dexamethasone combined with 2 ml of 2% lignocaine containing epinephrine. In contrast, the reference cohort (Group II) received 2 ml of sterile water combined with 2 ml of 2% lignocaine containing epinephrine. Anesthetic onset and duration were measured; subsequently, pain, swelling, and trismus were tracked over 7 postoperative days, with statistical analysis using an independent t-test and a repeated-measures ANOVA. The experimental cohort demonstrated an earlier anesthetic onset by 69 s and a prolonged anesthetic action lasting 128.4 min (P < 0.001). Pain intensity scores (Visual Analog Scale) during the initial 24 h were 4.9 and 7.5 in the experimental and reference cohorts, respectively (P < 0.001). Mean analgesic intake up to postoperative day 7 totaled 12.6 and 18.4 doses in the experimental and reference cohorts, respectively (P < 0.001). Swelling was notably diminished in the experimental cohort; furthermore, trismus was significantly decreased by 1 cm on postoperative days 1 and 2, and by 0.2 cm on day 7. Incorporating dexamethasone into the lignocaine nerve block reduces the onset latency and markedly prolongs the duration of anesthesia, while diminishing pain, edema, and trismus. Corticosteroids directly blended with the local anesthetic agent can reduce the postoperative burden linked to third molar surgery through a single needle puncture.
