Use of corticosteroids in oral surgery.

Perioperative use of corticosteroids has been advocated for reduction of pain, edema, and trismus following oral surgical procedures. Clinical trials involving the use of corticosteroids in oral surgery are reviewed with emphasis on the following points: 1) the type of procedure; 2) the specific regimen and its relative potency; and 3) the methods used to determine results. The potential for complications induced by perioperative corticosteroid use, such as adrenal suppression and delayed wound healing, are also discussed. Initial trials subjectively demonstrated that corticosteroids reduced the amount of inflammation associated with oral surgery, especially edema. Subsequent objective evaluation of corticosteroid use has shown consistent reductions in edema. Corticosteroid doses ranged from 80 to 625 mg hydrocortisone equivalent anti-inflammatory dosage. No significant adverse reactions were noted. Based on these studies, the use of perioperative corticosteroids appears to be a safe and rational method of reducing postoperative complications following the removal of impacted third molars. Conclusions about corticosteroid use in other oral surgical procedures cannot be reached until more research is conducted.