A Randomized Clinical Trial of the Effects of Submucosal Dexamethasone After Surgery for Mandibular Fractures

Dongol, Ashok; Jaisani, Mehul Rajesh; Pradhan, Leeza; Dulal, Soniya; Sagtani, Alok

doi:10.1016/j.joms.2014.12.042

Cited by 14 publications

(15 citation statements)

References 31 publications

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“…In mandibular fracture surgery, the submucosal injection of DXM 8 mg at the surgical incision site decreased pain significantly (VAS score, 2 vs 0) at the measurement point of 72 hours, but not at 2, 4, 8, 12, 24, or 48 hours or 7 days postoperatively. 5 This effect appeared to be mild, which could be explained by the lower DXM dose than administered in the present study and that DXM was administered after an algogenic stimulus. DXM delivered some of its effect with a delay, because it acts in part by downregulating genes that induce inflammation mediator production.…”

Section: Discussionmentioning

confidence: 50%

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Analgesic Effect of Perioperative Systemic Dexamethasone on Blowout Fracture Surgery

Kormi

Snäll

Koivusalo

et al. 2017

Journal of Oral and Maxillofacial Surgery

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Section: Discussionmentioning

confidence: 50%

“…However, a study found that the submucosal administration of dexamethasone (DXM) 8 mg after mandibular fractures showed some benefit. 5 To the best of the authors' knowledge, no studies have analyzed the systemic effect of GCs on pain in facial trauma surgery.…”

mentioning

confidence: 99%

Analgesic Effect of Perioperative Systemic Dexamethasone on Blowout Fracture Surgery

Kormi

Snäll

Koivusalo

et al. 2017

Journal of Oral and Maxillofacial Surgery

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“…In comparison, Dongol et al reported that submucosal administration of dexamethasone after open reduction and internal fixation for mandibular fractures was effective in reducing post-operative swelling and pain. However, they did not observe any significant difference in mouth opening or difficulty in mandibular function [30].…”

Section: Corticosteroidsmentioning

confidence: 77%

“…Not many randomised trials have been undertaken to study the effects of corticosteroids in oral and maxillofacial surgery. With regards to pain and swelling, its effect in traumatology has been studied once only in two separate RCTs; one on patients with blow out fracture [20] and the other on those with mandibular fracture [30]. In the observer-blinded study on the effect of dexamethasone 30 mg in blowout fracture surgery, Kormi et al concluded that dexamethasone decreased post-operative pain and recommended it as a preemptive analgesic.…”

Section: Corticosteroidsmentioning

confidence: 99%

66 Years of Corticosteroids in Dentistry: And We Are Still at a Cross Road?

Ngeow¹,

Lim²,

Ahmad³

2018

Corticosteroids

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Most of the corticosteroids prescribed in dentistry are for topical applications or short-term usage, rarely for its systemic effects or for long-term consumption, as in the treatment of some medical conditions. Among the various specialties in dentistry, oral and maxillofacial surgery, oral medicine and endodontics are the more frequent users of corticosteroids. Corticosteroids are used in oral and maxillofacial procedures to reduce associated post-operative inflammation. The most researched outcome on the use of corticosteroids in oral and maxillofacial surgery revolves around their impact to reduce post-operative pain, swelling and trismus. Topical corticosteroids, on the other hand, are effective in treating various oral mucosal lesions including oral ulcerations and oral presentations of auto-immune diseases. Corticosteroids are also used as part of the treatment of temporomandibular joint disorders. Intracanal placement of corticosteroids is used in endodontic treatment. This chapter reviews the use of corticosteroids in the three specialties of dentistry as mentioned.

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“…Difficulty in mandibular movements (mandibular protrusion and lateral excursion, speech and mastication) was evaluated 24, 48, and 72 hours and 7 days after ORIF by means of grading scale of mild, moderate, and severe difficulty . (6) Paraesthesia was evaluated objectively by brush stroke method and subjectively by questioning the patient. Hemodynamic changes, complete blood picture and random blood glucose levels were also measured preoperative and postoperatively.…”

Section: Materials and Methodmentioning

confidence: 99%

Administration of corticosteroids in mandibular fractures- A double edged sword

Jadhav

Sinha²,

Tiwari³

et al. 2016

IJMSCI

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Aim: To compare the effectiveness of five day versus one day perioperative dose of corticosteroids in mandibular fractures operated via an intraoral approach. Materials and method: This is a prospective, randomized, controlled, double blind clinical study involving 144 subjects from (2011-2015) who underwent Open reduction and internal fixation (ORIF) via intraoral approach for simple, non-comminuted, fractures of mandible. The subjects were randomly assigned into 2 groups of 72 each by lottery method. Patients in Group A (control group) were administered a tapering dose of Dexamethasone 8mg IV over 5days while patients in Group B (test group) received one preoperative and one postoperative dose of intravenous (IV) Dexamethasone. Both groups were administered 1 st dose of 8mg Dexamethasone simultaneously. Both the groups were followed up on the 1 st day, 3 rd day, 1 st week post operatively and were evaluated for pain (VAS on 10cm scale), swelling, paraesthesia, nausea and vomiting and any other adverse effects.Results: Postoperatively swelling at 48hours was higher in test group by 7.5% which was statistically significant (p = 0.001). Paraesthesia was also 10% higher in test group but wound dehiscence was higher in control group by 7.5%. The test group also recorded lower incidence of infection clinically as well as radiographically. Conclusion: 5 day steroid regimen and 1 day regimen were equally effective in increasing patients comfort by reducing swelling. However, 1 day regimen was significantly satisfactory with regard to healing and long term outcomes while being cost effective at the same time.

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A Randomized Clinical Trial of the Effects of Submucosal Dexamethasone After Surgery for Mandibular Fractures

Cited by 14 publications

References 31 publications

Analgesic Effect of Perioperative Systemic Dexamethasone on Blowout Fracture Surgery

Analgesic Effect of Perioperative Systemic Dexamethasone on Blowout Fracture Surgery

66 Years of Corticosteroids in Dentistry: And We Are Still at a Cross Road?

Administration of corticosteroids in mandibular fractures- A double edged sword

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