Introduction: Glucocorticoids, also known as corticosteroids or steroids, are drugs derived from cholesterol. They are synthesized by the adrenal cortex, along with other hormones, such as cortisol and aldosterone. Glucocorticoids are drugs recommended for patients undergoing surgery on the oral cavity, facial skeleton, and related cervical structures due to their high efficacy against inflammatory and immune processes. However, these drugs are restricted due to their multiple and serious adverse effects. The objective of this study was to verify the efficacy of corticosteroids administered in major surgeries of the oral cavity, as well as of the cervical and facial structures, based on the characteristics of the patient so as to select the best therapeutic strategy. Methods: Articles in the databases of PubMed, Nature Portfolio, Medline, Cochrane Library, and Google Scholar were thoroughly examined. Results: A total of 54 articles were selected to address the proposed objectives. The results obtained show that it is effective and safe to use glucocorticoids as pre- or postsurgical therapy in oral and maxillofacial surgery to control the processes of inflammation, pain, lockjaw, and edema. However, when referring to the use of these drugs, one must proceed with caution and pay particular attention when handling them. The concentration of the glucocorticoids used must be individualized, as well as the selection of the route of administration. Various studies show that, although the oral route is the most used route, the most effective route is the intramuscular route due to its easy absorption. However, for patients who have recurrent inflammatory and vesiculobullous ulcerative lesions, the topical route should be chosen to mitigate side effects, considering that recurrent applications must be made to prevent the worsening of the lesion and to avoid having to use medications enterally. In patients with cervicofacial infections, antibiotics continue to be the main drugs used to manage the condition in conjunction with corticosteroids. It is important to know the possible interactions of glucocorticoids with other medicines or food: it has been described that the interaction between Ritonavir, an antiretroviral drug that inhibits human immunodeficiency virus (HIV) proteases, and prednisone causes an increase in the concentration of prednisone, leading to possible toxicity in normally safe doses and, in many cases, iatrogenic Cushing’s syndrome. It is also important to know the systemic or topical adverse effects of the chronic or high-dose use of glucocorticoids. Conclusions: It can be concluded that by making adequate use of glucocorticoid therapy in oral and maxillofacial surgery to manage clinical manifestations, it is possible to attenuate the morbidities of treatment and intervention.

Background and Objectives: Osteomyelitis is a progressive bone infection requiring a combination of antimicrobial and anti-inflammatory therapies. While antibiotics remain the cornerstone of treatment, the role of NSAIDs and steroidal anti-inflammatory drugs (SAIDs) in modulating inflammation and improving clinical outcomes warrants further investigation. This systematic review evaluates the effectiveness and safety of combined antibiotic and NSAID/SAID therapy in osteomyelitis, aligning treatment strategies with disease stage and pathogenesis. Materials and Methods: A systematic search was conducted in Web of Science, Scopus, and PubMed from July 2024 to November 2024, following PRISMA and CARE guidelines. The studies were selected based on detailed pharmacological data, treatment outcomes, and follow-up analysis. The risk of bias was assessed using the Critical Appraisal Skills Programmed (CASP) tool. Statistical reliability between coders was evaluated using Cohen’s kappa coefficient (κ = 0.636–0.909) and intra-class correlation coefficient (ICC = 1.0). Results: Four case studies, representing acute, chronic, recurrent, and SAPHO syndrome-associated osteomyelitis, demonstrated variable responses to combined therapy. Antibiotics alone were effective in acute cases, while NSAIDs/SAIDs significantly contributed to inflammatory control in chronic and immune-mediated osteomyelitis. Glucocorticoids (e.g., prednisolone, methylprednisolone) showed efficacy in reducing systemic inflammation, with no major adverse effects reported. The transition from intravenous to oral antibiotic therapy was observed in all cases, ensuring sustained infection control. Conclusions: This review highlights the critical role of NSAIDs/SAIDs in complementing antibiotic therapy, particularly in chronic and refractory osteomyelitis. Stage-specific pharmacological interventions improve treatment outcomes, and future research should explore bisphosphonates and immunomodulatory agents to refine therapeutic approaches. These findings reinforce the need for personalized osteomyelitis management based on pathogenesis, microbiology, and disease progression.

Optimal postoperative analgesia remains pivotal in endodontic success, particularly under acute inflammatory conditions. Although glucocorticoids such as dexamethasone exhibit potent anti-inflammatory efficacy, their prophylactic application in endodontics has not been extensively validated. This study assessed whether preoperative dexamethasone offers superior analgesia to postoperative ibuprofen in endodontic pain control. A randomized, controlled Phase IV clinical trial was undertaken at the Faculty of Dentistry, University of Salamanca, involving 82 ASA I patients undergoing single-visit root canal treatment. Subjects were equally randomized into two arms: the experimental group received 4 mg oral dexamethasone one hour preoperatively, while the control group was administered 400 mg ibuprofen at four-hour intervals post-treatment. Postoperative pain was evaluated using the Visual Analog Scale (VAS) at 4, 6, 8, 12, and 24 h. Intergroup differences were analyzed using the Mann–Whitney U test. The dexamethasone cohort demonstrated statistically significant reductions in VAS scores between 6- and 24-h post-intervention (p < 0.001), with no adverse events or need for rescue analgesia observed. Gender-based variation in pain perception was not significant. A single 4 mg preoperative oral dose of dexamethasone markedly enhances early postoperative analgesia in root canal treatment relative to standard ibuprofen regimens. These results support its integration into preemptive root canal protocols, contingent upon further multicenter validation. Approved by the Bioethics Committee (Ref. 2025_01/345; March 10, 2025). Clinical trial registration: NCT069063150 (April 1, 2025).The study adhered to the ethical standards of the 1964 Declaration of Helsinki and its later amendments. Graphical abstract