Review of dexamethasone administration for management of complications in postoperative third molar surgery

Selvido, Diane Isabel; Bhattarai, Bishwa Prakash; Niyomtham, Nattisa; Riddhabhaya, Apiwat; Vongsawan, Kadkao; Pairuchvej, Verasak; Wongsirichat, Natthamet

doi:10.5125/jkaoms.2021.47.5.341

Cited by 10 publications

(6 citation statements)

References 74 publications

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“…5 In recent years, various methods have been utilised to minimise postoperative complications, such as topical platelet-rich fibrin, topical medications, various flap designs and osteotomies with different instruments. [6][7][8][9][10] However, traditional osteotomy techniques have certain drawbacks and are prone to generate high temperatures during osteotomy leading to damage to adjacent bones, teeth and soft tissues. 11 Ultrasound osteotome is a new osteotomy technology, which uses piezoelectric ceramic technology to convert electrical energy into mechanical energy, and can distinguish between hard and soft tissues during the cutting process, which can minimise the risk of soft tissue damage during the cutting process.…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, various methods have been utilised to minimise postoperative complications, such as topical platelet‐rich fibrin, topical medications, various flap designs and osteotomies with different instruments 6–10 . However, traditional osteotomy techniques have certain drawbacks and are prone to generate high temperatures during osteotomy leading to damage to adjacent bones, teeth and soft tissues 11 .…”

Section: Introductionmentioning

confidence: 99%

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RETRACTED: Influences of ultrasound osteotome on wound infection and wound complications following removal of mandibular wisdom teeth

Li,

Liu,

Wei

et al. 2024

International Wound Journal

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We conducted this study to assess the effect of ultrasound osteotome on surgical site wound infection and pain following removal of mandibular wisdom teeth. A computerised search of Embase, Cochrane Library, PubMed, Wanfang and China National Knowledge Infrastructure databases for publicly available randomised controlled trials (RCTs) on the clinical effects of applying ultrasound osteotome to extract mandibular wisdom teeth was conducted from the inception of the databases to September 2023. Two researchers independently screened the retrieved results for literature screening, quality assessment and data extraction. RevMan 5.4 software was applied for data analysis. A total of 17 RCTs were included in this study, including 848 cases in the ultrasound osteotome group and 842 cases in the control group. The analysis revealed, compared with the control group, the ultrasound osteotome group showed a significantly lower incidence of postoperative wound infection (1.42% vs. 5.46%, odds ratio [OR]: 0.30, 95% confidence intervals [CI]: 0.17–0.53, p < 0.0001), fewer postoperative complications (6.35% vs. 22.12%, OR: 0.23, 95% CI: 0.17–0.32, p < 0.00001), shorter operative time (standardised mean differences [SMD]: −1.30, 95% CI: −1.97 to −0.64, p = 0.0001) and lower wound pain scores (SMD: −2.26 95% CI −2.80 to −1.73, p < 0.00001). Strong evidence suggests that ultrasound osteotome applied to extract mandibular wisdom teeth is more advantageous in terms of lower postoperative wound infection, less wound pain, fewer postoperative complications and shorter operative time compared with conventional treatment methods, but large‐scale, multicentre RCTs are still needed to obtain more accurate results.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

RETRACTED: Influences of ultrasound osteotome on wound infection and wound complications following removal of mandibular wisdom teeth

Li,

Liu,

Wei

et al. 2024

International Wound Journal

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“…As a synthetic glucocorticoid ( 23 ), Dex regulates inflammatory and immune response by targeting cellular homeostasis and the gene activity and has been extensively used to treat critically ill patients due to its confirmed safety ( 24 ). Reports show that short-term treatment with Dex has a protective effect on myocardial ischemia and reperfusion injury ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone Alleviates Myocardial Injury in a Rat Model of Acute Myocardial Infarction Supported by Venoarterial Extracorporeal Membrane Oxygenation

