Clinical articlesThe impact of intravenous corticosteroids with third molar surgery in patients at high risk for delayed health-related quality of life and clinical recovery
Section snippets
Patients and methods
A prospective clinical trial conducted at multiple clinical centers was designed to compare the effectiveness of IV corticosteroids without antibiotics on outcomes after third molar surgery in patients expected to be at higher risk for delayed recovery. The group of patients (CSG) receiving IV corticosteroids at surgery was compared with a nonconcurrent control group of patients (CTG) who did not receive corticosteroids or antibiotics selected by the same inclusion/exclusion criteria. Neither
Results
Sixty patients with 4 third molars scheduled for removal were enrolled in the CSG and treated by 8 surgeons at 2 academic centers and 1 community practice. All patients received IV corticosteroids just before surgery without the administration of antibiotics. Thirty-seven patients received dexamethasone sodium phosphate 8 mg and 23 patients methlyprednisolone sodium succinate 40 mg. In the CTG, 60 patients were enrolled and treated by 22 surgeons at 3 academic centers and 9 community practices.
Discussion
The principal finding of this study was that a single IV dose of a glucocorticosteroid administered just before third molar surgery with no antibiotics given concurrently had no detrimental impact on wound healing in patients predicted to be at higher risk for delayed clinical recovery. In addition, from the patients’ perspective, corticosteroids had a beneficial but minimal impact on recovery for HRQOL domains. Recovery for 7 of 10 outcomes for lifestyle, oral function, and pain were improved
Acknowledgment
The authors offer a special thanks to the surgeons and their patients who volunteered to provide data for this analysis. The authors thank Debora Price, Lyna Rogers, and Terri Horton for assistance in managing data for this project.
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Research grant support was received from the Dental Foundation of North Carolina, Oral and Maxillofacial Surgery Foundation, and the American Association of Oral and Maxillofacial Surgeons.