This Cochrane review update looked at local interventions used for the prevention and treatment of alveolar osteitis (dry socket) following tooth extraction. 49 RCTs were included providing moderate certainty evidence for chlorhexidine rinses and gel for probably reduction in dry sockets.
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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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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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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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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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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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Blogs on burning mouth syndrome, pain control following third molar surgery and the possible association between serum zinc levels and recurrent apthous unceration were the most popular blogs during January – March 2021.
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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.
This review of the effectiveness of leukocyte-and platelet-rich fibrin (L-PRF) and advanced-platelet-rich fibrin (A-PRF) in mandibular third molar extraction included 10 RCTs. While the findings suggest some benefits the studies are small and limited in number so the findings should be interpreted cautiously.
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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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