Background/Aim. It is important that the height of the edentulous alveolar
   ridge after tooth extraction remains at a reasonable acceptable level for as
   long as possible. The aim of this study was to report preliminary results of
   the clinical effect of local oral submucous administration of dexamethasone
   after tooth extractions in order to prepare alveolar supporting tissues for
   acceptance of removable dentures. Methods. In a total of 15 patients (11
   partially and 4 completely edentulous) the quantity of 0.25 mL to 0.5 mL of
   dexamethasone was injected bucally and orally in the region of the tooth
   socket after complicated extractions. Results. Healing of extraction wounds
   was uneventful in all the patients, without pain or local inflammation.
   Conclusion. Dexamethasone can be locally applied to oral tissues to prevent
   post-extraction inflammation and extensive resorption of the residual
   alveolar ridge. The obtained results are promising for patients undergoing
   classic prosthodontic rehabilitation soon after tooth extraction,
   demonstrating that there are no adverse effects after local oral
   corticosteroids administration. [Projekat Ministarstva nauke Republike
   Srbije, br. 175021

Poštić Srđan D.

Todorović Ljubomir

Directory of Open Access Journals

Vojnosanit Pregl 2014; 71(5): 499–502. VOJNOSANITETSKI PREGLED Strana 499Correspondence to: SrĀan D. Poštiý, Clinic of Dental Prosthetic, Faculty of Dentistry, University of Belgrade, Rankeova 4, 11 000Beograd, Serbia. Phone: +381 11 2435719. E-mail: srdjan.postic@stomf.bg.ac.rsPRELIMINARYREPORTUDC: 616.314-089.87-08:[615.357:577.175DOI: 10.2298/VSP121004008PA preliminary study on local administration of dexamethasone aftertooth extraction ņ Better preservation of residual alveolar ridge?Preliminarno ispitivanje lokalne primene deksametazona posle ekstrakcije zuba– bolja oþuvanost rezidualnog alveolarnog grebena?Srdjan D. Poštiü, Ljubomir TodoroviüFaculty of Dental Medicine, University of Belgrade,Belgrade, SerbiaAbstractBackground/Aim. It is important that the height of theedentulous alveolar ridge after tooth extraction remains at areasonable acceptable level for as long as possible. The aim ofthis study was to report preliminary results of the clinical effectof local oral submucous administration of dexamethasone af-ter tooth extractions in order to prepare alveolar supportingtissues for acceptance of removable dentures. Methods. In atotal of 15 patients (11 partially and 4 completely edentulous)the quantity of 0.25 mL to 0.5 mL of dexamethasone was in-jected bucally and orally in the region of the tooth socket aftercomplicated extractions. Results.  Healing of extractionwounds was uneventful in all the patients, without pain or lo-cal inflammation. Conclusion. Dexamethasone can be locallyapplied to oral tissues to prevent post-extraction inflammationand extensive resorption of the residual alveolar ridge. Theobtained results are promising for patients undergoing classicprosthodontic rehabilitation soon after tooth extraction, dem-onstrating that there are no adverse effects after local oral cor-ticosteroids administration.Key words:oral surgical procedures, preprosthetic; toothextraction; alveolar process; rehabilitation;dexamethasone; treatment outcome.ApstraktUvod/Cilj. Od kljuÿnog znaÿaja je da visina bezubog alve-olarnog grebena posle vaĀenja zuba ostaje što duže na pri-hvatljivom nivou. Cilj rada bio je da se prikažu preliminarnirezultati efekata lokalne submukozne primene deksameta-zona na tkiva iz kojih su ekstrahovani zubi radi pripreme al-veolarnih tkiva i noseýih tkiva za prihvatanje zubnih prote-za. Metode. Kod ukupno 15 pacijenata (11 krezubih i 4 be-zuba) dato je od 0.25 mL do 0.5 mL deksametazona perinjectionem bukalno i oralno u alveolarne ÿašice posle kompli-kovanih ekstrakcija zuba. Rezultati. Zarastanja rana kodsvih pacijenata bila su neometana, bez bolova ili lokalnihupala. Zakljuÿak. Deksametazon može biti lokalno dat uoralna tkiva sa ciljem prevencije postekstrakcione upale i iz-ražene resorpcije rezidualnog alveolarnog grebena. Rezultatistudije su obeýavajuýi za leÿenje pacijenata koji ýe biti sto-matoprotetski rehabilitovani neposredno posle ekstrakcijazuba i ukazuju na to da nema neželjenih efekata prilikomlokalne primene kortikosteroida na tkiva iz kojih su ekstra-hovani zubi.Kljuÿne reÿi:hirurgija, oralna, preprotetske procedure; zub,ekstrakcija; alveolni nastavak; rehabilitacija;deksametazon; leÿenje, ishod.IntroductionCorticosteroids otherwise sovereign anti-inflammatoryand anti-oedematous drugs, are frequently used in oral sur-gery to prevent, or at least minimize, postoperative pain andoedema due to surgical trauma 1–3.  