The maxillary sinus is a pyramidal-shaped cavity and is the largest of the paranasal cavities. The maxillary sinus borders are comprised of 1) the nasal cavity medially, 2) the floor of the ocular orbit superiorly, 3) the maxillary tuberosity posteriorly, 4) the canine fossa anteriorly, and 5) the apical portion of the alveolar process inferiorly. During the aging process, and to a greater degree, after the loss of posterior teeth, the maxillary sinuses progressively increase their volume at the expenses of the superior-posterior alveolar ridge, which can complicate or impede dental implant placement. To overcome this problem, the bone augmentation technique known as sinus lift or maxillary sinus augmentation (MSA) was introduced in 1970. This surgical procedure, and in particular, the lateral approach, has remained essentially unchanged in its execution protocol since it was first described. However, the procedure now exists as a one or two stage variant depending on whether the implants are placed simultaneously or consecutively to augmentation.

The , although rather invasive, appears to be the most successful among the intra-oral bone augmentation techniques, with an implant survival rate comparable to implants placed in native bone. The low frequency of reported post-operative infections, which is reported to be between 2% and 5.6%, contributes to safety and effectiveness of the procedure. However, sinus infections can still occur. An infection of the maxillary sinus can remain localized or spread to neighboring structures, leading to life threatening scenarios if not properly treated. For this reason, it is recommended to follow specific pharmacological protocols to prevent such consequences.

Currently, pre- and post-operative prophylaxis regimens for MSA procedures include the use of antibiotics. However, corticosteroids are less commonly used, and if so, are generally administered only pre- or peri-operatively via oral or intramuscular route. This decision is operator-dependent and is not as standardized as antibiotics.

The use of corticosteroid drugs in oral surgery is much debated; those who use them aim to reduce the direct effects of inflammation on post-operative symptoms such as edema. This is because corticosteroids decrease the activity and migration of inflammatory cells (T helper lymphocytes, monocytes, and macrophages) on the site of trauma and their production of pro-inflammatory substances (histamine, leukotrienes, prostaglandins, and cytokines). Furthermore, the inhibition of enzyme phospholipase A₂ and prostaglandin production makes corticosteroids a potent analgesic substance, which reduces post-operative pain.

A challenging factor regarding MSA-related complications is that the post-operative infections can be either true sinus infections (i.e., acute sinusitis) or bone graft related infections (i.e., bacterial contamination of graft). A sinus infection is distinguished from a bone graft infection in that it occurs within the sinus space surrounded by the Schneiderian membrane (SM) versus a bone graft infection which is found between the inferior aspect of the SM and the apical portion of alveolar process.

In light of these considerations, the purpose of this systematic review is to identify whether the administration of corticosteroids during the MSA surgical procedure operative phase affects post-operative symptoms, including swelling, pain, and infection rate.