Third molar surgery and antibiotics to prevent infection

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This review and infection of dry socket after third molar surgery identified 58 RCTs of whihc 34 contributed to a meta-analyses. The findings indicated that metronidazle and amoxicillin did reduce infection but the findings were of low certainty.

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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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Ibuprofen prior to lower third molar removal

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This review of the effect of pre-emptive ibuprofen on post-operative pain after lower third molar surgery included 5 RCTs. Only one of the included studies was at low risk of bias so there is insufficient evidence to support the routine use of pre-emptive ibuprofen to reduce post-operative pain after lower third molar removal

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Cyanoacrylate tissue adhesive in postoperative palatal pain management

Gingival graft

This review assessing the effect of cyanoacrylate tissue adhesive (CTA) in the management of palatal wound healing and post-operative pain after epithelialised gingival graft harvesting included just 4 small RCTs. While the findings suggest a potential benefit with CTA both the quantity and quality of the available evidence is very limited.

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Superior labial frenum and maxillary midline diastema

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This review aiming to provide information about the association between a superior labial frenum and maxillary midline diastema included 11 cross-sectional studies. The findings suggest that papillary and papillary penetrating frenum may be associated with maxillary midline diastema but the evidence is limited.

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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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Maxillary sinus augmentation – relative performance of available biomaterials and the challenge of small studies

Sinus Lift

Mark Steven Howe takes a detailed look at this Bayesian network meta-analysis (NMA) assessing the relative performance of diffferent biomaterials used for maxillary sinus augmentation. 34 RCTs with 28 different treatment options providing a large number of potential pairwise comparisons although only a small number used direct data. The findings suggest little difference beween the various biomaterials but the available studies are small with only 5 being at low risk of bias.

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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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Dental implants – post-operative pain management

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

This review evaluating clinical efficacy of analgesics in mitigating orofacial pain following dental implant surgery included 9 RCTs. While the findings suggest analgesics may be beneficial the number of studies is small an additional infromation is required on which medication,, dosage, dosing schedule, administration route and adverse effects.

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