They can be used locallyor systemically, administered by injection or orally 4. Al-though corticosteroids have several general effects 5, theirsingle use (preoperative or postoperative) is supposed not tohave any undesired effect on the adrenal-pituitary regulationof steroid secretion 1.The problem of edentulous ridge reduction has beennoted in the dental literature for many years. A number ofauthors have discussed this problem due to difficulties fororofacial rehabilitation by means of proper denture de-sign 6, 8. It is well known that marked atrophy and reductionof alveolar bone following tooth loss complicate prostho-dontic rehabilitation 7, 9–11. Difficulties have been encoun-tered even in taking impressions of edentulous jaws with re-duced and resorbed edentulous ridges 11, as well as inachieving and maintaining the stability of fabricated acrylicdentures, particularly in the mandible 11. Consequently,Strana 500 VOJNOSANITETSKI PREGLED Volumen 71, Broj 5Poštiý S, Todoroviý Lj. Vojnosanit Pregl 2014; 71(5): 499–502.edentulous patients with the resorbed residual ridges have se-rious problems in chewing with dentures 9, 11, 12. For thesereasons it is crucially important that the height of the eden-tulous alveolar ridge, after tooth extraction, remains at a rea-sonable acceptable level for as long as possible. Addition-ally, it is necessary that fabricated acrylic dentures, throughconstant pressure on the edentulous ridge, do not cause de-layed resorption of residual ridge.It is possible that steroids, due to their marked localanti-inflammatory effect could lessen the ridge resorptionafter tooth extraction as one of the possible reasons for thisevent is local tissue inflammation as a consequence of tissueinjury. The aim of this study was to report preliminary re-sults of the clinical effect of local oral submucous admini-stration of dexamethasone after tooth extractions in order toprepare alveolar supporting tissues for the acceptance of re-movable dentures.MethodsA total of 15 otherwise healthy patients (without visiblesymptoms of local osteoporosis, or any other intraoral disor-der except tooth caries or periodontal disease), 11 partiallyand 4 completely edentulous (9 women aged 45–52 years,and 6 men aged 54–63 years), undergoing tooth extractionprior to classic prosthodontic rehabilitation, were includedinto the study. Altogether, 23 teeth were removed, 3 teeth atthe most in a single patient. In each patient, at least one ex-traction was difficult, meaning the need for a bone portionremoval with burs, or removal of a part of buccal or lingualcortical plate.To prevent an extensive post-extraction bone resorp-tion and possible complications of extraction wound heal-ing, immediately after the completion of difficult tooth ex-traction, a submucous 0.5 mL dexamethasone injection(Dexason®, Galenika, Belgrade) was administered, bucallyand orally (altogether 4 mg of dexamethasone), beside thesocket of the tooth that was removed with difficulties (Fig-ure 1).All the patients were followed-up regularly, and pros-thodontic rehabilitation with removable partial or full den-tures started two weeks afterwards.Fig. 1 – Dexamethasone injection beside the post-extractionwound.ResultsAfter administration of dexamethasone, no symptomsof local pain or inflammation, or any other complication,were noted (Figure 2).The bones of the alveolar ridge were solid enough toenable making of dentures without the need of any additionalplastic procedure, and control radiographs (Figure 3) re-vealed the absence of signs of undesired bone remodelling orextensive resorption.Fig. 3 – Control radiogram after the wound had been healed. a) b)Fig. 2 – The lower (a) and upper (b) jaw 2 weeks after local administration of dexamethasone.Volumen 71, Broj 5 VOJNOSANITETSKI PREGLED Strana 501Poštiý S, Todoroviý Lj. Vojnosanit Pregl 2014; 71(5): 499–502.Figure 4 shows the favorable finding of the upper jawin one patient, 2 weeks after local administration of dexa-methasone.Fig. 4 – The upper jaw of a female patient 2 weeks after localadministration of dexamethasone.Consequently, all the patients were successfully reha-bilitated with removable dentures (Figure 5). Fig. 5 – Local finding after the complete dentures had beenmade.DiscussionThe anti-inflammatory effect of corticosteroids has beenproved for many local or systemic disorders 13, 14. Therefore,indications for the use of corticosteroids due to their anti-inflammatory effect are wide, ranging from any kind of localinflammation to many postoperative complications in oral andmaxillofacial surgery. Therefore, the use of corticosteroids hasalso been recommended for pain reduction, oedema, and tris-mus following oral surgical procedures 1, 2, 4.Dexamethasone was injected beside the post-extractionsocket so that it could demonstrate maximal anti-inflammatoryeffect and remain locally and not rinsed by salivary flow. Itwas injected in a total dose that is usually used for single in-traoral application when anti-inflammatory dexamethasone ef-fect is desired 1–4. It was considered not to use dexamethasoneif patients had any possible contraindication for steroiduse 5, 15, and such patients were excluded from the study.Although the anti-inflammatory effect of dexameth-asone is well-known, there are no studies investigating itspossible influence on the reduction of post-extraction alveo-lar ridge resorption. In spite the fact that all the 15 treatedpatients in this preliminary study had difficult tooth extrac-tions, the wound healing in the post-extraction period wasuneventful, and the residual alveolar ridge did not demon-strate signs of excessive resorption or malformation. We be-lieve that this is mainly due to anti-inflammatory effect ofthe used dexamethasone. However, the number of treatedpatients is relatively small, and a double-blind controlledtrial is under way to confirm possible favourable effect ofdexamethasone in wound healing after tooth extraction.ConclusionDexamethasone can be locally applied to oral tissues toprevent post-extraction inflammation and extensive resorp-tion of the residual alveolar ridge. The obtained results arepromising for patients undergoing classic prosthodontic re-habilitation soon after tooth extraction, demonstrating thatthere are no adverse effects of such corticosteroids use.AcknowledgmentThis study was supported by Grant No 175021 from theMinistry of Education, Science and Technological Develop-ment of the Republic of Serbia.REFERENCES1. Alexander RE, Throndson RR. A review of perioperative cortico-steroid use in dentoalveolar surgery. Oral Surg Oral Med OralPathol Oral Radiol Endod 2000; 90(4): 406î15.2. Montgomery MT, Hogg JP, Roberts DL, Redding SW. The use of glu-cocorticosteroids to lessen the inflammatory sequelae followingthird molar surgery. J Oral Maxillofac Surg 1990; 48(2): 179î87.3. Gersema L, Baker K. Use of corticosteroids in oral surgery. JOral Maxillofac Surg 1992; 50(3): 270î7.4. Markovic A, Todorovic Lj. Effectiveness of dexamethasone andlow-power laser in minimizing oedema after third molar sur-gery: a clinical trial. Int J Oral Maxillofac Surg 2007; 36(3):226î9.5. Falkenstein E, Tillmann HC, Christ M, Feuring M, Wehling M.Multiple actions of steroid hormones: a focus on rapid, non-genomic effects. Pharmacol Rev 2000; 52(4): 513î56.6. Atwood DA. Reduction of residual ridges: a major oral diseaseentity. J Prosthet Dent 1971; 26(3): 266î79.7. Zmyslowska E, Ledzion S, Jedrzejewski K. Factors affecting man-dibular residual ridge resorption in edentulous patients: a pre-liminary report. Folia Morphol (Warsz) 2007; 66(4): 346î52.Strana 502 VOJNOSANITETSKI PREGLED Volumen 71, Broj 5Poštiý S, Todoroviý Lj. Vojnosanit Pregl 2014; 71(5): 499–502.8. Ortman HR. Factors of bone resorption of the residual ridge. JProsthet Dent 1962; 12(3): 429î40.9. Xie Q, Närhi TO, Nevalainen JM, Wolf J, Ainamo A. Oral statusand prosthetic factors related to residual ridge resorption inelderly subjects. Acta Odontol Scand 1997; 55(5): 306î13.10. Poštiý S, Markoviý D, Krstiý M, Rakoÿeviý Z, Brkoviý S . Radio-graphic assessment of edentulous residual ridge reductions.Proceedings of the 15th Congress of the BaSS; 2010 April22î25; Greece, Thessaloniki; 2010.11. Zarb GA, Bolender CL, Eckert SE, Jacob RF, Fenton AH, Meric-ske-Stern R. Prosthodontic treatment for edentulous patients:Complete dentures and implant-supported prostheses. St.Louis: Mosby; 2004.12. Maeda Y, Wood WW. Finite element method simulation ofbone resorption beneath a complete denture. J Dent Res 1989;68(9): 1370î3.13. Stoll ML, Good J, Sharpe T, Beukelman T, Young D, Waite PD, etal. Intra-articular corticosteroid injections to the temporoman-dibular joints are safe and appear to be effective therapy inchildren with juvenile idiopathic arthritis. J Oral MaxillofacSurg 2012; 70(8): 1802î7.14. ElHag M, Coghlan K, Christmas P, Harvey W, Harris M. The anti-inflammatory effects of dexamethasone and therapeutic ultra-sound in oral surgery. Brit J Oral Maxillofac Surg 1985; 23(1):17î23.15. Assimes TL, Lessard LM. The use of perioperative corticoster-oids in craniomaxillofacial surgery. Plast Reconstruc Surg1999; 103(1): 313î22.Received on November 4, 2012.Revised on February 4, 2013.Accepted on February 7, 2013.OnLine-First February, 2014.

