The efficacy of methylprednisolone versus dexamethasone in reducing postoperative sequelae after third molar surgery: A systematic review and meta-analysis

Objectives: Methylprednisolone and dexamethasone are the most commonly encouraged steroids in oral surgery to suppress the inflammatory response after third molar extraction. In this study, we aimed to compare the efficacy of dexamethasone and methylprednisolone in reducing postoperative sequelae after third molar extraction. Methods: We searched for randomized controlled trials (RCTs) via PubMed, Scopus, web of science, and Cochrane till June 2021 using relevant keywords. The extracted data were pooled as mean difference (MD) with 95 % confidence interval (CI) by review manager software (RevMan.5.4). Results: We included five RCTs with a total of 205 impacted molars. We found that swelling regression was clinically significant favoring dexamethasone on the first day (MD = 2.18; 95 % CI: [1.04, 3.33], P = 0.0002), second day (MD = 3.68; 95 % CI: [2.57, 4.79], P < 0.00001), third day (MD = 3.11; 95 % CI: [1.70, 4.51], P < 0.0001), and seventh day (MD = 1.25; 95 % CI: [0.52, 1.99], P = 0.0008). Also, trismus reduction was clinically significant favoring dexamethasone on the second day (MD = -4.00; 95 % CI: [-5.58, -2.42], P < 0.00001) and seventh day (MD = -1.84; 95 % CI: [-3.28, -0.41]; P = 0.01). On the other hand, no significant differences was found between dexamethasone and methylprednisolone in reducing postoperative pain. Conclusion: Dexamethasone (8 mg) has better swelling and trismus control compared to methylprednisolone (40 mg). However, no difference between dexamethasone and methylprednisolone in postoperative pain relief. (c) 2021 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI. Published by Elsevier Ltd. All rights reserved.*