Corticosteroids are potent anti-inflammatory and immunosuppressive agents that play an essential role in managing a wide range of conditions in oral and maxillofacial surgery. They act by inhibiting phospholipase A2, thereby reducing the production of inflammatory mediators like prostaglandins and leukotrienes. Their clinical uses include managing autoimmune, allergic, respiratory, and gastrointestinal diseases, as well as controlling postoperative pain, edema, and trismus. In oral and maxillofacial practice, corticosteroids are used in treating oral ulcerative and vesiculobullous lesions, temporomandibular disorders, keloids, hypertrophic scars, Bell's palsy, central giant cell granuloma, hemangiomas, and for reducing postoperative complications after surgeries. However, their use requires careful monitoring due to possible adverse effects such as adrenal suppression, immunosuppression, Cushingoid features, osteoporosis, and metabolic disturbances. Their benefits are maximized when used at the lowest effective dose for the shortest duration, with proper tapering and perioperative coverage in patients with adrenal suppression.
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