Photobiomodulation for post-operative pain, swelling and trismus after third molar surgery

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This review of the effects of photobiomodulation (PBM) on pain, oedema, and trismus after extraction of impacted mandibular third molars included 33 RCTs. However 30 of the included studies were considered to be at high risk of bias, and while the results suggested small benefits for PBM in relation to reduction of pain and swelling these were not considered to be clinically important.

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Single or multiple visit root canal therapy?

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This Cochrane review update comparing single and multiple vist root canal treatments in patients over the age of 10 included 47 RCTs. There was no evidence to suggest that one treatment regimen (single‐visit or multiple‐visit RoCT) is more effective than the other although more patients report pain in the first week with the single visit approach.

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Third molar surgery – Er:Yag lasers and post-operative problems

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This review of the effectiveness of Er:YAG lasers in reducing pain, oedema and trismus compared to rotary instruments for the removal of impacted lower third molars included 6 small studies only one of which was at low risk of bias. The findings suggest a reduction in swelling and a small reduction in pain however the findings should be viewed cautiously because of the limited amount and quality of the evidence.

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Platelet-rich fibrin and third molar post extraction problems

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This review of the effectiveness of leukocyte-and platelet-rich fibrin (L-PRF) and advanced-platelet-rich fibrin (A-PRF) in mandibular third molar extraction included 10 RCTs. While the findings suggest some benefits the studies are small and limited in number so the findings should be interpreted cautiously.

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Third molar extraction– effect of preoperative oral corticosteroids on pain, swelling and trismus

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Four RCTs involving a total of 212 patients were included in this review of a single pre-operative dose of oral corticosteroids in reducing pain,swelling & trismus after surgical removal of lower third molars. While the findings suggested there was little benefit to the patients none of the studies were small and none of them were at low risk of bias.

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Third molar surgery – Lingual or buccal-based flaps?

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This review of postoperative discomfort, operative time, and wound healing in the short-term follow-up following surgical extraction of lower third molars with lingual- or buccal-based flaps included 7 RCTs. The quality of the included studies was limited and few differences were seen between the type of flaps.

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Third molar surgery: Does low-level laser therapy reduce post-operative morbidity?

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This review of whether low-level laser therapy (LLLT) is effective in reducing postoperative morbidity in patients undergoing surgical removal of mandibular third molars included 17 RCTs. The findings suggest a reduction in post-operative swelling but not pain or trismus.

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Post-operative endodontic symptoms: Are they improved by prophylactic antibiotics?

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This review of the efficacy of prophylactic oral antibiotics in the management of post-operative endodontic symptoms included 10 RCTs. The findings and show that there is no superiority in using adjunctive antibiotics for the prevention of post-operative endodontic symptoms.

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Third molars: Which surgical technique for removal?

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This Cochrane review upate compares the relative benefits and risks of different techniques for surgical removal of mandibular wisdom teeth. While the review includes 25 new trials the quality of the studies was variable with many having biases that could have influenced the findings so no meaningful conclusions could be drawn.

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Third molars: Envelope or triangular flap for mandibular third molar surgery?

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This review comparing the effects of envelope and triangular flaps for mandibular third molar surgery included 20 RCTs involving 770 patients. A majority of the studies were of cross-over design with the findings suggesting no differences in teh outcomes between the two flap designs.

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