Should Periodontists Prescribe Postoperative Oral Corticosteroids to Control Pain and Swelling? A Systematic Review

Wagner, Jennah C.; Gilbert, William A.

doi:10.1002/cap.10169

Cited by 8 publications

(6 citation statements)

References 52 publications

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“…Sub‐analyses to explore the effects of these factors were not possible based on the available data, so we urge the readers to interpret the results with caution. Likewise, pre‐ and post‐operative care regimens (e.g., corticosteroid and antibiotics intake) have been suggested to impact the incidence of post‐operative complications and patients' perception of dental implant therapy (Payer et al, 2020; Wagner et al, 2022). However, data on regimens used in the included studies suffered from a high level of heterogeneity and there was a general lack of reporting of this information, hindering the systematic evaluation of their effect in this review.…”

Section: Discussionmentioning

confidence: 99%

Comparative evidence of different surgical techniques for the management of vertical alveolar ridge defects in terms of complications and efficacy: A systematic review and network meta‐analysis

Alotaibi

Rocchietta

Buti

et al. 2023

J Clinic Periodontology

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AimTo systematically appraise the available evidence on vertical ridge augmentation (VRA) techniques and estimate a treatment‐based ranking on the incidence of complications as well as their clinical effectiveness.Materials and MethodsSearches were conducted in six databases to identify randomized clinical trials comparing VRA techniques up to November 2022. The incidence of complications (primary) and of early, major, surgical and intra‐operative complications, vertical bone gain (VBG), marginal bone loss, need for additional grafting, implant success/survival, and patient‐reported outcome measures (secondary) were chosen as outcomes. Direct and indirect effects and treatment ranking were estimated using Bayesian pair‐wise and network meta‐analysis (NMA) models.ResultsThirty‐two trials (761 participants and 943 defects) were included. Five NMA models involving nine treatment groups were created: onlay, inlay, dense‐polytetrafluoroethylene, expanded‐polytetrafluoroethylene, titanium, resorbable membranes, distraction osteogenesis, tissue expansion and short implants. Compared with short implants, statistically significant higher odds ratios of healing complications were confirmed for all groups except those with resorbable membranes (odds ratio 5.4, 95% credible interval 0.92–29.14). The latter group, however, ranked last in clinical VBG.ConclusionsVRA techniques achieving greater VBG are also associated with higher incidence of healing complications. Guided bone regeneration techniques using non‐resorbable membranes yield the most favourable results in relation to VBG and complications.

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Section: Discussionmentioning

confidence: 99%

Comparative evidence of different surgical techniques for the management of vertical alveolar ridge defects in terms of complications and efficacy: A systematic review and network meta‐analysis

Alotaibi

Rocchietta

Buti

et al. 2023

J Clinic Periodontology

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“…The prescription of opioids is usually not necessary to control postoperative pain and discomfort and must be reserved for specific situations in which the first line of therapy is not effective. If there is no medical contraindication, prescription of corticosteroids in decreasing daily doses (e.g., dexamethasone 8 mg QD the day of the surgery, 6 mg QD the day after the intervention, 4 mg QD 2 days after the intervention, and 2 mg QD 3 days after the surgical procedure) may also be considered to reduce postoperative edema and other sequelae, such as trismus 67 . Subjects should return between 10 and 14 days after the surgical intervention for suture removal, careful plaque and debris removal, and reinforcement of postoperative instructions.…”

Section: Treatment Alternativesmentioning

confidence: 99%

Treatment alternatives for the rehabilitation of the posterior edentulous maxilla

Ávila‐Ortiz

Végh

Mukaddam

et al. 2023

Periodontology 2000

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Rehabilitation of the edentulous maxilla with implant‐supported fixed dental prostheses can represent a significant clinical challenge due to limited bone availability and surgical access, among other factors. This review addresses several treatment options to replace missing teeth in posterior maxillary segments, namely the placement of standard implants in conjunction with maxillary sinus floor augmentation, short implants, tilted implants, and distal cantilever extensions. Pertinent technical information and a concise summary of relevant evidence on the reported outcomes of these different therapeutic approaches are presented, along with a set of clinical guidelines to facilitate decision‐making processes and optimize the outcomes of therapy.

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“…A previous systematic review assessed the effectiveness of oral use of corticosteroids to control pain and swelling of patients undergoing third molar extraction, periodontal procedures or implant surgeries ( Wagner et al, 2022 ). Recently, a clinical practice guideline for management of acute dental pain was published ( Carrasco-Labra, et al, 2024 ).…”

Section: Introductionmentioning

confidence: 99%

Preemptive oral analgesia with steroidal and nonsteroidal anti-inflammatory drugs in periodontal surgery: a systematic review

Lages,

Bergamaschi,

Lopes

et al. 2024

Front. Pharmacol.

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Introduction: Periodontal procedures can promote prolonged intense pain, particularly in clinical situations requiring surgical procedures. In this context, preemptive analgesia has also been assessed for its utility in controlling post-operative pain and discomfort in patients undergoing periodontal invasive procedures. This study assessed the efficacy and safety of preemptive oral analgesia with steroidal and non-steroidal anti-inflammatory drugs in periodontal surgeries.Methods: This systematic review performed a search in the following electronic sources: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via PubMed), EMBASE (via Ovid), Web of Science, Virtual Health Library and in clinical trials electronic databases for relevant randomized clinical trials (RCTs); published up to July 2023. Primary outcomes assessed were post-operative pain, edema and trismus. A narrative synthesis of the findings was carried out.Results: Six RCTs, involving a total of 250 participants, were included. The studies reviewed had a high risk of bias, particularly due to allocation concealment and blinding of participants and personnel. The RCTs reported only the outcome pain. The preemptive use of dexamethasone 8 mg, etoricoxib 90 mg or 120 mg and ketorolac 20 mg seems to be more effective for controlling post-operative pain than placebo.Discussion: The anti-inflammatory drugs evaluated proved to be effective for controlling post-operative pain. However, given the limitations regarding lack of studies, methodological biases, disparities in drugs and doses, report restricted the pain outcome; further RCTs confirming the effectiveness and safety of these drugs in periodontal surgical procedures are warranted.

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Should Periodontists Prescribe Postoperative Oral Corticosteroids to Control Pain and Swelling? A Systematic Review

Abstract: Focused Clinical Question In generally healthy patients receiving third molar, periodontal, or dental implant surgery, do postoperative oral corticosteroids effectively limit pain and swelling compared with placebo or alternative medications?

Cited by 8 publications

References 52 publications

Comparative evidence of different surgical techniques for the management of vertical alveolar ridge defects in terms of complications and efficacy: A systematic review and network meta‐analysis

Comparative evidence of different surgical techniques for the management of vertical alveolar ridge defects in terms of complications and efficacy: A systematic review and network meta‐analysis

Treatment alternatives for the rehabilitation of the posterior edentulous maxilla

Preemptive oral analgesia with steroidal and nonsteroidal anti-inflammatory drugs in periodontal surgery: a systematic review

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