Can adjunctive corticosteroid therapy improve patient-centered outcomes following third molar surgery? A systematic review
- PMID: 35975802
- PMCID: PMC9445603
- DOI: 10.4317/medoral.25177
Can adjunctive corticosteroid therapy improve patient-centered outcomes following third molar surgery? A systematic review
Abstract
Background: Third molar surgery is frequently associated with postoperative discomfort such as pain, edema and trismus. We aimed to evaluate the current evidence on the efficacy of adjunctive corticosteroid therapy in improving patient-centered outcomes following third molar surgery.
Material and methods: This systematic review assessed and searched PubMed, Google scholar, Scopus, web of science, clinicaltrials.gov and Cochrane central for controlled trials, up to May 2021. The primary outcome measures were patient-centered outcomes such as quality of life following the use of adjunctive corticosteroid therapy in third molar removal. Only randomized controlled trials published in English language were included.
Results: A total of 355 studies were initially identified, and 12 studies were finally included. The results showed that both methylprednisolone and dexamethasone decreased postoperative side effects such as pain, trismus, and edema and consequently were improving patient reported outcomes. In this regard, none of the included papers reported any significant statistical difference between these two drugs (p > 0.05). The analysis regarding the route of administration for the corticosteroids showed that local and intravenous injection of dexamethasone had equivalent effects, and both methods showed better results as compared to simple oral administration.
Conclusions: Adjunctive use of corticosteroid drugs may improve patient-centered outcomes following third molar surgery. However, there is no significant difference between drugs and routs of administration. Comparing various administration routs, local submucosal injection of dexamethasone seems to be a straightforward, painless and cost-effective adjunctive therapy.
Conflict of interest statement
Conflicts of interest The authors declare that they have no Conflicts of interest.
Figures
Similar articles
-
Efficacy of corticosteroids versus placebo in impacted third molar surgery: systematic review and meta-analysis of randomized controlled trials.Int J Oral Maxillofac Surg. 2019 Jan;48(1):118-131. doi: 10.1016/j.ijom.2018.05.023. Epub 2018 Jun 23. Int J Oral Maxillofac Surg. 2019. PMID: 29941229
-
Comparison of the Effects of Dexamethasone Administration on Postoperative Sequelae Before and After "Third Molar" Extraction Surgeries.Endocr Metab Immune Disord Drug Targets. 2020;20(3):356-364. doi: 10.2174/1871530319666190722120405. Endocr Metab Immune Disord Drug Targets. 2020. PMID: 31416411 Review.
-
Pre-emptive effect of dexamethasone and methylprednisolone on pain, swelling, and trismus after third molar surgery: a split-mouth randomized triple-blind clinical trial.Int J Oral Maxillofac Surg. 2014 Jan;43(1):93-8. doi: 10.1016/j.ijom.2013.05.016. Epub 2013 Jun 28. Int J Oral Maxillofac Surg. 2014. PMID: 23810681 Clinical Trial.
-
Third Molar Surgery Outcomes: A Randomized Clinical Trial Comparing Submucosal and Intravenous Dexamethasone.J Oral Maxillofac Surg. 2021 Feb;79(2):295-304. doi: 10.1016/j.joms.2020.09.020. Epub 2020 Sep 17. J Oral Maxillofac Surg. 2021. PMID: 33058774 Clinical Trial.
-
Submucosal dexamethasone injection improves quality of life measures after third molar surgery: a comparative study.J Oral Maxillofac Surg. 2011 Sep;69(9):2289-97. doi: 10.1016/j.joms.2011.01.037. Epub 2011 Apr 22. J Oral Maxillofac Surg. 2011. PMID: 21514710 Clinical Trial.
Cited by
-
Localised 0.2% chlorhexidine irrigation delivery system versus oral antibiotics in reducing postoperative complications in the surgical extraction of impacted mandibular third molar (IMTM). - a randomised controlled trial.Med Oral Patol Oral Cir Bucal. 2024 Sep 1;29(5):e690-e697. doi: 10.4317/medoral.26676. Med Oral Patol Oral Cir Bucal. 2024. PMID: 39154253 Free PMC article. Clinical Trial.
-
Patient-reported outcomes of zirconia dental implants: a systematic review and future directions.J Patient Rep Outcomes. 2025 Jan 14;9(1):7. doi: 10.1186/s41687-025-00839-8. J Patient Rep Outcomes. 2025. PMID: 39808357 Free PMC article.
-
Effect of Preoperative Administration of Dexamethasone vs. Methylprednisolone in Surgical Extraction of Impacted Lower Third Molars: Randomized Controlled Clinical Trial.J Clin Med. 2024 Aug 7;13(16):4614. doi: 10.3390/jcm13164614. J Clin Med. 2024. PMID: 39200756 Free PMC article.
-
Efficacy of submucosal administration of tramadol on acute pain following third molar surgery: a systematic review and meta-analysis.Front Oral Health. 2024 Nov 18;5:1360298. doi: 10.3389/froh.2024.1360298. eCollection 2024. Front Oral Health. 2024. PMID: 39624649 Free PMC article.
-
Preemptive use of anti-inflammatories and analgesics in oral surgery: a review of systematic reviews.Front Pharmacol. 2024 Jan 24;14:1303382. doi: 10.3389/fphar.2023.1303382. eCollection 2023. Front Pharmacol. 2024. PMID: 38328575 Free PMC article.
References
-
- Susarla SM, Dodson TB. Risk factors for third molar extraction difficulty. J Oral Maxillofac Surg. 2004;62:1363–71. - PubMed
-
- Coulthard P, Bailey E, Esposito M, Furness S, Renton TF, Worthington HV. Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database Syst Rev. 2014;7:CD004345. - PubMed
-
- de Jongh A, van Wijk AJ, Lindeboom JA. Psychological impact of third molar surgery: a 1-month prospective study. J Oral Maxillofac Surg. 2011;69:59–65. - PubMed
-
- Negreiros RM, Biazevic MGH, Jorge WA, Michel-Crosato E. Relationship between oral health-related quality of life and the position of the lower third molar: postoperative follow-up. J Oral Maxillofac Surg. 2012;70:779–86. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical