The effects of steroids in preventing facial oedema, pain, and neurosensory disturbances after bilateral sagittal split osteotomy: a randomized controlled trial

• Published in: International journal of oral and maxillofacial surgery 2015-02, Vol.44 (2), p.252-258
• Main Authors: Widar, F, Kashani, H, Alsén, B, Dahlin, C, Rasmusson, L
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Betamethasone - administration & dosage; Betamethasone - therapeutic use; Cephalometry; Cranial Nerve Injuries - etiology; Cranial Nerve Injuries - prevention & control; Dentistry; Double-Blind Method; Edema - etiology; Edema - prevention & control; Facial Pain - etiology; Facial Pain - prevention & control; Female; Glucocorticoids - administration & dosage; Glucocorticoids - therapeutic use; Humans; Hypoesthesia; Inferior alveolar nerve; Male; Mandibular Diseases - surgery; Middle Aged; Odontologi; Orthognathic surgery; Osteotomy; Osteotomy, Sagittal Split Ramus; Pain Measurement; Prospective; Prospective Studies; Sagittal split ramus; Steroid; Surgery
• ISSN: 0901-5027; 1399-0020; 1399-0020
• DOI: 10.1016/j.ijom.2014.08.002

Abstract A randomized, prospective, controlled trial was conducted to determine the efficacy of single and repeated betamethasone doses on facial oedema, pain, and neurosensory disturbances after bilateral sagittal split osteotomy. Thirty-seven patients (mean age 23.62 years, range 17–62 years) with either mandibular prognathism or retrognathism were enrolled consecutively into the study and divided into three groups: control ( n = 12), repeated dose 4 + 8 + 4 mg betamethasone ( n = 14), single dose 16 mg betamethasone ( n = 11). The intake of diclofenac and paracetamol was assessed individually. Measurements of facial oedema, pain, and sensitivity in the lower lip/chin were obtained 1 day, 7 days, 2 months, and 6 months postoperatively. Furthermore, we investigated the possible influences of gender, age, total operating time, amount of bleeding, postoperative hospitalization, and advancement versus setback of the mandible. A significant difference ( P = 0.017) was observed in percentage change between the two test groups and the control group regarding facial oedema (1 day postoperatively). Less bleeding was associated with improved pain recovery over time ( P = 0.043). Patients who required higher postoperative dosages of analgesics due to pain had significantly delayed recovery of the inferior alveolar nerve at 6 months postoperatively ( P < 0.001). Betamethasone did not reduce neurosensory disturbances over time.