Department of periodontics, Dental Implants Research center Dental Research Institute, School of Dentistry Isfahan University of Medical Sciences, Isfahan, Iran
Med Oral Patol Oral Cir Bucal. 2022 Sep 1;27(5):e410-e418. doi: 10.4317/medoral.25177.
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.
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.
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.
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.
第三磨牙手术常伴有术后不适，如疼痛、肿胀和牙关紧闭。我们旨在评估辅助皮质类固醇治疗在改善第三磨牙手术后以患者为中心的结局方面的现有证据。
本系统评价评估并搜索了 PubMed、Google Scholar、Scopus、Web of Science、clinicaltrials.gov 和 Cochrane 中心的对照试验，截至 2021 年 5 月。主要结局指标是使用辅助皮质类固醇治疗第三磨牙拔除后患者的生活质量等以患者为中心的结局。仅纳入以英文发表的随机对照试验。
最初确定了 355 项研究，最终纳入了 12 项研究。结果表明，甲泼尼龙和地塞米松均可减轻术后副作用，如疼痛、牙关紧闭和肿胀，从而改善患者报告的结局。在这方面，纳入的论文均未报告这两种药物之间存在任何显著的统计学差异（p > 0.05）。关于皮质类固醇给药途径的分析表明，地塞米松局部和静脉注射具有等效作用，与单纯口服给药相比，这两种方法的效果都更好。
辅助使用皮质类固醇药物可能会改善第三磨牙手术后以患者为中心的结局。然而，药物和给药途径之间没有显著差异。比较各种给药途径，地塞米松局部黏膜下注射似乎是一种简单、无痛且具有成本效益的辅助治疗方法。
