The study found that in patients taking prednisolone after tooth extraction, healing of the extraction site may be delayed. The delay in healing is affected by certain doses of prednisolone, as well as some other factors.
The study included 80 patients who had a tooth extracted under local anesthesia and who were taking oral prednisone. Depending on the recovery, patients were divided into groups and a comparison was made of the reason for using prednisolone and the dosage.
Prednisolone dosage was significantly higher in the delayed healing group compared to the accelerated healing group. The main factors for delayed healing were the dosage of prednisolone taken and osteosclerotic changes around the extraction site.
“In this study, the cut-off dose of prednisone was 8.0 mg/day, which was defined as the preoperative dose that causes delayed healing,” write study authors led by Hiroyuki Hato of Hokkaido University in Japan. Exceeding this dose may increase adverse side effects.
The wound healing process is divided into three phases: the inflammation phase, the proliferation phase and the remodeling phase. At each phase, prednisolone regulates cytokine expression and immune cell migration, causing delayed wound healing.
Osteosclerotic changes in the maxilla and mandible result from infection, causing inflammation and potentially leading to nutrient deficiencies and delayed healing. In the present study, osteosclerotic changes outside the alveolar bone near the extracted tooth were significantly associated with delayed healing.
“Long-term chronic inflammation due to osteosclerotic changes can lead to osteomyelitis outside the alveolar bone,” Hato and colleagues write.
The present study focused on wound healing and preoperative antibacterial agents as factors preventing delayed healing after tooth extraction in patients taking oral prednisolone. None of these factors in delayed healing is considered independently of each other.
“Careful attention to prednisolone dosage and radiographic findings during tooth extraction is important to prevent delayed healing,” Hato and colleagues concluded.