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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Alveolar ridge preservation techniques

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16 RCTs were included in this Cochrane review update of the effectiveness of techniques for alveolar ridge preservation (ARP) following dental extractions prior to implant placement. The findings suggest that ARP techniques may minimise the overall changes in residual ridge height and width six months after extraction, but the evidence is very uncertain

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Osteoradionecrosis incidence and the timing of dental extractions

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This review of whether the incidence of osteoradionecrosis differed between patients who have dental extractions before or after radiotherapy (RT) included 24 studies (19 retrospective 5 prospective). While the findings suggest that the incidence is similar if extractions are undertaken before or after RT the quality of the evidence is limited.

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Tooth extraction: Do antibiotics prevent complications?

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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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Alveolar ridge preservation: which grafting material?

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This review of grafting materials for alveolar ridge preservation included 38 small RCTs. 34 different materials were investigated with the findings suggesting that no grafting material increased new bone formation between 3 and 6 months after tooth extraction.

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Caries prevention in children: The RECUR trial

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This multi-centre RCTs of a single dental nurse delivered ‘talking’ intervention informed by motivational interviewing approaches was successful in reducing new caries experience in a group of high risk children at 2 years.

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Third molar extraction: Does closure technique influence post-operative complications?

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This review to assess the influence of two suture methods on the postoperative complications of lower third molar extraction included 5 RCTs . Findings suggest the use of secondary closure has a favourable effect on pain, facial swelling, and trismus but the quality of the evidence is limited.

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Direct anticoagulant agents: management before invasive dental procedures

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This review of the evidence of bleeding events following invasive oral procedures in patients using direct anticoagulant agents (DOACs) identified 21 studies but no RCTs. The review found no important differences in bleeding events in patients who continued versus patients who discontinued DOAC therapy.

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Oral anticoagulant therapy: Preventing bleeding in patients having dental extractions

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This Cochrane review of antifibrinolytic agents for preventing bleeding in people on oral anticoagulants undergoing dental extractions or minor oral surgery included 4 RCTs. Topical tranexamic acid was effective in reducing post-operative bleeding following dental procedures.

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Fixed appliance orthodontics: extraction or non-extraction and soft tissue changes

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52 studies were identified for this review of the effect of extraction or non-extraction fixed orthodontic treatment of soft tissue profiles . However they were mainly poor quality retrospective studies providing very low quality evidence suggesting that tooth extractions might be associated with differences in the soft tissue profile compared to non-extraction treatment.

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