Do corticosteroids reduce postoperative pain following third molar intervention?

Sugragan, Chollathit; Sirintawat, Nattapong; Kiattavornchareon, Sirichai; Khoo, Lee Kian; Kc, Kumar; Wongsirichat, Natthamet

doi:10.17245/jdapm.2020.20.5.281

Cited by 11 publications

(9 citation statements)

References 38 publications

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“…It is almost certain that swelling and, to some extent, trismus could be significantly reduced by the use of corticosteroids. [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] The positive effects of steroids in maxillofacial surgery were emphasized in many studies, in particular in reducing facial edema after LFI osteotomy and BSSO. 29 Kim 30 showed the positive effect of these drugs in nerve injury healing, highlighting that the use of steroids during or after surgery can effectively prevent temporary injuries by reducing pressure created by edema.…”

Section: Discussionmentioning

confidence: 99%

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The Influence of Bolus of Methylprednisolone on Postorthognathic Surgery Symptoms: A Controlled Clinical Trial

Amodeo¹,

Cerbelli²,

Pisano

et al. 2023

Journal of Craniofacial Surgery

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Objective: Despite improvements in maxillary and mandibular osteotomy, complications still result in around 20%. Post and intraoperative standard therapies, based on the use of betamethasone and tranexamic acid, could help to minimize the onset of side effects. The aim of the study was to compare the role of a supplementary bolus of methylprednisolone rather than the standard therapy in the onset of postoperative symptoms. Methods: The authors enrolled 10 patients, affected by class 2 and 3 Dentoskeletal, submitted to the institution for maxillomandibular repositioning osteotomy between October 2020 and April 2021. Patients were divided into 2 groups as follows: 5 patients (group A) received standard therapy consisting of the administration of 4 mg of betamethasone, intraoperatively, and 1 g of tranexamic acid in 2 administrations. The remaining 5 patients (group B) received a supplementary bolus of 20 mg methylprednisolone before the end of the surgery.All patients received, in the postoperative period, 4 mg of betamethasone every 12 hours, for 3 days. Postoperative outcomes were evaluated with a questionnaire evaluating speaking discomfort, pain when swallowing, feeding discomfort, drinking discomfort, swelling, and ache. Each parameter was associated with a numeric rating scale ranging from 0 to 5. Results: The authors observed that patients treated with a supplementary bolus of methylprednisolone (group B) had a statistically significant reduction of all postoperative symptoms as compared with patients of group A (*P < 0.05, **P < 0.01 Fig. 1). Conclusion:The study highlighted that the additional bolus of methylprednisolone improved all of the 6 parameters inves-tigated by the questionnaire submitted to patients, resulting in a faster recovery and improvement of the patient's compliance with surgery. Further studies with a larger population are needed to confirm preliminary results.

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Section: Discussionmentioning

confidence: 99%

“…Their positive effect in oral surgery in reducing postoperative discomfort and sequelae, especially in the third molar surgery, is well known. It is almost certain that swelling and, to some extent, trismus could be significantly reduced by the use of corticosteroids 13–28 …”

Section: Discussionmentioning

confidence: 99%

The Influence of Bolus of Methylprednisolone on Postorthognathic Surgery Symptoms: A Controlled Clinical Trial

Amodeo¹,

Cerbelli²,

Pisano

et al. 2023

Journal of Craniofacial Surgery

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“…Los corticoides son hormonas sintéticas o semisintéticas que poseen una acción antiinflamatoria potente y son utilizadas en un amplio grupo de enfermedades, como asma, artritis reumatoide, enfermedad inflamatoria intestinal y varias enfermedades autoinmunitarias todas las cuales se asocian al incremento en la expresión de genes inflamatorios. Los corticoides son utilizados por odontólogos principalmente para tratar y prevenir cuadros severos de origen inflamatorio (1,2), en algunas ocasiones también se utilizan en infecciones para reducir la inflamación y edema, pero pueden conducir a la supresión inmune y empeorar la infección. Estudios sugieren que, puede haber consecuencias graves si los corticosteroides se utilizan como monoterapia, y muestran que los antibióticos y la operación siguen siendo claves para el manejo de infecciones cervicofaciales (3).…”

Section: Introductionunclassified

Perfil prescriptivo de corticoides en el servicio de urgencias del Hospital Odontológico de la ciudad de Formosa, Argentina

Rea,

Ramírez,

Eugenia Pomarada

et al. 2023

Acta Odontol. Colomb.

