Submucosal injection of dexamethasone reduces postoperative discomfort after third-molar extraction: A systematic review and meta-analysis.

BACKGROUND: The authors conducted a systematic review and meta-analysis on the effect of dexamethasone (DX) on edema, trismus, and pain during early and late postoperative periods after third-molar (M3) extraction.

TYPES OF STUDIES REVIEWED: The authors identified eligible reports by searching PubMed, Embase, and the Cochrane Central Register of Controlled Trials up through April 2016. The full text of the studies that met the minimum inclusion requirements were those in which the investigators evaluated the effects of submucosal injection of DX compared with inactive treatments in patients undergoing surgical extraction of an M3.

RESULTS: The authors included 11 eligible trials in this study. Participants receiving DX had significantly less edema during both early (standardized mean difference, 3.28; 95% confidence interval [CI], 2.21-4.36; P < .00001) and late (standardized mean difference, 0.56; 95% CI, 0.27-0.86; P < .00001) periods after surgery, as well as less trismus than did control participants during the early (standardized mean difference, 5.34; 95% CI, 2.44-8.24; P = .004) phase, but there was no strong evidence for the reduction of trismus in the late period. Because of heterogeneity in intervention and outcome assessments across the studies, the authors only qualitatively summarized pain outcomes.

CONCLUSIONS AND PRACTICAL IMPLICATIONS: The findings of this study suggest that submucosal injection of DX reduced not only early and late edema but also early trismus in experimental compared with control participants after M3 extraction, which makes it a likely choice for dental clinical use. However, larger and higher-quality trials are needed to guard against bias to confirm the effect in late trismus and pain.