Background:Corticosteroids are widely used in maxillofacial and orthognathic surgery owing to their potent anti-inflammatory, immunomodulatory, and antiemetic properties. Although concerns persist regarding their potential adverse effects on wound healing, infection risk, and glucose metabolism, recent evidence supports their safety and efficacy when used as short-term perioperative therapy.Objective:This review aims to summarize current evidence on the clinical efficacy, optimal dosage, timing, and safety profile of corticosteroid administration—particularly dexamethasone—in orthognathic surgery.Methods:A comprehensive review of randomized controlled trials, systematic reviews, and meta-analyses published between 1974 and 2025 was conducted. Studies evaluating perioperative corticosteroid use in orthognathic and related maxillofacial procedures were analyzed with respect to postoperative outcomes, including edema, trismus, pain, nausea and vomiting (PONV), wound healing, infection risk, and systemic adverse effects.Results:Evidence consistently demonstrates that a single intravenous dose of 8–16 mg dexamethasone significantly reduces postoperative edema, trismus, pain, and PONV without increasing the risk of impaired wound healing or infection. Incorporation of corticosteroids into Enhanced Recovery After Surgery (ERAS) protocols enhances patient comfort, decreases opioid consumption, and promotes earlier discharge. Short-term administration (
Arslan et al. (Fri,) studied this question.