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: Remove or retain asymptomatic disease-free impacted teeth?

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This Cochrane review of the effects of removal compared with retention (conservative management) of asymptomatic disease-free impacted wisdom teeth updates the 2016 version. No new studies were identified so the conclusions are unchanged.

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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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Platelet-rich fibrin and third molar surgery outcomes

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This review of the effectiveness of platelet-rich fibrin (PRF) in reducing postoperative complications of third molar surgery included 10 small RCTs suggesting that PRF may reduce but not prevent some complications.

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Tooth socket preservation using autologous platelet concentrates

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33 studies were included in this review of the effectiveness of autologous platelet concentrates (APCs) in the preservation of fresh extraction sockets. The studies were mainly small and of less than 6 months duration suggesting a positive effect.

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Chlorhexidine gel and alveolar osteitis

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This review of the effectiveness of chlorhexidine gel for the prevention of alveolar osteitis (AO) included 10 trials published since 2010. The findings suggest a 57% reduction in incidence of AO similar to other reviews of this topic.

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Chlorhexidine gels and rinses reduce dry socket after third molar extraction

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This review of the effectiveness of chlorhexidine for prevention of dry socket after third molar removal includes 18 RCTs. The finding suggest a 47% (95%CI,38-55) reduction in cases following its use.

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Third molars: insufficient evidence for removal of impacted asymptomatic disease-free teeth

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This update of an earlier Cochrane review comparing retention or extraction of of asymptomatic disease-free impacted third molars only identified 2 studies of low to very low quality evidence providing insufficient evidence to inform practice.

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Third molar removal: antibiotics reduced risk of dry socket

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This review of antibiotic prophylaxis for the removal of third molars included 22 RCTs and suggest that antibiotic use lowered the infection risk by 60%. The number pf patients needed to treat to prevent one infection was 14 (95%CI;11-19).

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Third molars: single dose of preoperative antibiotic reduced infection

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10 RCTs were included in this review of preoperative antibiotics for removal of third molars. The use of antibiotics significantly reduced the odds of surgical site infection or alveolar osteitis (OR = 0.30; 95% CI, 0.19 to 0.47; P≤.00001)

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