Cheng

Zhang

Wei

et al. 2022

Front. Public Health

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Myocardial ischemia causes myocardial inflammation. Research indicates that the venoarterial extracorporeal membrane oxygenation (VA ECMO) provides cardiac support; however, the inflammatory response caused by myocardial ischemia remains unresolved. Dexamethasone (Dex), a broad anti-inflammatory agent, exhibits a cardioprotective effect. This study aims to investigate the effect of Dex on a rat model of acute myocardial infarction (AMI) supported by VA ECMO. Male Sprague-Dawley rats (300–350 g) were randomly divided into three groups: Sham group (n = 5), ECMO group (n = 6), and ECMO + Dex group (n = 6). AMI was induced by ligating the left anterior descending (LAD) coronary artery. Sham group only thoracotomy was performed but LAD was not ligated. The ECMO and ECMO + Dex groups were subjected to 1 h of AMI and 2 h of VA ECMO. In the ECMO + Dex group, Dex (0.2 mg/kg) was intravenously injected into the rats after 1 h of AMI. Lastly, myocardial tissue and blood samples were harvested for further evaluation. The ECMO + Dex group significantly reduced infarct size and levels of cTnI, cTnT, and CK-MB. Apoptotic cells and the expression levels of Bax, Caspase3, and Cle-Caspase3 proteins were markedly lower in the ECMO + Dex group than that in the ECMO group. Neutrophil and macrophage infiltration was lower in the ECMO + Dex group than in the ECMO group. A significant reduction was noted in ICAM-1, C5a, MMP-9, IL-1β, IL-6, and TNF-α. In summary, our findings revealed that Dex alleviates myocardial injury in a rat model of AMI supported by VA ECMO.

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“…Dexamethasone is one of the most potent synthetic corticosteroids with a much greater anti-inflammatory effect and minimal unfavorable impact on leukocyte chemotaxis [ 4 ]. It has a plasma half-life of 100-300 minutes with a biological half-life of 36-72 hours [ 5 ]. Oral surgeons have been using dexamethasone since 1965 [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Efficacy of Oral and Intramuscular Administration of Dexamethasone on Postoperative Pain, Swelling, and Trismus After Surgical Removal of Impacted Third Molar: A Comparative Split-Mouth Study

Lakhani¹,

Joshi²,

Pawar³

et al. 2023

Cureus

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Context Over the past 60 years, several researchers have conducted extensive studies on the use of dexamethasone to reduce the postoperative complications of lower third molar surgery, namely, pain, edema, and trismus. In this study, we compared the oral and intramuscular methods of dexamethasone administration. Purpose The aim of this research was to assess pain, edema, and trismus in the postoperative period following the surgical removal of the lower third molar using 8 mg of dexamethasone given orally or by intramuscular injection. Method A split-mouth technique was employed for the study, in which each of the two bilaterally impacted mandibular third molars was removed one at a time, separated by at least two weeks. There were 26 participants in this experiment. Two groups were created from the research sample: group A (injection dexamethasone) and group B (tablet dexamethasone). The pain was assessed on the first, second, and third postoperative days. On the first, third, and seventh postoperative days, the parameters, such as edema and trismus, were evaluated. Results As per our study, in terms of edema and trismus, there was less of a statistically significant difference between the two interventions at all time points. While the pain score had a significant difference between both interventions. Conclusion Hence, we conclude that oral dexamethasone is an effective alternative to intramuscular dexamethasone. Oral dexamethasone is comparatively simple, less invasive, painless, and easy for the surgeon and for apprehensive patients, and it offers a cost-effective solution for the suffering often associated with the extraction of impacted lower third molars.

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Review of dexamethasone administration for management of complications in postoperative third molar surgery

Cited by 10 publications

References 74 publications

RETRACTED: Influences of ultrasound osteotome on wound infection and wound complications following removal of mandibular wisdom teeth

RETRACTED: Influences of ultrasound osteotome on wound infection and wound complications following removal of mandibular wisdom teeth

Dexamethasone Alleviates Myocardial Injury in a Rat Model of Acute Myocardial Infarction Supported by Venoarterial Extracorporeal Membrane Oxygenation

Evaluation of the Efficacy of Oral and Intramuscular Administration of Dexamethasone on Postoperative Pain, Swelling, and Trismus After Surgical Removal of Impacted Third Molar: A Comparative Split-Mouth Study

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