Corticosteroids in Dentistry| Application and Adverse Effect of Corticosteroid
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Corticosteroids are very similar to Steroid hormones produced naturally in Adrenal Cortex of humans. Protein, Carbohydrates and Fat metabolism, maintenance of fluid electrolytes and adapting the body to stress. Corticosteroids are antinflammatory, analgesics, effective on ulceration promotes the healing of nerve injuries. Oral Sub-mucus Fibrosis, Central Giant Cell Granuloma, Lichen Planus (for 5 min, 0.5% application of Clobetasol Propionates with Nystatin) in a Gingival Tray. Bullous and Mucous Pemphigoid, Melkerson Rosenthal syndrome, Bell's Palsy, Post-Herpetic neuralgia.
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Corticosteroids in Dentistry| Application and Adverse Effect of Corticosteroid
- 2. • 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.
- 3. STRUCTURE OF ADRENAL CORTEX • OUTER – Zona Glomerulosa – produce mineralocorticoids: aldosterone • MIDDLE – Zona Fasciculata – produce glucocorticoids: cortisol • INNER – Zona Reticularis – produce sex hormones: testosterone
- 5. • There are principal steroids is : • Glucocorticoids: Affects carbohydrate, protein, and fat metabolism. • Mineralocorticoids: Affects Na + , K + , and fluid balance. • Sex hormones
- 6. • The normal secretion rate of the principal corticoids in human is: • Hydrocortisone: 10-20 mg daily (nearly half of this is in the few morning hours). • Aldosterone: 0.125 mg daily • Dehydroepiandosterone : 30 mg/day • Corticosterone : 2 mg/day
- 8. ANTI-INFLAMMATORYAND 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.
- 10. 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.
- 11. AFTER THIRD MOLAR SURGERY • Corticosteroids exert anti - inflammatory action, reducing liquid transudation and oedema formation, decreasing cell exudates, inhibiting vascular dilatation and reducing fibrin deposit around the inflamed area. • They inhibit the leukocyte chemotaxis , numerous chemical inflammation mediators.
- 12. APPLICATION IN ENDODONTICS • Ledermix - An antibiotic/corticosteroid combination – is used for vital pulp dressing and as a root canal medicament.
- 13. • Zinc oxide eugenol along with steroids is also used as root canal sealer. • Steroids along with chloramphenicol reduces postoperative thermal sensitivity.
- 14. 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
- 16. • Erythema multiforme • Osteoradionecrosis of jaw • Pemphigus vulgaris • NERVE LESIONS – • Bell's palsy • Post herpetic neuralgia • Melkersson Rosenthal Syndrome
- 17. HERPES RECURRENT APTHOUS STOMATITIS ERYTHMA MULTIFORME ORAL PEMPHIGUS
- 18. WHEN NOT TO ADVICE CORTICOSTEROIDS
- 19. • Renal failure. • Pregnancy • Diabetes mellitus • Hypertension • Hypersensitivity • Peptic ulcer • Osteoporosis • Epilepsy • Congestive heart failure
- 21. With topical administration • Mucosal atrophy • Candidiasis • Acne • Dermatitis • Allergic reaction • Tachyphylaxis • Spread of infections
- 22. With long and high dose Systemic Administration • Suppression of hypothalamus pituitary axis • Cushing syndrome • Hypertension • Buffalo hump • Diabetes • Skin fragility • Moon face
- 24. BETAMETHASONE
- 26. USE IN CHILDREN • As a general rule, steroids should be avoided in growing children. • However, the child with recurrent severe aphthae would be poorly managed without addressing the individual lesions. • Controlled and intermittent use of a medium potency GC is often the treatment of choice. • Compliance and application require careful monitoring.
- 28. To book an appmt. contact Dr.Rajat Sachdeva Dr Sachdeva’s Dental Aesthetic & Implant Institute I 101, Ashok Vihar Phase 1, Delhi- 110052 Contact us at Phone : +919818894041 01142464041