Corticosteroids are steroid hormones from the adrenal cortex that play a crucial role in metabolism and stress adaptation. In dentistry, they exhibit anti-inflammatory and analgesic effects, aiding in post-surgical recovery and various oral conditions. However, corticosteroids should be used cautiously due to potential adverse effects, particularly in specific populations such as children.

1. CORTICOSTEROIDS IN
DENTISTRY

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

15. OSMF LICHEN PLANUS

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

20. ADVERSE EFFECTS OF
CORTICOSTEROIDS

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

23. HYDROCORTISONE TRIAMCINOLONE

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.

27. @dentalcoursesdelhi
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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
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