The use of dental implants has steadily increased and in recent years the largest increase has been noted in patients aged between 65-74 years. This age group are also likely to be on long-term prescription of antiplatelet and oral anticoagulants as prophylaxis against thromboembolic events. Dental implant placement as a surgical procedure presents a risk [read the full story…]
This Cochrane review update of interventions for the prevention or treatment of medication-relatesd osteonecrosis of the jaw (MRONJ) included 13 RCTs. However the studies provided insufficient to either claim or refute a benefit of the interventions tested for prophylaxis or treatment of MRONJ.
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28 mainly retrospective studies were included in this review which aimed to determine if tooth extraction prior to head and neck radiotherapy (RT )is associated with a reduced risk of developing osteoradionectosis (ORN). The findings showed a significant association of post-RT dental extractions with the risk of ORN development, odds ratio = 1.98 (95%CI: 1.17 to 3.35. However the certainty of the evidence was low to moderate.
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This review investigating whether the presence of third molars during sagittal split osteotomy of the mandible increases the risk of complications included 15 studies. The findings suggests no statistically significant relationship between the presence of 3Ms and complications. However a majority of the studies were retrospective with 13 studies being considered to be at high risk of bias so the certainty of the evidence is considered to be very low.
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This review and infection of dry socket after third molar surgery identified 58 RCTs of whihc 34 contributed to a meta-analyses. The findings indicated that metronidazle and amoxicillin did reduce infection but the findings were of low certainty.
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This review comparing the anaesthetic efficacy of intraosseous injection(IO) and conventional inferior alveolar nerve block (INAB) in mandibular third molar surgery included 4 small RCTs. The findings suggest no significant difference between IO and INAB techniques.
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This review of the effect of pre-emptive ibuprofen on post-operative pain after lower third molar surgery included 5 RCTs. Only one of the included studies was at low risk of bias so there is insufficient evidence to support the routine use of pre-emptive ibuprofen to reduce post-operative pain after lower third molar removal
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This review aiming to provide information about the association between a superior labial frenum and maxillary midline diastema included 11 cross-sectional studies. The findings suggest that papillary and papillary penetrating frenum may be associated with maxillary midline diastema but the evidence is limited.
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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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Mark Steven Howe takes a detailed look at this Bayesian network meta-analysis (NMA) assessing the relative performance of diffferent biomaterials used for maxillary sinus augmentation. 34 RCTs with 28 different treatment options providing a large number of potential pairwise comparisons although only a small number used direct data. The findings suggest little difference beween the various biomaterials but the available studies are small with only 5 being at low risk of bias.
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