Vojnosanitetski pregled

A preliminary study of local administration of dexamethasone after tooth extraction: Better preservation of residual alveolar ridge?

Background/Aim. It is important that the height of the edentulous alveolar ridge after tooth extraction remains at a reasonable acceptable level for as long as possible. The aim of this study was to report preliminary results of the clinical effect of local oral submucous administration of dexamethasone after tooth extractions in order to prepare alveolar supporting tissues for acceptance of removable dentures. Methods. In a total of 15 patients (11 partially and 4 completely edentulous) the quantity of 0.25 mL to 0.5 mL of dexamethasone was injected bucally and orally in the region of the tooth socket after complicated extractions. Results. Healing of extraction wounds was uneventful in all the patients, without pain or local inflammation. Conclusion. Dexamethasone can be locally applied to oral tissues to prevent post-extraction inflammation and extensive resorption of the residual alveolar ridge. The obtained results are promising for patients undergoing classic prosthodontic rehabilitation soon after tooth extraction, demonstrating that there are no adverse effects after local oral corticosteroids administration.Uvod/Cilj. Od ključnog značaja je da visina bezubog alveolarnog grebena posle vađenja zuba ostaje što duže na prihvatljivom nivou. Cilj rada bio je da se prikažu preliminarni rezultati efekata lokalne submukozne primene deksametazona na tkiva iz kojih su ekstrahovani zubi radi pripreme alveolarnih tkiva i nosećih tkiva za prihvatanje zubnih proteza. Metode. Kod ukupno 15 pacijenata (11 krezubih i 4 bezuba) dato je od 0.25 mL do 0.5 mL deksametazona per injectionem bukalno i oralno u alveolarne čašice posle komplikovanih ekstrakcija zuba. Rezultati. Zarastanja rana kod svih pacijenata bila su neometana, bez bolova ili lokalnih upala. Zaključak. Deksametazon može biti lokalno dat u oralna tkiva sa ciljem prevencije postekstrakcione upale i izražene resorpcije rezidualnog alveolarnog grebena. Rezultati studije su obećavajući za lečenje pacijenata koji će biti stomatoprotetski rehabilitovani neposredno posle ekstrakcija zuba i ukazuju na to da nema neželjenih efekata prilikom lokalne primene kortikosteroida na tkiva iz kojih su ekstrahovani zubi

