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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Sagittal split osteotomy – Do third molars increase the risk of complications?

Orthognatic_surgery

This review investigating whether the presence of third molars during sagittal split osteotomy of the mandible increases the risk of complications included 15 studies. The findings suggests no statistically significant relationship between the presence of 3Ms and complications. However a majority of the studies were retrospective with 13 studies being considered to be at high risk of bias so the certainty of the evidence is considered to be very low.

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Intraosseous injection or inferior alveolar nerve block for third molar surgery?

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This review comparing the anaesthetic efficacy of intraosseous injection(IO) and conventional inferior alveolar nerve block (INAB) in mandibular third molar surgery included 4 small RCTs. The findings suggest no significant difference between IO and INAB techniques.

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Third molar surgery – Er:Yag lasers and post-operative problems

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This review of the effectiveness of Er:YAG lasers in reducing pain, oedema and trismus compared to rotary instruments for the removal of impacted lower third molars included 6 small studies only one of which was at low risk of bias. The findings suggest a reduction in swelling and a small reduction in pain however the findings should be viewed cautiously because of the limited amount and quality of the evidence.

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Chemotherapy for oral cavity and oropharyngeal cancer

Chemotherapy

This review of whether chemotherapy, in addition to radiotherapy and/or surgery for oral cavity and oropharyngeal cancer, results in improved overall survival included 100 studies. the findings indicated some benefit only when used in a few specific circumstances.

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Platelet-rich fibrin to reduce post-operative complications of lower third molar removal

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This review of platelet-rich fibrin (PRF) to reducedpostoperative complications following lower third molar surgery included 6 RCTs.
The findings are consistent to other reviews finding that PRF derivative may lead to improvements in postoperative outcomes from third molar surgery but the amount of evidence is limited.

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Osteonecrosis in bisphosphonate users having dental procedures

osteonecrosis

This review of the the frequency of osteonecrosis of the jaw in bisphosphonate users undergoing dental interventions included 27 studies. having dental procedures of 2.7% (95%CI: 0.9 to 5.2%) being higher in those having dental extractions 4.1% (95%CI: 1.5 to 7.7%).

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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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Titanium or biodegradable osteosyntheses in orthognathic surgery?

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This review assessing the efficacy and morbidity of biodegradable vs. titanium osteosyntheses in orthognathic surgery included 33 studies 11 of which were RCTs. The findings suggest that biodegradable osteosyntheses is a valid alternative to titanium osteosyntheses for orthognathic surgery, but the quality of evidence is low.

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