Comparison of the Effects of Dexamethasone Administration on Postoperative Sequelae Before and After “Third Molar" Extraction Surgeries

Abstract

Introduction: Impacted third molars (ITMs) surgery, is one of the most common methods in the field of oral and maxillofacial surgical operations. Administration of corticosteroid such as dexamethasone diminishes the postoperative sequelae. The study aimed to compare the impact of dexamethasone administration on pre-operative and post-operative complications in third molar surgery. Methods: We collected all randomized controlled trial data on the influences of pre-operative and postoperative dexamethasone administration between 2006-2019 on third molar surgery sequelae by searching the keywords: dexamethasone, third molar surgery, wisdom teeth, corticosteroids, oral surgery, maxillofacial surgery, preoperative, postoperative, pain, swelling, and trismus in international databases such as: Web of Science (ISI), PubMed, Scopus, Embase and Cochrane Library. Results: Twenty-three articles were included in this narrative review. Among them, 22 studies used dexamethasone in particular and 1 study used dexamethasone with amoxicillin. Twenty studies evaluated the prescription of dexamethasone in pre-operative and post-operative routes on pain, trismus and edema following third molars operation. Five studies administered dexamethasone postoperatively and 15 studies administered the drug preoperatively. Two studies evaluated the preoperative and postoperative administration method. Fourteen studies used a 4 mg dexamethasone dose and drug administration was variable. The treatment period in postoperative studies varied between 1 to 7 days. Conclusion: Dexamethasone appears to be a promising agent in in reduction of post-operative complications following third molar surgery. As a potent anti-inflammatory agent, it has an effective role in pain, trismus and edema reduction distinguished from the routes of administration, dosage and timing, pre or postoperative prescription.