Poštić, Srđan

Todorović, Ljubomir

School of dental Medicine dIgitaL archivE

Vojnosanit Pregl 2014; 71(5): 499–502. VOJNOSANITETSKI PREGLED Strana 499Correspondence to: Sr an D. Pošti , Clinic of Dental Prosthetic, Faculty of Dentistry, University of Belgrade, Rankeova 4, 11 000Beograd, Serbia. Phone: +381 11 2435719. E-mail: srdjan.postic@stomf.bg.ac.rsP R E L I M I N A R YR E P O R TUDC: 616.314-089.87-08:[615.357:577.175DOI: 10.2298/VSP121004008PA preliminary study on local administration of dexamethasone aftertooth extraction  Better preservation of residual alveolar ridge?Preliminarno ispitivanje lokalne primene deksametazona posle ekstrakcije zuba– bolja o uvanost rezidualnog alveolarnog grebena?Srdjan D. Pošti , Ljubomir TodoroviFaculty of Dental Medicine, University of Belgrade,Belgrade, SerbiaAbstractBackground/Aim. It is important that the height of theedentulous alveolar ridge after tooth extraction remains at areasonable acceptable level for as long as possible. The aim ofthis study was to report preliminary results of the clinical effectof local oral submucous administration of dexamethasone af-ter tooth extractions in order to prepare alveolar supportingtissues for acceptance of removable dentures. Methods. In atotal of 15 patients (11 partially and 4 completely edentulous)the quantity of 0.25 mL to 0.5 mL of dexamethasone was in-jected bucally and orally in the region of the tooth socket aftercomplicated extractions. Results. Healing of extractionwounds was uneventful in all the patients, without pain or lo-cal inflammation. Conclusion. Dexamethasone can be locallyapplied to oral tissues to prevent post-extraction inflammationand extensive resorption of the residual alveolar ridge. Theobtained results are promising for patients undergoing classicprosthodontic rehabilitation soon after tooth extraction, dem-onstrating that there are no adverse effects after local oral cor-ticosteroids administration.Key words:oral surgical procedures, preprosthetic; toothextraction; alveolar process; rehabilitation;dexamethasone; treatment outcome.ApstraktUvod/Cilj. Od klju nog zna aja je da visina bezubog alve-olarnog grebena posle va enja zuba ostaje što duže na pri-hvatljivom nivou. Cilj rada bio je da se prikažu preliminarnirezultati efekata lokalne submukozne primene deksameta-zona na tkiva iz kojih su ekstrahovani zubi radi pripreme al-veolarnih tkiva i nose ih tkiva za prihvatanje zubnih prote-za. Metode. Kod ukupno 15 pacijenata (11 krezubih i 4 be-zuba) dato je od 0.25 mL do 0.5 mL deksametazona perinjectionem bukalno i oralno u alveolarne ašice posle kompli-kovanih ekstrakcija zuba. Rezultati. Zarastanja rana kodsvih pacijenata bila su neometana, bez bolova ili lokalnihupala. Zaklju ak. Deksametazon može biti lokalno dat uoralna tkiva sa ciljem prevencije postekstrakcione upale i iz-ražene resorpcije rezidualnog alveolarnog grebena. Rezultatistudije su obe avaju i za le enje pacijenata koji e biti sto-matoprotetski rehabilitovani neposredno posle ekstrakcijazuba i ukazuju na to da nema neželjenih efekata prilikomlokalne primene kortikosteroida na tkiva iz kojih su ekstra-hovani zubi.Klju ne re i:hirurgija, oralna, preprotetske procedure; zub,ekstrakcija; alveolni nastavak; rehabilitacija;deksametazon; le enje, ishod.IntroductionCorticosteroids otherwise sovereign anti-inflammatoryand anti-oedematous drugs, are frequently used in oral sur-gery to prevent, or at least minimize, postoperative pain andoedema due to surgical trauma 1–3.  