Third molars: Which surgical technique for removal?

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This Cochrane review upate compares the relative benefits and risks of different techniques for surgical removal of mandibular wisdom teeth. While the review includes 25 new trials the quality of the studies was variable with many having biases that could have influenced the findings so no meaningful conclusions could be drawn.

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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 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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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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Third molar surgery: Steroids had a beneficial effect on pain, swelling and trismus

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This review of effectiveness of corticosteroids in the post-operative control of pain, swelling and trismus after third molar surgery included 17 RCTs suggesting that corticosteroid use had beneficial effects on pain swelling and trismus.

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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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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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Third molar removal: conventional or piezoelectric device for osteotomy?

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Fifteen studies (5 RCTs) were included in this review of piezoelectric surgery for third molar removal. The findings suggest better outcomes with piezoelectric surgery however the limited quality of the available evidence means that the findings should be viewed with caution.

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Cryotherapy to reduce pain and swelling after facial surgery

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

This review of postoperative hilothrarpy (cryotherapy) in facial surgery included 6 RCTs none of which were at low risk of bias. The findings suggest that it reduces swelling and pain in the early postoperative period. However more high quality studies from a broader range of researches are needed to confirm the findings.

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Third molar removal – does piezoelectric surgery improve outcomes?

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This review of piezoelectric surgery for third molar removal included 9 studies, 6 of which were RCTs. The findings suggest that outcomes were better for piezoelectric surgery but these findings should be viewed cautiously.

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