Comparative Evaluation of Locally Injected Dexamethasone with and Without Vitamin C in Mandibular Fractures: A Randomized Controlled Trial

Maxillofacial trauma is becoming an increasing issue in Indian states, and fractures in the mandibular parasymphysis region are the most common. Standard treatment modality is open reduction and internal fixation but even that is not spared from complications. Corticosteroid administration locally has grown in favor; intramuscular injections of the drug close to the surgical site have been found to reduce postoperative edema. Despite being simple to apply, it may result in soft tissue dehiscence. In contrast, Vitamin C offers a promising substitute for improving the healing process when given submucosally. The purpose of this study was to evaluate and compare the postoperative wound healing, swelling, and pain in patients receiving local intramuscular injections of dexamethasone alone versus those receiving a combination of dexamethasone and Vitamin C.

A total of 30 patients participated in study. Participants were divided into two groups by random allocation. Intraoperatively, injection dexamethasone was injected in one group into the mentalis muscle. In the second group, injection Vitamin C was injected submucosally near the suture line along with injection dexamethasone.

Present study showed that there was a significant reduction in facial swelling in both groups along with reduction in postoperative pain. Intergroup comparison showed that soft tissue wound healing was better in patients who received Vitamin C injections.

Vitamin C promotes the collagen synthesis which counteracts the degrading effect of dexamethasone on the soft tissues. Hence, the use of dexamethasone in combination with Vitamin C in management of mandibular parasymphysis fracture is recommended.