The impact of intravenous corticosteroids with third molar surgery in patients at high risk for delayed health-related quality of life and clinical recovery

Paul S. Tiwana, Susan P. Foy, Daniel A. Shugars, Robert D. Marciani, Shawn M. Conrad, Ceib Phillips, Raymond P. White

Research output: Contribution to journalArticle

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Abstract

To compare recovery for clinical and health-related quality of life (HRQOL) outcomes after third molar surgery in patients predicted to be at risk for delayed recovery, treated with or without intravenous (IV) corticosteroids at surgery. Patients at least 18 years of age and with all 4 third molars below the occlusal plane were given IV corticosteroids just before third molar surgery. Clinical and HRQOL outcomes of these patients were compared with those of a nonconcurrent control group who did not receive corticosteroids. No antibiotics were administered. The control group was selected using the same criteria and treated under the same surgical protocol as the corticosteroid group. Differences between the groups were assessed with Cochran-Mantel-Haenszel row mean score statistics. Sixty patients were in each cohort. The incidence of delayed clinical recovery, a postsurgery visit with treatment, was higher in the control group compared with the corticosteroid group. In the corticosteroid group, 6 patients (10%) had 1 postsurgery visit with treatment. In the control group without corticosteroids, 17 patients (28%) had at least 1 postsurgery visit with treatment (P =. 01). Compared with the control group, nausea tended to bother patients less on postsurgery day 1 (P =. 07); sleep was improved on postsurgery days 1 through 4 (P <. 05). Though not statistically significant, corticosteroids reduced the patients' reported recovery by at least 1 day for pain, lifestyle, and oral function. Administration of IV corticosteroids before third molar surgery without antibiotics does not hamper clinical recovery even when healthy adult patients are predicted to have delayed recovery. Overall, IV corticosteroid administration had a limited, but beneficial effect on HRQOL outcomes.

Original languageEnglish (US)
Pages (from-to)55-62
Number of pages8
JournalJournal of Oral and Maxillofacial Surgery
Volume63
Issue number1
DOIs
StatePublished - Jan 2005

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Third Molar
Adrenal Cortex Hormones
Quality of Life
Control Groups
Intravenous Administration
Dental Occlusion
Anti-Bacterial Agents
Nausea
Life Style
Sleep
Therapeutics
Pain

ASJC Scopus subject areas

  • Dentistry(all)
  • Surgery

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The impact of intravenous corticosteroids with third molar surgery in patients at high risk for delayed health-related quality of life and clinical recovery. / Tiwana, Paul S.; Foy, Susan P.; Shugars, Daniel A.; Marciani, Robert D.; Conrad, Shawn M.; Phillips, Ceib; White, Raymond P.

In: Journal of Oral and Maxillofacial Surgery, Vol. 63, No. 1, 01.2005, p. 55-62.

Research output: Contribution to journalArticle

Tiwana, Paul S. ; Foy, Susan P. ; Shugars, Daniel A. ; Marciani, Robert D. ; Conrad, Shawn M. ; Phillips, Ceib ; White, Raymond P. / The impact of intravenous corticosteroids with third molar surgery in patients at high risk for delayed health-related quality of life and clinical recovery. In: Journal of Oral and Maxillofacial Surgery. 2005 ; Vol. 63, No. 1. pp. 55-62.
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abstract = "To compare recovery for clinical and health-related quality of life (HRQOL) outcomes after third molar surgery in patients predicted to be at risk for delayed recovery, treated with or without intravenous (IV) corticosteroids at surgery. Patients at least 18 years of age and with all 4 third molars below the occlusal plane were given IV corticosteroids just before third molar surgery. Clinical and HRQOL outcomes of these patients were compared with those of a nonconcurrent control group who did not receive corticosteroids. No antibiotics were administered. The control group was selected using the same criteria and treated under the same surgical protocol as the corticosteroid group. Differences between the groups were assessed with Cochran-Mantel-Haenszel row mean score statistics. Sixty patients were in each cohort. The incidence of delayed clinical recovery, a postsurgery visit with treatment, was higher in the control group compared with the corticosteroid group. In the corticosteroid group, 6 patients (10{\%}) had 1 postsurgery visit with treatment. In the control group without corticosteroids, 17 patients (28{\%}) had at least 1 postsurgery visit with treatment (P =. 01). Compared with the control group, nausea tended to bother patients less on postsurgery day 1 (P =. 07); sleep was improved on postsurgery days 1 through 4 (P <. 05). Though not statistically significant, corticosteroids reduced the patients' reported recovery by at least 1 day for pain, lifestyle, and oral function. Administration of IV corticosteroids before third molar surgery without antibiotics does not hamper clinical recovery even when healthy adult patients are predicted to have delayed recovery. Overall, IV corticosteroid administration had a limited, but beneficial effect on HRQOL outcomes.",
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