Submucosal administration of dexamethasone versus methyl prednisolone in management of postoperative sequelae after mandibular third molar impaction - A systematic review

Abstract

Third molar extraction is one of the most commonly performed minor surgical procedure in any dental practice worldwide, often accompanied by various postoperative sequelae such as swelling pain and trismus which intern affects the quality of life of a patient. Over the past few decades, different methods have been proposed in the literature and were clinically evaluated to reduce the postoperative discomfort after mandibular third molar impaction and out of which corticosteroids, have shown promising results. Dexamethasone (administered either orally, submucosally, IV or IM), methylprednisolone acetate and methylprednisolone sodium succinate (IV or IM or submucosal) are most commonly preferred corticosteroids in oral and maxillofacial surgery. The main objective is to systematically review the comparison of the effectiveness of submucosal administration of dexamethasone with methylprednisolone following mandibular third molar impaction in reducing the postoperative sequelae, and its discomfort and searches were performed in the PubMed, Medline, Scopus, and Cochrane Library databases. Two articles were most relevant, and the results of the comparison of the selected articles were analysed. From this deliberate audit, it is very well may be inferred that submucosal injection of dexamethasone plays a promising role in reducing the postoperative sequelae which includes swelling, pain and trismus and its discomfort following mandibular third molar impaction when compared with that of methylprednisolone.

Efficacy of Preemptive Dexamethasone versus Methylprednisolone in the Management of Postoperative Discomfort and Pain after Mandibular Third Molar Surgery: A Systematic Review and Meta-Analysis

“…Kandamani et al [ 10 ] compared the efficacy of dexamethasone versus methylprednisolone in managing postoperative sequelae after M3M surgery. However, they only evaluated the RCTs involving the submucosal administration of the drugs and included only two studies in their review [ 15 , 20 ].…”

“…However, there was no consensus regarding the preferred corticosteroid, route, and dosage [ 9 ]. A systematic review compared the efficacy of dexamethasone versus methylprednisolone in M3M surgeries, which included RCTs that used the submucosal corticosteroid [ 10 ]. With this background, this systematic review evaluated the efficacy of dexamethasone versus methylprednisolone in managing postoperative discomfort and pain after M3M surgery.…”