Corticosteroids used in oralsurgery /certified fixed orthodontic courses by Indian dental academy

778 views

Published on


The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078

0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
778
On SlideShare
0
From Embeds
0
Number of Embeds
21
Actions
Shares
0
Downloads
1
Comments
0
Likes
1
Embeds 0
No embeds

No notes for slide

Corticosteroids used in oralsurgery /certified fixed orthodontic courses by Indian dental academy

  1. 1. CORTICOSTEROIDS IN ORAL AND MAXILLOFACIAL SURGERY www.indiandentalacademy.com
  2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  3. 3.  Introduction  Aim & Objectives  Adrenal physiology  Pharmacological actions  Applications in oral surgery  Risks, contraindications & complications  Management of dental patients with adrenal insufficiency  Conclusion  References www.indiandentalacademy.com
  4. 4. www.indiandentalacademy.com
  5. 5. Steroids the Sleaziest of Drugs Steroids are fast catching up with antibiotics as the most abused class of drugs in doctor's black bag. High doses of corticosteroids and other immunosuppressive agents cause AIDS Mohammed Ali Al-Bayati Ph.D www.indiandentalacademy.com
  6. 6.  Discuss the pharmacological effects of glucocorticoids  Side effects and contraindications of steroid use  Distinguish the short term from long term therapy  Describe possible indications & regimens for their use in oral surgery www.indiandentalacademy.com
  7. 7.  Adrenocorticoids  Primary corticosteroid Hydrocortisone www.indiandentalacademy.com
  8. 8. www.indiandentalacademy.com
  9. 9. www.indiandentalacademy.com
  10. 10.  Biosynthesis  Transport in the blood  Metabolism  Mechanism of action www.indiandentalacademy.com
  11. 11. www.indiandentalacademy.com
  12. 12. www.indiandentalacademy.com
  13. 13.  Transcortin or Corticosteroid binding Globulin  Bound form – 94%  Free form – 6 % www.indiandentalacademy.com
  14. 14.  Glucuronic acid or sulfate conjugation  25% - bile & faeces  75% - urine www.indiandentalacademy.com
  15. 15. www.indiandentalacademy.com
  16. 16. Corticosteroids Phospholipids Lipocortin Phospholipase A2 Arachidonic acids lipoxygenase Cycylooxygenase Leukotriene Prostaglandins, Thromboxane Prostacyclins www.indiandentalacademy.com
  17. 17.  Injectable: Betamethasone, Dexamethasone, Prednisolone, Methylprednisolone, Hydrocortisone, Triamcinolone  Oral: Betamethasone ,Fludricortisone ,Prednisolone,Prednisone, Methylprednisolone  Topical: Betamethasone ,Clobetasol ,Flucinolone ,Mometasone  Inhalation: Beclomethasone ,Budesonide ,Flunisolode www.indiandentalacademy.com
  18. 18. www.indiandentalacademy.com
  19. 19.  Carbohydrate, Protein & Fat Metabolism: Gluconeogenesis Glycogen deposition in liver (activation of hepatic glycogen synthase) Negative nitrogen balance & hyperglycaemia Redistribution of Fat www.indiandentalacademy.com
  20. 20.  Aldosterone is more important  Act on D.T. & C.D. of kidney ◦ Na+ reabsorption ◦ Urinary excretion of K+ and H+ Calcium excretion by the kidney www.indiandentalacademy.com
  21. 21.  Restrict capillary permeability  Maintain tone of arterioles Corticosteroid induced hypertension ?? www.indiandentalacademy.com
  22. 22.  Mild euphoria  Maintain level of sensory perception & normal level of excitability of neurones HIGH DOSES LOWER SIEZURE THRESHOLD - CAUTIOUS USE IN EPILEPTICS www.indiandentalacademy.com
  23. 23. www.indiandentalacademy.com
  24. 24. www.indiandentalacademy.com
  25. 25. www.indiandentalacademy.com
  26. 26.  Replacement therapy  Inflammatory states  Leukemia  Shock  Severe allergic reactions  Dermatology  Immunosuppresion www.indiandentalacademy.com
  27. 27. www.indiandentalacademy.com
  28. 28.  Topical use: non-infections, ulcerative diseases in oral cavity. Inhibit the inflammatory reaction, redness and edema  Systemic use: third molar extraction, pre-prosthetic surgery, reconstructive oral surgery, orthognatic surgery www.indiandentalacademy.com
  29. 29. CONDITION Aphthous ulcer dentin hypersensitivity desquamative gingivitis oral lichen planus post extraction pulp capping pulpotomy severe allergy TMJ arthritis symptoms oral pemphigus Oral Submucous Fibrosis ADMINISTRATION Topical Topical Topical,systemic Topical,systemic Systemic Topical Topical Systemic Systemic Topical,systemic Local www.indiandentalacademy.com
  30. 30. www.indiandentalacademy.com
  31. 31. www.indiandentalacademy.com
  32. 32. www.indiandentalacademy.com
  33. 33.  Minor surgical stress  Moderate surgical stress  Major surgical stress www.indiandentalacademy.com
  34. 34. www.indiandentalacademy.com
  35. 35. www.indiandentalacademy.com
  36. 36. www.indiandentalacademy.com
  37. 37.  Use of Corticosteroids in Oral Surgery; J Oral Maxillofac Surg 50:270-277, 1992; Lisa Gersema, Karen Baker  Efficacy and safety of steroid use for postoperative pain relief; The journal of bone & joint surgery · JBJS.Org; Volume 88-A · number 6 · June 2006  Supplemental corticosteroids for dental patients with adrenal insufficiency :Reconsideration of the problem;Craig S. Miller, James W. Little,; Donald A. Falace, JADA, Vol. 132, November 2001; 1570  Corticosteroids and Oral Surgery: Jason Bodnar, Anesth Prog 48:130-132 2001  Perioperative Glucocorticoid Coverage - A Reassessment 42 Years After Emergence of a Problem; Michael Salem, Robert E. Tainsh, Annals Of Surgery;April 1994;Vol. 219, No. 4,416-425  Textbook of Modern Pharmacology with Clinical Applications by Charles R Craig  Textbook of Review of Medical Physiology by William Ganong www.indiandentalacademy.com
  38. 38. Happy reading www.indiandentalacademy.com
  39. 39. www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

×