Corticosteroids drugs, fall under category of steroid hormones that are produced naturally in the adrenal cortex of humans. They are similar to endogenous cortisol which is important in protein, carbohydrate and fat metabolism, maintenance of fluid electrolytes and adapting the body to stress.
Some common corticosteroids used in dentistry :
- Hydrocortisone – short acting
- Dexamethasone – long acting
- Methylprednisolone – intermediate acting
- Prednisolone – intermediate acting
Steroids have been widely used drugs in dentistry. Corticosteroids can be administered in ways : Topically / orally / Intravenously.
Anti-inflammatory and Analgesic Action of Corticosteroids
They affect the functions of endothelial cells, mast cells and monocytes decreasing the release of proteolytic enzymes and inflammatory mediators, suppressing the inflammatory processes.
It exhibits analgesic effect by inhibiting prostaglandin synthesis.
APPLICATION IN ENDODONTICS
- Ledermix – An antibiotic/corticosteroid combination – is used for vital pulp dressing and as a root canal medicament.
- Zinc oxide eugenol along with steroids is also used as root canal sealer
- Steroids along with chloramphenicol reduces postoperative thermal sensitivity.
APPLICATION IN ORAL SURGERY
- In the prevention of postoperative pain / trismus / edema / inflammation.
- Topically for preventing ulceration on operated site
- Corticosteroids promote the healing of nerve injuries following compression or trauma.
APPLICATION IN ORAL MEDICINE
- In Oral sub-mucous fibrosis – applied topically as a mucosal patch for ulcerative or painful mucosa.
- In central giant cell granuloma – Topically, triamcinolone acetonide is applied.
- Lichen planus– 5 minute application of 0.05% clobetasol propionate with nystatin in a gingival tray.
- Bullous and mucous membrane pemphigoid
- Erythema multiforme
- Osteoradionecrosis of jaw
- Pemphigus vulgaris
NERVE LESIONS
- Bell’s palsy
- Post herpetic neuralgia
- Melkersson Rosenthal Syndrome
When Not to Advice Corticosteroids
- Renal failure.
- Pregnancy
- Diabetes mellitus
- Hypertension
- Hypersensitivity
- Peptic ulcer
- Osteoporosis
- Epilepsy
- Congestive heart failure
Adverse Effects of Corticosteroids
- With topical administration
- Mucosal atrophy
- Candidiasis
- Acne
- Dermatitis
- Allergic reaction
- Tachyphylaxis
- Spread of infections
- With long and high dose Systemic Administration
- Suppression of hypothalamus pituitary axis
- Cushing syndrome
- Hypertension
- Buffalo hump
- Diabetes
- Skin fragility
- Moon face
