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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Third molars: Factors associated with surgical difficulty

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This review of variables associated with surgical difficulty in the extraction of third molars included 16 prospective cohort studies suggesting a number of variable that may be associated with surgical difficulty.

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Elective neck dissection for early stage oral cancer?

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This UK multi-centre RCT of elective neck dissection(END) for early stage oral cancer found higher rates for overall and disease free survival in those patients having END.

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Top Dental Elf Blogs Jul – Sep 2019

The Dental Elf brings you daily updates of evidence-based dentistry research

Pulpotomy of permanent teeth with irreversible pulpitis, the management of direct anticoagulant agents for invasive dental treatments and laser preparation of tooth surfaces for fissure sealant placement were out most popular blogs in July, August and September.

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Mandibular angle fractures: Does presence of third molars in fracture line affect postoperative complications?

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This review of whether the presence of the lower third molar in the mandibular angle fracture line is associated with postoperative complications included 34 studies. The quality of teh included studies was low to very low so the findings should be viewed cautiously.

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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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Dual antiplatelet therapy and post-operative bleeding following minor oral surgery

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This review of bleeding complications in patients on dual antiplatelet therapy compared to patients on single antiplatelet or no antiplatelet therapy for patients undergoing oral surgery included 16 studies but no randomised trials. Findings suggest that dual antiplatelet therapy should not be discontinued but the evidence is of low quality.

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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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Mandibular angle fractures: 1 or 2 miniplates?

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This review of the use of 1 or 2 miniplates for the treatment of mandibular angle fractures included 13 studies 3 of which were RCTs. The findings suggest fewer complications with single miniplate fixation.

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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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