Recently following much procrastination I decided to move to a situation of using pre-operative steroids for my implant patients.
There appears to be several advantages to this:
1. Reduced swelling post procedure
2. Reduced postoperative discomfort
3. Reduced wound opening
There are obvious disadvantages with steroids, particularly in relation to medical history for patients but also the fact that they increase alertness and make people ‘wired’ therefore producing insomnia if taken at the wrong time of day.
I researched into this to see what people were doing and what the evidence said and also posted on ITInet worldwide to get a feel for what guys around the globe were doing with steroids.
In the end we settled on the protocol below:
Dexamethasone
8mg - 30 minutes pre-operatively
6mg – day following surgery
4mg – day following
We have provided an advice sheet for patients, which is available on request from colincampbellfa@gmail.com and began the process of using steroids in many of our cases before Christmas. We generally use them in larger cases, anterior cases where we have to advance tissue and sinus graft patients. So far it has been in universally accepted and the results have been dramatic.
Well worth considering if you are involved in implant dentistry and I think it is likely that we will extend it to even more of our patients as we proceed through this trial period.
Incidentally, it costs us about 70p per case.
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