They can be used locallyor systemically, administered by injection or orally 4. Al-though corticosteroids have several general effects 5, theirsingle use (preoperative or postoperative) is supposed not tohave any undesired effect on the adrenal-pituitary regulationof steroid secretion 1.The problem of edentulous ridge reduction has beennoted in the dental literature for many years. A number ofauthors have discussed this problem due to difficulties fororofacial rehabilitation by means of proper denture de-sign 6, 8. It is well known that marked atrophy and reductionof alveolar bone following tooth loss complicate prostho-dontic rehabilitation 7, 9–11. Difficulties have been encoun-tered even in taking impressions of edentulous jaws with re-duced and resorbed edentulous ridges 11, as well as inachieving and maintaining the stability of fabricated acrylicdentures, particularly in the mandible 11. Consequently,Strana 500 VOJNOSANITETSKI PREGLED Volumen 71, Broj 5Pošti  S, Todorovi  Lj. Vojnosanit Pregl 2014; 71(5): 499–502.edentulous patients with the resorbed residual ridges have se-rious problems in chewing with dentures 9, 11, 12. For thesereasons it is crucially important that the height of the eden-tulous alveolar ridge, after tooth extraction, remains at a rea-sonable acceptable level for as long as possible. Addition-ally, it is necessary that fabricated acrylic dentures, throughconstant pressure on the edentulous ridge, do not cause de-layed resorption of residual ridge.It is possible that steroids, due to their marked localanti-inflammatory effect could lessen the ridge resorptionafter tooth extraction as one of the possible reasons for thisevent is local tissue inflammation as a consequence of tissueinjury. The aim of this study was to report preliminary re-sults of the clinical effect of local oral submucous admini-stration of dexamethasone after tooth extractions in order toprepare alveolar supporting tissues for the acceptance of re-movable dentures.MethodsA total of 15 otherwise healthy patients (without visiblesymptoms of local osteoporosis, or any other intraoral disor-der except tooth caries or periodontal disease), 11 partiallyand 4 completely edentulous (9 women aged 45–52 years,and 6 men aged 54–63 years), undergoing tooth extractionprior to classic prosthodontic rehabilitation, were includedinto the study. Altogether, 23 teeth were removed, 3 teeth atthe most in a single patient. In each patient, at least one ex-traction was difficult, meaning the need for a bone portionremoval with burs, or removal of a part of buccal or lingualcortical plate.To prevent an extensive post-extraction bone resorp-tion and possible complications of extraction wound heal-ing, immediately after the completion of difficult tooth ex-traction, a submucous 0.5 mL dexamethasone injection(Dexason®, Galenika, Belgrade) was administered, bucallyand orally (altogether 4 mg of dexamethasone), beside thesocket of the tooth that was removed with difficulties (Fig-ure 1).All the patients were followed-up regularly, and pros-thodontic rehabilitation with removable partial or full den-tures started two weeks afterwards.Fig. 1 – Dexamethasone injection beside the post-extractionwound.ResultsAfter administration of dexamethasone, no symptomsof local pain or inflammation, or any other complication,were noted (Figure 2).The bones of the alveolar ridge were solid enough toenable making of dentures without the need of any additionalplastic procedure, and control radiographs (Figure 3) re-vealed the absence of signs of undesired bone remodelling orextensive resorption.Fig. 3 – Control radiogram after the wound had been