The use of glucocorticosteroids to lessen the inflammatory sequelae following third molar surgery

Michael T. Montgomery, James P. Hogg, David L. Roberts, Spencer W. Redding

Research output: Contribution to journalArticle

73 Scopus citations

Abstract

Acceptance of the use of glucocorticosteroids in dentistry to control post-surgical inflammation has been impaired by concerns over side effects, adrenal suppression, and efficacy. The pattern of administration generally used is characterized as short-term, high-dose or pulse therapy, which has not been associated with significant side effects or adrenal suppression beyond 10 days. The selection of an appropriate glucocorticosteroid with minimal mineralocorticoid activity and extended biological activity is desirable. Oral and parenteral dosing are possible, and the latter can be administered as acetates (repository) or esters. The efficacy of glucocorticosteroids in reducing pain, swelling, and trismus after third molar surgery is difficult to ascertain because of methodological inconsistencies between investigations. In general, studies that used low dosing schedules have failed to produce dramatic and prolonged results. High-dosing intravenous (IV) studies have demonstrated significant short-term improvements, but the effects were not sustained. Combining IV administration with multiple oral dosing or a single intramuscular (IM) dose may be required to extend short-term improvement. High-dosing IM studies have shown significant and sustained anti-inflammatory effects with a single dose administered either pre- or post-operatively.

Original languageEnglish (US)
Pages (from-to)179-187
Number of pages9
JournalJournal of Oral and Maxillofacial Surgery
Volume48
Issue number2
DOIs
StatePublished - Jan 1 1990

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ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology

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