Content area
Full Text
Abstract
Corticosteroids are potent anti-inflammatory drugs that resemble cortisol, a naturally produced hormone by the body. Their main use is to reduce inflammation, especially when the body mistakenly triggers inflammation where it shouldn't exist. Corticosteroids are widely used in the treatment of diseases, disorders and conditions affecting the oral and maxillofacial area and the adjacent associated structures. The diseases of the oral and maxillofacial region may be either local or the manifestation of systemic problem. Corticosteroids have their widest application in the management of acute and chronic conditions which have an allergic, immunologic, or inflammatory basis. Most of the oral and maxillofacial surgeons utilize corticosteroids based on their efficacy to control outcomes of surgery and to yield a comfortable post-surgery period. This paper reviews the uses of corticosteroids in oral and maxillofacial surgery.
Key Words: Corticosteroids, hydrocortisone, glucocorticoids, anti-inflammatory action, oral surgery, dexamethasone
Introduction
Corticosteroids (CS) are known to reduce inflammation, fluid transudation and edema. Corticosteroids (Glucocorticoids) represent the most efficacious anti-inflammatory agents and that is the reason why they are often used in several different conditions [1]. The mechanism of action of corticosteroid has been largely reviewed by several authors and that are mostly preferred in maxillofacial surgery include dexamethasone (administered orally), dexamethasone sodium phosphate (IV or IM), dexamethasone acetate (IM), methylprednisolone (orally), methylprednisolone acetate and methylprednisolone sodium succinate (IV or IM). In the past, betamethasone has been used as well. Often used in oral surgery are long-acting corticosteroid compounds. Among these, the most frequently used is dexamethasone that is about 25-30 times more potent than cortisol [2]. It is available in oral, parenteral and topical formulations and is largely used in oral surgery, pre- or only post-surgery due to its long half life and high efficacy. The use of steroids in oral surgical procedures may present as an area of ambiguity for many practitioners. Some practitioners may consider the use of steroids only as a supplement in patients undergoing extensive oral surgery procedures, but steroids such as dexamethasone can be a valuable tool when performing moderate to moderately severe oral surgical procedures [3]. The use of corticosteroids can decrease the severity of postoperative sequelae in many patients and hence, decreasing the morbidity after oral surgery.
Physiology Of Corticosteroids
There are three groups...