Effectiveness of Submucosal Injection of Dexamethasone versus Triamcinolone Acetonide in the Management of Mental Nerve Paraesthesia Following Mandibular Parasymphysis Fracture: A Clinical Trial

Abstract

Introduction: Mental nerve paraesthesia is a common complication of mandibular parasymphysis fractures due to nerve compression, inflammation, and post-traumatic edema. Although fracture reduction restores anatomical continuity, neurosensory recovery may remain delayed. Corticosteroids may improve recovery by reducing perineural inflammation and edema.

To evaluate and compare the effectiveness of submucosal dexamethasone and triamcinolone acetonide (Kenocort) injections in improving mental nerve paraesthesia following parasymphysis fractures.

Methods  clinical trial was conducted among 40 patients presenting with mandibular parasymphysis fractures associated with mental nerve paraesthesia. Participants were randomly allocated into two groups. Group A received submucosal dexamethasone injection (4 mg/1 ml) and Group B received submucosal triamcinolone acetonide injection (10 mg/1 ml). Sensory evaluation was performed using light touch, pin-prick, two-point discrimination, and VAS-based subjective sensation scoring. Follow-up was conducted at baseline, week 1, week 2, week 4, and week 8. Statistical analysis was performed using paired and independent t-tests, with p<0.05 considered significant.

Results A Both groups showed statistically significant improvement in neurosensory recovery. Mean VAS sensation scores improved from 3.1 ± 1.0 to 8.4 ± 1.1 in Group A and from 3.0 ± 1.1 to 8.0 ± 1.2 in Group B by week 8. Group A demonstrated significantly faster improvement at week 1 and week 2 (p<0.05), while no statistically significant difference was noted between groups at week 8 (p>0.05). Two-point discrimination improved earlier in the dexamethasone group compared to the kenocort group.

Conclusions: Submucosal corticosteroid injections are effective in the management of mental nerve paraesthesia following parasymphysis fractures. Dexamethasone provides faster early neurosensory recovery compared to triamcinolone acetonide, while both agents achieve comparable recovery by 8 weeks.

Clinical Significance Early submucosal corticosteroid therapy may reduce duration of paraesthesia and improve postoperative patient comfort and sensory outcomes.