A randomized, prospective, controlled trial was conducted to determine the efficacy of single and repeated
betamethasone doses on facial oedema,
pain, and neurosensory disturbances after bilateral sagittal split
osteotomy. Thirty-seven patients (mean age 23.62 years, range 17-62 years) with either mandibular
prognathism or
retrognathism were enrolled consecutively into the study and divided into three groups: control (n=12), repeated dose 4+8+4mg
betamethasone (n=14), single dose 16mg
betamethasone (n=11). The intake of
diclofenac and
paracetamol was assessed individually. Measurements of facial oedema,
pain, and sensitivity in the lower lip/chin were obtained 1 day, 7 days, 2 months, and 6 months postoperatively. Furthermore, we investigated the possible influences of gender, age, total operating time, amount of
bleeding, postoperative hospitalization, and advancement versus setback of the mandible. A significant difference (P=0.017) was observed in percentage change between the two test groups and the control group regarding facial oedema (1 day postoperatively). Less
bleeding was associated with improved
pain recovery over time (P=0.043). Patients who required higher postoperative dosages of
analgesics due to
pain had significantly delayed recovery of the inferior alveolar nerve at 6 months postoperatively (P<0.001).
Betamethasone did not reduce neurosensory disturbances over time.