Role of Corticosteroids as Adjunctive Therapy in Patients With Odontogenic Cervicofacial Infections: Systematic Review

Objective: The main aim is to evaluate the efficacy and safety of corticosteroid administration as adjuvant therapy in patients with odontogenic cervicofacial infections. Methods: We searched five databases, grey literature and manually reviewed bibliographic references for observational studies. Outcomes included hospital length of stay, intensive care unit admission, reoperation and other postoperative complications. The risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analyses were not performed due to the heterogeneity of the results. Results: We included four observational studies. Dexamethasone use reduced the odds of reoperation (odds ratio (OR): 0.9; 95% CI: 0.8–0.98). Additionally, higher doses of dexamethasone were associated with a shorter hospital stay (β: −0.2; 95% CI: −0.3 to −0.07). However, another study reported a longer hospital stay among patients who received corticosteroids than those who did not; p < 0.001. Furthermore, corticosteroid use was associated with lower odds of intensive care unit admission (OR: 0.51; 95% CI: 0.09–2.72); p > 0.05. The only reported adverse event was prolonged hyperglycemia (0.8%). Conclusions: The adjuvant use of corticosteroids in managing patients with odontogenic cervicofacial infections has potential beneficial effects and appears safe. However, the evidence remains unclear, and further studies are needed to evaluate potential benefits and harms.