A review of perioperative corticosteroid use in dentoalveolar surgery

Objectives, Dental surgeons are often advised to use: corticosteroids durin g and after third molar removal and other dentoalveolar surgery to reduce p ostsurgical edema, but recommendations for use are rarely accompanied by de finitive guidance regarding the type of steroid, dosage, or duration of adm inistration. Many regimens in use appear to be based on anecdotal informati on from articles in the 1960s and 1970s and might be subtherapeutic. Few re gimens have been updated with data from more recent studies, and well-desig ned comparison studies are lacking. Study design. In this article, the literature from the past 30 years is rev iewed, meaningful findings are highlighted, and available data are used as a basis for formulating interim clinical recommendations for corticosteroid use pending the emergence of more evidence-based data. A meta-analysis of data was not performed. Results. Recent data suggest that perioperative corticosteroid regimens sho uld be administered in higher doses and for longer durations than recommend ed in the past and should be started before surgery for optimum benefit. Conclusions, Based on the literature review, interim recommendations for th e use of corticosteroids are proposed, including dosages and regimens that appear rational for oral, intramuscular, or intravenous corticosteroid admi nistration before and after extractions and other dentoalveolar surgery. Th ese largely empiric recommendations might require adjustment when evidence- based data become available in future studies. There; is a great need for w ell-designed clinical research to further evaluate protocols for corticoste roid use.