healed. a) b)Fig. 2 – The lower (a) and upper (b) jaw 2 weeks after local administration of dexamethasone.Volumen 71, Broj 5 VOJNOSANITETSKI PREGLED Strana 501Pošti  S, Todorovi  Lj. Vojnosanit Pregl 2014; 71(5): 499–502.Figure 4 shows the favorable finding of the upper jawin one patient, 2 weeks after local administration of dexa-methasone.Fig. 4 – The upper jaw of a female patient 2 weeks after localadministration of dexamethasone.Consequently, all the patients were successfully reha-bilitated with removable dentures (Figure 5). Fig. 5 – Local finding after the complete dentures had beenmade.DiscussionThe anti-inflammatory effect of corticosteroids has beenproved for many local or systemic disorders 13, 14. Therefore,indications for the use of corticosteroids due to their anti-inflammatory effect are wide, ranging from any kind of localinflammation to many postoperative complications in oral andmaxillofacial surgery. Therefore, the use of corticosteroids hasalso been recommended for pain reduction, oedema, and tris-mus following oral surgical procedures 1, 2, 4.Dexamethasone was injected beside the post-extractionsocket so that it could demonstrate maximal anti-inflammatoryeffect and remain locally and not rinsed by salivary flow. Itwas injected in a total dose that is usually used for single in-traoral application when anti-inflammatory dexamethasone ef-fect is desired 1–4. It was considered not to use dexamethasoneif patients had any possible contraindication for steroiduse 5, 15, and such patients were excluded from the study.Although the anti-inflammatory effect of dexameth-asone is well-known, there are no studies investigating itspossible influence on the reduction of post-extraction alveo-lar ridge resorption. In spite the fact that all the 15 treatedpatients in this preliminary study had difficult tooth extrac-tions, the wound healing in the post-extraction period wasuneventful, and the residual alveolar ridge did not demon-strate signs of excessive resorption or malformation. We be-lieve that this is mainly due to anti-inflammatory effect ofthe used dexamethasone. However, the number of treatedpatients is relatively small, and a double-blind controlledtrial is under way to confirm possible favourable effect ofdexamethasone in wound healing after tooth extraction.ConclusionDexamethasone can be locally applied to oral tissues toprevent post-extraction inflammation and extensive resorp-tion of the residual alveolar ridge. The obtained results arepromising for patients undergoing classic prosthodontic re-habilitation soon after tooth extraction, demonstrating thatthere are no adverse effects of such corticosteroids use.AcknowledgmentThis study was supported by Grant No 175021 from theMinistry of Education, Science and Technological Develop-ment of the Republic of Serbia.R E F E R E N C E S1. Alexander RE, Throndson RR. A review of perioperative cortico-steroid use in dentoalveolar surgery. Oral Surg Oral Med OralPathol Oral Radiol Endod 2000; 90(4): 406 15.2. Montgomery MT, Hogg JP, Roberts DL, Redding SW. The use of glu-cocorticosteroids to lessen the inflammatory sequelae followingthird molar surgery. J Oral Maxillofac Surg 1990; 48(2): 179 87.3. Gersema L, Baker K. Use of corticosteroids in oral surgery. JOral Maxillofac Surg 1992; 50(3): 270 7.4. Markovic A, Todorovic Lj. Effectiveness of dexamethasone andlow-power laser in minimizing oedema after third molar sur-gery: a clinical trial. Int J Oral Maxillofac Surg 2007; 36(3):226 9.5. Falkenstein E, Tillmann HC, Christ M, Feuring M, Wehling M.Multiple actions