Medication‐related osteonecrosis of the jaw and non-antiresorptive medications

osteonecrosis

This review of the association between non-antiresorptive medications and medication‐related osteonecrosis of the jaw (MRONJ) included 70 studies. A majority of the studies (77%) were case series and the quantity and quality of the evidence is low so the findings should be interpreted cautiously.

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Dental implants – post-operative pain management

The authors sought to review available literature relating to SSRI withdrawal syndromes

This review evaluating clinical efficacy of analgesics in mitigating orofacial pain following dental implant surgery included 9 RCTs. While the findings suggest analgesics may be beneficial the number of studies is small an additional infromation is required on which medication,, dosage, dosing schedule, administration route and adverse effects.

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Third molar extraction– effect of preoperative oral corticosteroids on pain, swelling and trismus

Impacted_Wisdom_Tooth_aka_Lower_Left_Third_Molar_38_RVG_IOPA_Xray

Four RCTs involving a total of 212 patients were included in this review of a single pre-operative dose of oral corticosteroids in reducing pain,swelling & trismus after surgical removal of lower third molars. While the findings suggested there was little benefit to the patients none of the studies were small and none of them were at low risk of bias.

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Interventions for oral lichen planus

Lichen_planusWickham's

This systematic review and network meta-analysis comparing interventions for the management of oral lichen planus included 55 RCTs. While the findings suggested that topical corticosteroids may be most effective the evidence is of low to very low certainty.

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Photodynamic therapy for oral lichen planus

Lichen_planusWickham's

This review looked at the efficacy of photodynamic therapy (PDT) for the treatment or oral lichen lplanus (OLP) and compares PDT with steroid therapy. 16 studies were included with the findings suggesting that photodynamic therapy may offer patients with OLP improved pain relief and better efficacy compared to topical corticosteroids.

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Oral submucous fibrosis: Is treatment with hyaluronidase and corticosteroids effective?

A_close_up_of_Areca_nut

This review of the efficacy of hyaluronidase combined with corticosteroids in the management of oral submucous fibrosis (OSF)included 6 small RCTs of short duration. Only one of the RCTs was considered to be at low risk of bias so additional well conducted and reported studies with larger sample are needed to evaluate treatments for OSF.

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Oral Lichen Planus: Is treatment with corticosteroids safe and effective?

Lichen_planusWickham's

This Cochrane review of the efficacy and safety of corticosteroids for the treatment of people with oral lichen planus(OLP) included 35 RCTs suggesting that they may be more effective than placebo for reducing the pain of symptomatic OLP but the reliability of the finding is low.

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Nonsurgical root canal therapy: What is the most effective oral premedication to reduce post treatment pain?

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This review of the most effective oral premedication in reducing pain in adults after nonsurgical root canal therapy including 16 studies. While a premedication of choice is suggested most outcomes are only supported by very low quality evidence.

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Third molar surgery: Steroids had a beneficial effect on pain, swelling and trismus

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This review of effectiveness of corticosteroids in the post-operative control of pain, swelling and trismus after third molar surgery included 17 RCTs suggesting that corticosteroid use had beneficial effects on pain swelling and trismus.

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Orthognathic surgery: Are perioperative steroids beneficial?

Bariatric surgery and marked weight loss is likely to improve knee complaints but there is a need for high quality studies

This review of perioperative systemic corticosteroids on clinically important outcomes in patients undergoing orthognathic surgery identified 8 small RCTs. A reduction in facial oedema was seen in those receiving systemic corticosteroids. However the quality of the studies is limited and there is lack of evidence on other outcomes or adverse effects.

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