Alveolar osteitis: Are warm saline mouthwashes effective for prevention?

Unequal measures

This review of the effectiveness of warm saltwater mouthwashes in preventing incidence of dry socket following tooth extraction included 8 RCTs. Only one of the included studies was considered to be at low risk of bias with the findings indicting that saltwater was more effective than no moutwash but less effective than chlorhexidine.

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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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Tooth extraction: Do antibiotics prevent complications?

The authors sought to review available literature relating to SSRI withdrawal syndromes

This Cochrane review update of the effect of systemic antibiotic prophylaxis on the prevention of infectious complications following tooth extractions included 23 studies. There was very-low certainty evidence that prophylactic antibiotics may reduce the risk of infection and dry socket following third molar extraction compared to placebo.

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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: 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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