Third molars: Remove or retain asymptomatic disease-free impacted teeth?

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This Cochrane review of the effects of removal compared with retention (conservative management) of asymptomatic disease-free impacted wisdom teeth updates the 2016 version. No new studies were identified so the conclusions are unchanged.

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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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Bone regeneration: Is cortical perforation a benefit?

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This review of the effect of cortical perforations in bone regeneration considering the surgical technique included 16 small studies. All but one of teh studies was conducted in an animal model providing very little clinically relevant data.

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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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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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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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COX-2 inhibitors for pain management after third molar removal

Many drugs are licensed for use in Generalised Anxiety Disorder (GAD), but it is unclear what works best.

This review comparing the efficacy of Cox-2 inhibitors with ibuprofen after third molar removal included 12 RCTs suggesting that COX-2 inhibotors and Ibuprofen provide similar pain relief at 6, 8, and 12 h after third molar removal.

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