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Review
. 2017 Fall;64(3):136-143.
doi: 10.2344/anpr-64-05-08.

Preemptive Effect of Dexamethasone in Third-Molar Surgery: A Meta-Analysis

Saulo Gabriel Moreira Falci  1 , Thiago César Lima  2 , Carolina Castro Martins  3 , Cássio Roberto Rocha Dos Santos  1 , Marcos Luciano Pimenta Pinheiro  4
Affiliations
Review

Preemptive Effect of Dexamethasone in Third-Molar Surgery: A Meta-Analysis

Saulo Gabriel Moreira Falci et al. Anesth Prog. 2017 Fall.

Abstract

The aim of the present study was to assess the effectiveness of preemptive dexamethasone in surgery of the lower third molars and to compare it with other oral anti-inflammatories. An electronic search was conducted for preemptive effects related to lower third-molar surgery in 3 separate databases. The variables pain, swelling, and trismus were assessed. Meta-analysis was used to calculate the pooled effect measures for mean and standard deviation values (95% confidence interval [CI]). Seven split-mouth clinical trials were selected. Two studies were included in the meta-analysis. Three studies showed a low risk of bias; 2 studies exhibited a moderate risk and 2 a high risk of bias. Dexamethasone was better than nonsteroidal anti-inflammatories for preemptive effectiveness. Meta-analysis for swelling confirmed better results for dexamethasone than for methylprednisolone after 2 days (95% CI = -1.28 to -0.38), 4 days (95% CI = -1.65 to -0.71), 7 days (95% CI = -1.42 to -0.71), and overall (95% CI = -1.25 to -0.72). Dexamethasone was better than methylprednisolone for mouth opening after 4 days (95% CI = 0.18 to 1.07). There is insufficient evidence through meta-analysis to conclude that dexamethasone is better than other nonsteroidal anti-inflammatories or methylprednisolone as a preemptive analgesic. The results of this meta-analysis suggest that dexamethasone is more effective than methylprednisolone for swelling and trismus.

Keywords: Dexamethasone; Meta-analysis; Molar, third; Surgery, Oral.

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Figures

Figure 1
Figure 1
Study screening process.
Figure 2
Figure 2
Meta-analysis of dexamethasone versus methylpredinisolone for swelling, with statistical significance; I2 = 0.00, fixed-effect model used.
Figure 3
Figure 3
Meta-analysis of dexamethasone versus methylpredinisolone for trismus, with significance; I2 = 0.00, fixed-effect model used.
See this image and copyright information in PMC

References

    1. Kim K, Brar P, Jakubowski J, Kaltman S, Lopez E. . The use of corticosteroids and nonsteroidal antiinflammatory medication for the management of pain and inflammation after third molar surgery: a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107: 630– 640. - PubMed
    1. Coulthard P, Haywood D, Tai MA, Jackson-Leech D, Pleuvry BJ, Macfarlane TV. . Treatment of postoperative pain in oral and maxillofacial surgery. Br J Oral Maxillofac Surg. 2000; 38: 588– 592. - PubMed
    1. Simone JL, Jorge WA, Horliana AC, Canaval TG, Tortamano IP. . Comparative analysis of preemptive analgesic effect of dexamethasone and diclofenac following third molar surgery. Braz Oral Res. 2013; 27: 266– 271. - PubMed
    1. Jung YS, Kim MK, Um YJ, Park HS, Lee EW, Kang JW. . The effects on postoperative oral surgery pain by varying NSAID administration times: comparison on effect of preemptive analgesia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 100: 559– 563. - PubMed
    1. Moiniche S, Kehlet H, Dahl JB. . A qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief: the role of timing of analgesia. Anesthesiology. 2002; 96: 725– 741. - PubMed

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