Cleft lip and palate: maxillary distraction osteogenesis or orthognathic surgery for hypoplastic maxilla?

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This Cochrane review update of the effects and long-term results of maxillary distraction osteogenesis compared to orthognathic surgery for the treatment of hypoplastic maxilla in people with cleft lip and palate only includes 1 small RCT. The trial suggests that distraction osteogenesis may produce more satisfactory results however the trial is considered to be at very high risk of bias so the findings should be viewed cautiously.

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Orthognathic surgery: Are perioperative steroids beneficial?

Bariatric surgery and marked weight loss is likely to improve knee complaints but there is a need for high quality studies

This review of perioperative systemic corticosteroids on clinically important outcomes in patients undergoing orthognathic surgery identified 8 small RCTs. A reduction in facial oedema was seen in those receiving systemic corticosteroids. However the quality of the studies is limited and there is lack of evidence on other outcomes or adverse effects.

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Bicycle helmets and facial injuries

Get on your bikes kids!

This review of the effect of bicycle helmet use on facial injuries included 9 observational studies involving 23,461 patients. Those wearing helmets were less likely to sustain a facial injury (OR = 0.69, 95%CI; 0.63– 0.75)

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Keratocysts: conservative treatment approaches?

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29 mainly retrospective studies were included in this review of conservative management approaches for odontogenic keratocysts. While the findings suggest use of decompression followed by enucleation data for recurrence were lower than those found in previous reviews of the topic. High quality prospective studies are needed.

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Orthognathic surgery: limited evidence on antibiotic prophylaxis?

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

2 reviews and 2 RCTs were discussed in this review of the effect of antibiotics on postoperative infections in orthognathic surgery. There is a lack ofclarity on the preferred antibiotic and the optimal duration of administration.

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Mandibular angle fractures – Do third molars have an influence?

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16 observational studies were included in this review of the association between the presence of a lower third molar and the occurrence of a mandibular angle fracture in adults. The findings suggest that the odds of fracture are 3.16 (95%CI; 2.2- 4.54) higher in the presence of third molars

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Third molar extraction – does platelet-rich fibrin improve outcomes?

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6 studies were identified for this review of platelet-rich fibrin to improve outcomes after third molar extraction. The studies were small with contradictory findings so further high quality studies are needed.

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Coronectomy – a safe option for deeply impacted mandibular third molars?

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This review of coronectomy for management of impacted mandibular third molars included 14 studies suggesting that it is safe and reliable with a low failure rate (7%).

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Titanium or resorbable plates for orthognathic surgery

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This Cochrane review compared titanium & bioresorbable fixation systems for orthognathic surgery. Only 2 RCTS were identified providing insufficient evidence to determine if titanium plates or resorbable plates are superior.

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Palatally displaced canines: open or closed surgical exposure?

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This updated Cochrane review comparing open v closed surgical approaches for palatally displaced canines includes 3 studies involving 146 patients with the available evidence suggesting that neither surgical technique for exposing canine teeth is superior.

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