Alveolar osteitis – local management interventions

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This Cochrane review update looked at local interventions used for the prevention and treatment of alveolar osteitis (dry socket) following tooth extraction. 49 RCTs were included providing moderate certainty evidence for chlorhexidine rinses and gel for probably reduction in dry sockets.

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Metronidazole for treatment of non-periodontal dental infections

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This review of whether metronidazole used as monotherapy or in addition to a β-lactam antibiotic offers any additional benefit over β-lactam monotherapy in non- periodontal dental infections includes 3 RCTs. The findings suggest that metronidazole does not provide superior clinical results compared to β-lactam antibiotics for the treatment of non-periodontal dental infections. However the evidence is limited and of low quality.

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Tooth extraction prior to head and neck radiotherapy and osteoradionecrosis risk

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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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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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