Efficacy of different dexamethasone routes and doses in reducing the postoperative sequelae of impacted mandibular third-molar extraction

Almadhoon, Hossam Waleed; Hamdallah, Aboalmagd; Eida, Mohammed Abu; Al-Kafarna, Mohammed; Atallah, Duha Ahmad; AbuIriban, Roaa Waleed; Mostafa, Moamen; Abdelsalam, Alaa; Awad, Alaa Abdelsameia; Nawar, Asmaa Ahmed; Elsayed, Sarah; Almotairy, Nabeel

doi:10.1016/j.adaj.2022.08.017

Cited by 3 publications

(2 citation statements)

References 70 publications

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“…Overall, corticosteroids minimized inflammatory problems following third molar surgeries and had no major adverse reactions. These findings are consistent with the systematic reviews and meta-analyses published in the current literature [30,31].…”

Section: Discussionsupporting

confidence: 92%

Efficacy of Hydrocortisone, Povidone-Iodine, and Normal Saline as an Irrigating Solution During Surgical Removal of Impacted Mandibular Third Molars: A Randomized Controlled Trial

Ahmed,

Baliga,

Baliga

et al. 2024

Cureus

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BackgroundThe surgical removal of mandibular third molars is one of the most common procedures in dentistry. Researchers have extensively studied the treatment of postoperative sequelae such as pain, edema, trismus, and alveolar osteitis throughout the past six decades. Many approaches have been used to address clinical difficulties after third molar surgery, including various flap designs and irrigating solutions. The aim of this study was to compare the effects of three irrigating solutions, hydrocortisone, povidone-iodine, and normal saline, on pain, trismus, and edema following surgical removal of the impacted mandibular third molar. MethodologyThe study involved 105 participants who required surgical extraction of mandibular third molars. The patients' ages ranged from 18 to 40 years, and they fulfilled the inclusion criteria. Using a simple random sampling technique, they were divided into three groups (group 1: hydrocortisone, group 2: povidoneiodine, group 3: normal saline). The parameters evaluated were edema, pain, and trismus on the second and seventh postoperative days. All data were input into Microsoft Excel (Microsoft ® Corp., Redmond, USA) worksheets and analyzed using Stata 17.0 (StataCorp LLC, College Station, USA). The visual analog scale (VAS) score was used to measure postoperative pain, and postoperative swelling was measured using linear measurements from four fixed anatomical points and compared to preoperative values. To assess trismus, the inter-incisal distance was measured in millimeters with a caliper. A p-value of <0.01 was considered statistically significant. ResultsThe mean VAS score for pain in group 1 was lower than the other two groups. The effect of group 1 was significant on the second postoperative day but insignificant on the seventh postoperative day for swelling. The effect of all three groups on trismus was significant on the second and seventh days. ConclusionsHydrocortisone as an irrigating solution showed promising results in managing postoperative swelling in the first 48 hours, but its effect gradually declined by the seventh postoperative day. Additionally, it was effective in controlling postoperative pain and trismus. This suggests that utilizing hydrocortisone as an irrigating solution, compared to povidone-iodine, has been proven to be a significantly effective option in reducing postoperative pain, edema, and trismus resulting from the surgical removal of impacted teeth.

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Section: Discussionsupporting

confidence: 92%

Efficacy of Hydrocortisone, Povidone-Iodine, and Normal Saline as an Irrigating Solution During Surgical Removal of Impacted Mandibular Third Molars: A Randomized Controlled Trial

Ahmed,

Baliga,

Baliga

et al. 2024

Cureus

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“…The results of meta-analyses are presented in Table 2 . Falci et al (2017) , Almeida et al (2019) , Caporossi et al (2020) , Almadhoon et al (2022) , and Canellas et al (2022) evaluated the use of corticosteroids, while Caporossi et al (2020) and Cetira Filho et al (2020) assessed the use of NSAIDs.…”

Section: Methodsmentioning

confidence: 99%

Preemptive use of anti-inflammatories and analgesics in oral surgery: a review of systematic reviews

Pimenta,

Takahashi,

Barberato-Filho

et al. 2024

Front. Pharmacol.

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Objectives: This review of systematic reviews evaluated the effectiveness and safety of the preemptive use of anti-inflammatory and analgesic drugs in the management of postoperative pain, edema, and trismus in oral surgery.Materials and methods: The databases searched included the Cochrane Library, MEDLINE, EMBASE, Epistemonikos, Scopus, Web of Science, and Virtual Health Library, up to March 2023. Pairs of reviewers independently selected the studies, extracted the data, and rated their methodological quality using the AMSTAR-2 tool.Results: All of the 19 studies reviewed had at least two critical methodological flaws. Third molar surgery was the most common procedure (n = 15) and the oral route the most frequent approach (n = 14). The use of betamethasone (10, 20, and 60 mg), dexamethasone (4 and 8 mg), methylprednisolone (16, 20, 40, 60, 80, and 125 mg), and prednisolone (10 and 20 mg) by different routes and likewise of celecoxib (200 mg), diclofenac (25, 30, 50, 75, and 100 mg), etoricoxib (120 mg), ibuprofen (400 and 600 mg), ketorolac (30 mg), meloxicam (7.5, 10, and 15 mg), nimesulide (100 mg), and rofecoxib (50 mg) administered by oral, intramuscular, and intravenous routes were found to reduce pain, edema, and trismus in patients undergoing third molar surgery. Data on adverse effects were poorly reported.Conclusion: Further randomized clinical trials should be conducted to confirm these findings, given the wide variety of drugs, doses, and routes of administration used.

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Efficacy of Dexamethasone Injection at Different Sites on Postoperative Sequelae After Extracting Mandibular Impacted Third Molars: A Randomized Controlled Trial

Lou,

Weng,

et al. 2024

Journal of Oral and Maxillofacial Surgery

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Efficacy of different dexamethasone routes and doses in reducing the postoperative sequelae of impacted mandibular third-molar extraction

Cited by 3 publications

References 70 publications

Efficacy of Hydrocortisone, Povidone-Iodine, and Normal Saline as an Irrigating Solution During Surgical Removal of Impacted Mandibular Third Molars: A Randomized Controlled Trial

Efficacy of Hydrocortisone, Povidone-Iodine, and Normal Saline as an Irrigating Solution During Surgical Removal of Impacted Mandibular Third Molars: A Randomized Controlled Trial

Preemptive use of anti-inflammatories and analgesics in oral surgery: a review of systematic reviews

Efficacy of Dexamethasone Injection at Different Sites on Postoperative Sequelae After Extracting Mandibular Impacted Third Molars: A Randomized Controlled Trial

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