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In patients who underwent mandibular third molar surgery, both Dexamethasone and Methylprednisolone were equally effective in lowering postoperative pain and edema.
Both corticosteroids (Dexamethasone and Methylprednisolone) exhibited comparable effectiveness in reducing postoperative pain and edema, according to a systematic review and meta-analysis, although Dexamethasone considerably outperformed Methylprednisolone in the early postsurgical period in terms of reducing trismus. Anupam Singh et al. set out to compare the effectiveness of Methylprednisolone and Dexamethasone for the management of postoperative pain, edema, and trismus following mandibular third molar surgery.
For relevant literature search, databases such as PubMed, CINAHL, Scopus, DOSS, Web of Science, and Cochrane central were explored. Only studies that compared the effectiveness of using Dexamethasone against Methylprednisolone for mandibular third molar extraction were taken into account. Studies utilizing any additional corticosteroid drug were eliminated. Postoperative pain, the amount of rescue analgesics needed, edema, trismus, and adverse events were the outcomes evaluated.
Only 7 studies were selected for the systematic review after full text screening from the 1046 articles. Regarding the approach and the factors evaluated, a lot of variability was noted between the studies. Three studies had minimal risk of bias, while the risk was not clear in the remaining four studies. According to pooled analyses, there was no discernible difference between the test group and the control group in terms of pain, use of rescue analgesics, or edema.
For mandibular third molar removal surgery, preemptive administration of both corticosteroids adequately minimized postoperative pain and inflammation. But, Dexamethasone demonstrated reduced trismus (estimated standardized mean difference of -0.69 mm) in the early postoperative phase (postoperative day 2) as contrasted to Methylprednisolone, according to the forest plot analysis. No adverse effects were witnessed in any of the incorporated studies.
The evidence quality was low to moderate due to statistical heterogeneity. Therefore, to corroborate these findings, more investigations with bigger study populations and reduced bias risk are required.
The Scientific World Journal
Efficacy of Preemptive Dexamethasone versus Methylprednisolone in the Management of Postoperative Discomfort and Pain after Mandibular Third Molar Surgery: A Systematic Review and Meta-Analysis
Anupam Singh et al.
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