Author(s): Libório, Hélio Tomás Lourenço
Date: 2024
Persistent ID: http://hdl.handle.net/10400.14/47081
Origin: Veritati - Repositório Institucional da Universidade Católica Portuguesa
Subject(s): Third molar; Impacted teeth; Methylprednisolone; Corticosteroids; Oral surgery; Terceiro molar; Dentes inclusos; Metilprednisolona; Corticosteroides; Cirurgia oral
Background: Extraction of impacted third molars is a common procedure in dentistry, but the post-operative period can be uncomfortable. Methylprednisolone has emerged as a possible solution to improve outcomes. This systematic review seeks to evaluate its efficacy and safety, providing clear guidelines for oral health professionals and helping to optimize clinical practice and the patient experience. Materials and Methods: This study adopted a PICO approach to search for articles related to the use of methylprednisolone in third molar extraction. Two databases were used (Medline/PubMed and Scopus). The search included articles published in the last 10 years, with the language restriction to English. The analysis of the articles followed the PRISMA principles, with pre-defined inclusion and exclusion criteria. Results: Of the 158 articles identified, 149 were excluded due to duplication or not meeting the inclusion criteria. Nine articles were analyzed and five were selected for meta-analysis. In the methylprednisolone vs. control studies, there was no significant heterogeneity for pain at 24 hours (p=0.15, I²=47%) and 7 days (p=0.15, I²=47%), with non-significant effects (p=0.85). In the inter-incisal reduction, there was homogeneity at 48 hours (p=0.96, I²=0%) and 7 days (p=0.37, I²=0%), with a greater reduction in the methylprednisolone group (p<0.01 and p<0.05, respectively). Dexamethasone proved to be more effective than methylprednisolone in inter-incisal reduction at 48 hours and 7 days. Conclusion: While recognizing variations in efficacy, methylprednisolone shows benefits after surgery for impacted third molars. Dexamethasone was more effective in inter-incisal reduction. A personalized approach is essential to optimize results and ensure patient well-being.
