Prednisolone may cause delayed healing after tooth extraction

2020 01 23 19 26 0800 Dentist Patient Hygienist 400

Patients taking prednisolone following a tooth extraction may experience delayed healing of the extraction socket. A study published on September 8 in the Journal of Dental Sciences identified specific dosages of prednisolone and other factors associated with delayed healing of the extraction site.

The study included 80 patients who had a tooth extracted under local anesthesia and were taking prednisolone orally. Patients were divided into groups based on their healing, and their background and dosage of prednisolone were compared.

The dosage of prednisolone was significantly higher in the delayed healing group compared to the nondelayed healing group. The main factors for delayed healing included the dosage of prednisolone taken and osteosclerotic changes around the extraction socket.

"In this study, the cutoff dosage of 8.0 mg/day of prednisolone was determined as the preoperative dosage that causes delayed healing," wrote the study authors, led by Hiroyuki Hato of Hokkaido University in Japan. Exceeding this dosage may increase adverse side effects and cause healing failure, they wrote.

The wound-healing process can be divided into three phases: the inflammatory phase, the proliferative phase, and the remodeling phase. At each phase, prednisolone regulates the expression of cytokines and the migration of immune cells, causing delayed wound healing.

Osteosclerotic changes in the maxilla and mandible arise from infection, causing inflammation and potentially resulting in nutrient deprivation and delayed healing. In the present study, osteosclerotic changes beyond the alveolar bone near the extracted tooth were significantly associated with delayed healing.

"Long-term chronic inflammation of osteosclerotic changes can lead to osteomyelitis beyond the alveolar bone," Hato and colleagues wrote.

The present study focused on wound healing and preoperative antibacterial agents as factors that prevent delayed healing following tooth extraction in patients taking prednisolone orally. Neither of these factors was independent in delaying healing.

"Careful attention to dosage of prednisolone and findings of radiographs when performing tooth extraction is important to prevent delayed healing," Hato and colleagues concluded.

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