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Objetivo: identificar el perfil prescriptivo de corticoides en pacientes que asistieron al Servicio de Urgencias del Hospital Odontológico de la ciudad de Formosa, Argentina. Métodos: se realizó un estudio transversal, observacional y descriptivo, se analizaron las prescripciones de corticoides realizadas por odontólogos que atendieron en el Servicio de Urgencias del Hospital Odontológico de la ciudad de Formosa desde marzo 2019 a febrero 2020. Las variables de estudio fueron: características demográficas del paciente, diagnóstico clínico odontológico, corticoide prescrito, dosis y forma farmacéutica. Resultados: de un total de 9.635 historias clínicas, se observaron 3.244 prescripciones de corticoides (33,6%). De acuerdo a los corticoides prescritos, se halló a la dexametasona para vía intramuscular y además se utilizó dexametasona en tratamientos combinados con dipirona para vía intramuscular e ibuprofeno para vía oral. Los diagnósticos relacionados con prescripción de estos medicamentos fueron: pulpitis, periodontitis apical aguda, flemón/absceso, entre otras. De acuerdo al valor intrínseco terapéutico potencial, los fármacos prescritos en el hospital odontológico son de valor elevado, esto significa que demostraron eficacia para el tratamiento, el diagnóstico o la prevención de enfermedades del ser humano. Conclusiones: el estudio de la utilización de medicamentos en el Hospital Odontológico de la ciudad de Formosa permitió observar situaciones donde los corticoides no están indicados. Además, se señala la prescripción excesiva de la vía intramuscular. A partir de los resultados obtenidos es necesario realizar una retroalimentación a los prescriptores, por lo que se sugieren intervenciones para elaborar propuestas de solución a los problemas identificados y formular políticas de medicamentos.

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“…Preemptive approaches including cold application, postoperative instructions, and medications could prevent or reduce inflammatory complications after M3M removal 3 . Various medications have been employed to manage postoperative inflammatory complications through local or systemic administration [2][3][4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Efficacy of submucosal injection of hyaluronidase after mandibular third molar surgery: a randomized controlled trial

Lee

Kim

Nam

2022

JKAOMS

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Objectives: This study aimed to investigate the efficacy of postoperative submucosal injection of hyaluronidase (HUD) for reducing sequelae and quality of life (QOL) after mandibular third molar (M3M) surgery. Materials and Methods: Participants with bilateral impacted M3M underwent surgical extraction with a split-mouth randomized controlled study design. M3M were removed by the same surgeon in 2 sessions, one a control and the other experimental. Submucosal injection of HUD was performed in the experimental session and submucosal injection of saline in the control session. Mouth opening, facial swelling, and pain intensity were measured before surgery, and then 2 and 7 days after surgery. The QOL of participants following surgery was evaluated by means of a patient-centered outcome questionnaire (PCOQ). Results: A total of 36 patients was included in the final data analysis. There was a significant reduction in the maximal mouth opening and postoperative pain in the experimental side at the 2 and 7 days after surgery (P<0.05), and a remarkable difference in facial swelling was reported on the experimental side 7 days after surgery (P<0.05). The PCOQ demonstrated that participants reported less pain and swelling on the experimental side. Conclusion:The present study provides clinical evidence that submucosal administration of HUD immediately after M3M surgery reduced postoperative discomfort and improved patients' QOL.

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Do corticosteroids reduce postoperative pain following third molar intervention?

Cited by 11 publications

References 38 publications

The Influence of Bolus of Methylprednisolone on Postorthognathic Surgery Symptoms: A Controlled Clinical Trial

The Influence of Bolus of Methylprednisolone on Postorthognathic Surgery Symptoms: A Controlled Clinical Trial

Perfil prescriptivo de corticoides en el servicio de urgencias del Hospital Odontológico de la ciudad de Formosa, Argentina

Efficacy of submucosal injection of hyaluronidase after mandibular third molar surgery: a randomized controlled trial

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