Background: Surgical removal of impacted mandibular third molars often results in postoperative pain, swelling, and trismus. Corticosteroids like dexamethasone have been used to mitigate these sequelae. This study compares the efficacy of Twin Mix (2% lignocaine + dexamethasone) with Modified Twin Mix (4% articaine + dexamethasone) in controlling postoperative complications.

Materials and Methods: A prospective split-mouth study was conducted on 20 patients with bilaterally impacted mandibular third molars. Group A received Twin Mix and Group B received Modified Twin Mix. Parameters assessed included onset and duration of anesthesia, pain (VAS), mouth opening, and facial swelling on postoperative days 2, 7, and 14.

Results: Modified Twin Mix demonstrated significantly faster onset (p < 0.001) and longer duration of anesthesia (p < 0.001). It also showed significantly reduced pain scores and better mouth opening on postoperative day 7. No significant differences were observed in swelling at S1 and S2, but S3 showed significantly less swelling in the Modified Twin Mix group on day 14.

Conclusion: Modified Twin Mix is more effective than Twin Mix in providing prolonged anesthesia, faster onset, and improved postoperative comfort, making it a suitable alternative in third molar surgery.