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.
Objectives
This study aimed to perform a systematic review and meta‐analysis regarding the prevalence of traumatic dental injuries (TDI) in emergency dental services.
Methods
Seven electronic and two grey literature databases were searched, up to December 2021, for studies that reported the TDI prevalence among dental emergencies. The Joanna Briggs Institute critical appraisal checklist for prevalence studies, and The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach were used to assess the risk of bias and quality of evidence respectively. The R software was used to perform a proportion meta‐analysis on a random‐effects model to estimate the pooled prevalence and respective 95% CI.
Results
From a total of 1476 studies identified after excluding duplicates, 38 met the inclusion criteria, and another five were identified through hand searching, summing 43 included observational studies with a total sample of 209099 individuals searching for emergency dental care. The overall pooled prevalence of TDI was 15.4% (95% CI: 11%‐21%, I² = 100%). Paediatric dental emergency services and age group from 0 to 21 years presented the highest prevalence, 29% (95% CI: 22%‐38%, I² = 99.5%) and 24% (95% CI: 15%‐35%, I² = 98%) respectively.
Conclusions
The overall pooled prevalence of TDI in emergency dental services was 15.4%, and 24% in the age group under 21 years. Considering the impact of prompt and correct emergency care in the long‐term prognosis of TDI, such knowledge is relevant to organize emergency healthcare and support public policies in this area.
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