Therapeutic effects of local application of dexamethasone during bilateral sagittal split ramus osteotomy surgery.

PURPOSE: Bilateral sagittal split ramus osteotomy (BSSO) is one of the most common procedures used in the treatment of mandibular deformity. One common complication of this surgical procedure is hypoesthesia of the inferior alveolar nerve. The authors hypothesized that perioperative local application of dexamethasone would have positive therapeutic effects on neurosensory function. MATERIALS AND METHODS: This study investigated 18 patients (10 male, 8 female; mean age, 26.1 +/- 4.9 yr) who underwent BSSO. One side of each patient's mandible was randomly selected as the control side and the opposite side as the experimental side. A solution of dexamethasone 4 mg/1 mL was drawn into a syringe and poured directly on the distal segment of the exposed inferior alveolar nerve during splitting and 1 mL was poured on the same nerve immediately before the start of fixation. Neurosensory tests, including light touch, direction of movement, static 2-point touch, thermal stimuli, and pin prick discrimination, were conducted. The chi(2) and Fisher exact tests were used to evaluate the data. RESULTS: The difference between the control and experimental groups at all intervals was not significant for any of the neurosensory tests. CONCLUSION: Local application of dexamethasone on the exposed inferior alveolar nerve during BSSO is not recommended.