of steroid hormones: a focus on rapid, non-genomic effects. Pharmacol Rev 2000; 52(4): 513 56.6. Atwood DA. Reduction of residual ridges: a major oral diseaseentity. J Prosthet Dent 1971; 26(3): 266 79.7. Zmyslowska E, Ledzion S, Jedrzejewski K. Factors affecting man-dibular residual ridge resorption in edentulous patients: a pre-liminary report. Folia Morphol (Warsz) 2007; 66(4): 346 52.Strana 502 VOJNOSANITETSKI PREGLED Volumen 71, Broj 5Pošti  S, Todorovi  Lj. Vojnosanit Pregl 2014; 71(5): 499–502.8. Ortman HR. Factors of bone resorption of the residual ridge. JProsthet Dent 1962; 12(3): 429 40.9. Xie Q, Närhi TO, Nevalainen JM, Wolf J, Ainamo A. Oral statusand prosthetic factors related to residual ridge resorption inelderly subjects. Acta Odontol Scand 1997; 55(5): 306 13.10. Pošti  S, Markovi  D, Krsti  M, Rako evi  Z, Brkovi  S. Radio-graphic assessment of edentulous residual ridge reductions.Proceedings of the 15th Congress of the BaSS; 2010 April22 25; Greece, Thessaloniki; 2010.11. Zarb GA, Bolender CL, Eckert SE, Jacob RF, Fenton AH, Meric-ske-Stern R. Prosthodontic treatment for edentulous patients:Complete dentures and implant-supported prostheses. St.Louis: Mosby; 2004.12. Maeda Y, Wood WW. Finite element method simulation ofbone resorption beneath a complete denture. J Dent Res 1989;68(9): 1370 3.13. Stoll ML, Good J, Sharpe T, Beukelman T, Young D, Waite PD, etal. Intra-articular corticosteroid injections to the temporoman-dibular joints are safe and appear to be effective therapy inchildren with juvenile idiopathic arthritis. J Oral MaxillofacSurg 2012; 70(8): 1802 7.14. ElHag M, Coghlan K, Christmas P, Harvey W, Harris M. The anti-inflammatory effects of dexamethasone and therapeutic ultra-sound in oral surgery. Brit J Oral Maxillofac Surg 1985; 23(1):17 23.15. Assimes TL, Lessard LM. The use of perioperative corticoster-oids in craniomaxillofacial surgery. Plast Reconstruc Surg1999; 103(1): 313 22.Received on November 4, 2012.Revised on February 4, 2013.Accepted on February 7, 2013.OnLine-First February, 2014.

English

Preliminarno ispitivanje lokalne primene deksametazona posle ekstrakcije zuba - bolja očuvanost rezidualnog alveolarnog grebena?

Background/Aim. It is important that the height of the edentulous alveolar
   ridge after tooth extraction remains at a reasonable acceptable level for as
   long as possible. The aim of this study was to report preliminary results of
   the clinical effect of local oral submucous administration of dexamethasone
   after tooth extractions in order to prepare alveolar supporting tissues for
   acceptance of removable dentures. Methods. In a total of 15 patients (11
   partially and 4 completely edentulous) the quantity of 0.25 mL to 0.5 mL of
   dexamethasone was injected bucally and orally in the region of the tooth
   socket after complicated extractions. Results. Healing of extraction wounds
   was uneventful in all the patients, without pain or local inflammation.
   Conclusion. Dexamethasone can be locally applied to oral tissues to prevent
   post-extraction inflammation and extensive resorption of the residual
   alveolar ridge. The obtained results are promising for patients undergoing
   classic prosthodontic rehabilitation soon after tooth extraction,
   demonstrating that there are no adverse effects after local oral
   corticosteroids administration.</jats:p

A preliminary study of local administration of dexamethasone after tooth extraction: Better preservation of residual alveolar ridge?

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