Efficacy of preoperative dexamethasone in lower third molar surgeries: a systematic review

Lower third molar extraction surgery generates pain, edema and trismus as the main postoperative symptoms, which directly affect the patient life quality. The aim of this study is to evaluate the effectiveness of preoperative administration of dexamethasone in lower third molar surgeries to decrease postoperative symptoms. This systematic review followed the PRISMA recommendations. The search was realized in the PubMed, LILACS and Science Direct databases. The inclusion criteria were: patients with lower third molars with a similar impaction degree class II and III (Pell and Gregory classification) and with a standardized duration of surgery, limited to a maximum of 45 minutes. The GRADE tool was used to determine the level of evidence of the articles. Among the 296 articles found in the search and only 3 were included. The included studies evaluated 144 lower third molar surgeries, 72 using dexamethasone and 72 using placebo. In all 3 studies, pain and swelling had the lowest levels in the dexamethasone groups compared to the placebo groups. Only one study showed higher levels of trismus in the test group compared to the control group. In this study, dexamethasone was shown to be effective in reducing the postoperative symptoms analyzed, especially pain and edema.