Efficacy of corticosteroids versus placebo in impacted third molar surgery: systematic review and meta-analysis of randomized controlled trials

Almeida, Renata de Albuquerque Cavalcanti; Lemos, Caa; Moraes, Sandra Lúcia Dantas de; Pellizzer, Eduardo Piza; Vasconcelos, Belmiro Cavalcanti do Egito

doi:10.1016/j.ijom.2018.05.023

Cited by 34 publications

(18 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The first one is a genomic mechanism (slow-acting) that involves the diffusion of corticosteroid molecules through the cell membrane and binding with the cytosolic receptors GR-α and GR-ß for their subsequent transport to the nucleus, where they bind to specific DNA sequences and promote the expression of mRNA and subsequent synthesis of anti-inflammatory proteins. [17][18][19][20] The second one is a non-genomic (fast-acting) mechanism that involves dexamethasone binding with cell membrane receptors, resulting in the formation of second messengers such as cAMP or protein kinases, which inhibit the expression of phospholipase-A2 and COX-2 enzymes. [18][19][20][21][22][23] For this reason, dexamethasone was chosen because of its great anti-inflammatory effectiveness, long half-life and causes no sodium retention.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19][20] The second one is a non-genomic (fast-acting) mechanism that involves dexamethasone binding with cell membrane receptors, resulting in the formation of second messengers such as cAMP or protein kinases, which inhibit the expression of phospholipase-A2 and COX-2 enzymes. [18][19][20][21][22][23] For this reason, dexamethasone was chosen because of its great anti-inflammatory effectiveness, long half-life and causes no sodium retention. In addition, the intramuscular route was chosen for its accessibility, fast acting capabilities and greater control of the inflammatory process in mandibular third molar surgery.…”

Section: Discussionmentioning

confidence: 99%

“…On the first day, the recorded pain intensity in Group A was 0.91 ± 0.07 (95% CI=0.87 -0.97), while in Group B it was 1.07 ± 0.29 (95% CI=0.96 -1.23); p=0. 18.…”

Section: Pain Intensitymentioning

confidence: 99%

See 2 more Smart Citations

Comparison of the anti-inflammatory effectiveness of dexamethasone as pre-surgical and post-surgical therapy in mandibular third molar surgery: A randomized clinical trial.

et al. 2020

View full text Add to dashboard Cite

Objective: To compare the anti-inflammatory effectiveness of dexamethasone as pre-surgical and post-surgical therapy in mandibular third molar surgery. Materials and methods: Randomized clinical trial conducted in 60 patients in need of mandibular third molar extraction, ages ranging from 16 to 35 years old, at the Department of Oral and Maxillofacial Surgery of the Arzobispo Loayza National Hospital during the period of January-March, 2016. Patients were distributed in two randomized groups: Group A received 4mg dexamethasone intramuscular before the surgery, and Group B received the same medication post-surgery. Facial edema was assessed using the distance between facial points, trismus was evaluated using the interincisal distance, and pain intensity was determined using a Numerical Scale (NS). Results: Facial edema values were lower in Group A at 60 minutes (p=0.002) and after the first (p=0.001) and third days (p=0.009), compared to Group B. Regarding trismus, no significant differences between the groups were found. Regarding pain intensity, the highest point was recorded at 6 hours in both groups; however, no significant differences between the groups were found. Conclusion: Pre-surgical dexamethasone administration produced a significantly greater reduction in facial edema after mandibular third molar surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of the anti-inflammatory effectiveness of dexamethasone as pre-surgical and post-surgical therapy in mandibular third molar surgery: A randomized clinical trial.

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In a systematic review, Almeida et al . (23) found that the preemptive administration of corticosteroids achieved better results regarding the control of trismus, which may be explained by the fact that the drug is made available to the organism prior to the tissue injury. According to Alexander and Throndson (18), to obtain the maximum expected benefit from the preemptive use of corticosteroids, administration should be performed two to four hours prior to the procedure to obtain adequate tissue levels.…”

Section: Discussionmentioning

confidence: 99%

Effect of preemptive dexamethasone and etoricoxib on postoperative period following impacted third molar surgery - a randomized clinical trial

Rodrigues¹,

Pereira²,

Vasconcelos³

et al. 2019

Med Oral

View full text Add to dashboard Cite

Background The aim of this study was to compare the anti-inflammatory effects of dexamethasone and etoricoxib after third molar extraction. Material and Methods A prospective, randomized, controlled, split-mouth study was conducted. 19 volunteers were allocated randomly to receive 90mg etoricoxib 1 hour prior to the procedure or 4mg intramuscular dexamethasone immediately after anesthesia. Baseline measurements were obtained preoperatively, and subsequent assessments were made on immediate postoperative, at 72 hours and 7 days after surgery to measure postoperative facial swelling by use of linear measurements, interincisal mouth opening width and visual analog scale score for pain. The amount of analgesics consumed was recorded. Descriptive statistics and the independent-samples t-test were used to compare the two groups at P < 0.05. Results Dexamethasone was effective in the control roasted edema for measurements of the mandibular angle - wing of the nose and mandibular angle - labial commissure 72 hours after surgery. And for the measurement mandibular angle - mentum, in the time of 72 hours and 7 days. There was no statistically significant difference in relation to pain and trismus. Conclusions Considering significant results for some measures of the variable edema for the group that used intramuscular dexamethasone and the difference without statistical significance between groups for the other variables studied, we seem to reflect the intramuscular indication of the corticosteroid in a single dosage in relation to the use of etoricoxib as pre-emptive medication. Key words:Corticosteroids, COX-2 selective, third-molar surgery.

show abstract

“…The choice of route other than submucosal (oral administration, intramuscular, intravenous, intra‐alveolar, pterygomandibular space) did not affect the results, so oral administration was a good and easy option. To control trismus, preoperative use was superior to postoperative use (Almeida, Lemos, de Moraes, Pellizzer, & Vasconcelos, 2019).…”

Section: Complicationsmentioning

confidence: 99%

Comprehensive review of lower third molar management: A guide for improved informed consent

et al. 2020

View full text Add to dashboard Cite

Lower third molar removal is the most commonly performed dental surgical procedure. Nevertheless, it is difficult to ensure that all the informed consent forms given to patients are based on the best evidence as many newer publications could change the conclusions of previous research. Therefore, the goal of this review article is to cover existing meta‐analyses, randomized control trials, and related articles in order to collect data for improved and more current informed consent.

show abstract

Efficacy of corticosteroids versus placebo in impacted third molar surgery: systematic review and meta-analysis of randomized controlled trials

Cited by 34 publications

References 68 publications

Comparison of the anti-inflammatory effectiveness of dexamethasone as pre-surgical and post-surgical therapy in mandibular third molar surgery: A randomized clinical trial.

Comparison of the anti-inflammatory effectiveness of dexamethasone as pre-surgical and post-surgical therapy in mandibular third molar surgery: A randomized clinical trial.

Effect of preemptive dexamethasone and etoricoxib on postoperative period following impacted third molar surgery - a randomized clinical trial

Comprehensive review of lower third molar management: A guide for improved informed consent

Contact Info

Product

Resources

About