Submitted by PPG Odontologia (odontologia-pg@pucrs.br) on 2018-11-20T17:24:32Z No. of bitstreams: 1 ROGER_CORREA_DE_BARROS_BERTHOLD_TESE.pdf: 1248415 bytes, checksum: d90c44a1cbf0707fd34f2e4227edb743 (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-11-21T13:34:35Z (GMT) No. of bitstreams: 1 ROGER_CORREA_DE_BARROS_BERTHOLD_TESE.pdf: 1248415 bytes, checksum: d90c44a1cbf0707fd34f2e4227edb743 (MD5) / Made available in DSpace on 2018-11-21T13:45:56Z (GMT). No. of bitstreams: 1 ROGER_CORREA_DE_BARROS_BERTHOLD_TESE.pdf: 1248415 bytes, checksum: d90c44a1cbf0707fd34f2e4227edb743 (MD5) Previous issue date: 2018-09-19 / The surgical removal of impacted third molars is one of the most common procedures in oral surgery. The application of steroids or glucocorticoids in the perioperative period of these procedures is a practice used to reduce postoperative morbidity. However, the great variability of drugs and their applications makes it difficult to determine the true anti-inflammatory effect of these drugs. The present study evaluated the effect of corticosteroids on the reduction of postoperative pain, edema and trismus in the extraction of third molars by means of a systematic review and meta-analysis, comparing it with NSAIDs and control. A systematic search was performed on Pubmed, EMBASE and Cochrane Library databases, using specific terms assembled using customized strategies for each database. The results were transferred to Endnote x6 and analyzed by 2 independent reviewers, searching for relevant articles, by title and abstract. Seventy-five articles were retrieved in full text for analysis taking into consideration the eligibility criteria. After paired analysis, 34 articles met the criteria for final review. Considering the 100-mm visual analogue scale (VAS), the results indicated that individuals who received corticoids had a reduction in postoperative pain equivalent to -7.66 mm [-11.28, -4.04] at 48 h and -6.19 mm [-13.55, 1.18 ] at 168 h compared to the the control group. Considering the metric method for measuring the edema outcome, individuals who received corticoids showed a postoperative reduction of -2.52 mm [-3.27, -1.77] at 48 h and -0.56 mm [-0.79, -0.34] at 168 h compared to control. Considering the interincisal distance with respect to trismus, those who received corticoids had a postoperative reduction of -4.01 mm [-4.89, -3.12] at 48 h and -2.33 mm [-3.14, -1.51] at 168 h, compared to individuals in the control group. When corticoids were compared to NSAIDs and taking into consideration the standardized mean difference (SMD), the meta-analysis suggested a mild effect on reduction of pain and moderate effect on reduction of edema at 48 h postoperative: -0.26 [-0.45, -0.08] and -0.72 [-1.24, -0.20], respectively. / A exodontia de terceiros molares retidos ? o procedimento mais comum em cirurgia bucal. A indica??o de anti-inflamat?rios esteroidais ou glicocorticoides no perioperat?rio desse procedimento ? uma pr?tica utilizada para reduzir a morbidade p?s-cir?rgica. No entanto, a grande variabilidade de f?rmacos e aplica??es dos mesmos dificulta a verifica??o do real efeito anti-inflamat?rio desses medicamentos. A presente pesquisa avaliou por meio de revis?o sistem?tica e meta-an?lise o efeito dos glicocorticoides na redu??o da dor, edema e trismo p?s-operat?rios de terceiros molares retidos, comparando com anti-inflamat?rios n?o esteroidais (AINES) e controle (n?o receberam corticoides). Para tal, foi realizada uma busca sistem?tica nas bases de dados Pubmed, EMBASE e Cochrane Library, utilizando termos espec?ficos montados em estrat?gias personalizadas para cada uma. O resultado encontrado foi transferido ao Endnote x6 e analisado por 2 revisores independentes, buscando artigos relevantes, apenas por t?tulo e abstract. Setenta e cinco artigos foram recuperados em texto completo para an?lise, levando-se em considera??o os crit?rios de elegibilidade. Ap?s an?lise pareada, 34 artigos preencheram os crit?rios para a revis?o final. Considerando a escala visual anal?gica (EVA) de 100mm, o resultado sugere que os indiv?duos que receberam corticoides obtiveram redu??o de dor p?s-operat?ria equivalente a - 7.66mm [-11.28, -4.04] em 48h e -6.19mm [-13.55, 1.18] em 168h em rela??o aos indiv?duos do grupo controle. Considerando o m?todo m?trico de aferi??o para o desfecho edema, os indiv?duos que receberam corticoides obtiveram redu??o p?s-operat?ria de -2.52mm [-3.27, -1.77] em 48h e -0.56mm [-0.79, - 0.34] em 168h comparados aos indiv?duos do controle. Considerando a dist?ncia interincisal no que concerne ao trismo, os indiv?duos que receberam corticoides obtiveram redu??o p?s-operat?ria de -4.01mm [-4.89, -3.12] em 48h e -2.33mm [-3.14, -1.51] em 168h, comparados aos indiv?duos do controle. J? quando os corticoides foram comparados aos AINES, a meta-an?lise sugeriu efeito leve na redu??o da dor -0.26 [-0.45, -0.08] e moderado na redu??o do edema -0.72 [-1.24, -0.20] em 48h p?s-operat?rias, levando em considera??o o standardized mean difference (SMD).