Third molar surgery – Lingual or buccal-based flaps?

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This review of postoperative discomfort, operative time, and wound healing in the short-term follow-up following surgical extraction of lower third molars with lingual- or buccal-based flaps included 7 RCTs. The quality of the included studies was limited and few differences were seen between the type of flaps.

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Third molar surgery: Does low-level laser therapy reduce post-operative morbidity?

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This review of whether low-level laser therapy (LLLT) is effective in reducing postoperative morbidity in patients undergoing surgical removal of mandibular third molars included 17 RCTs. The findings suggest a reduction in post-operative swelling but not pain or trismus.

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Tooth extraction: Do antibiotics prevent complications?

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

This Cochrane review update of the effect of systemic antibiotic prophylaxis on the prevention of infectious complications following tooth extractions included 23 studies. There was very-low certainty evidence that prophylactic antibiotics may reduce the risk of infection and dry socket following third molar extraction compared to placebo.

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Articaine local anaesthesia and the risk of hyperaesthesia in third molar surgery

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This review of the risk of hyperaesthesia with articaine compared with other local anaesthetics in lower alveolar nerve block for lower third molar removal included 13 studies.The findings suggest that the use of articaine does not increase the risk of hyperaesthesia.

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Third molar extractions: Which anaesthetic solution for the best pain control?

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This review of the effectiveness of different anaesthetic solutions for pain control immediately after the extraction of lower third molars included 45 studies.13 studies were included in a network meta-analys whch suggested 5% bupivacaine reduces pain in patients during and immediately after the removal of lower third molars.

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Top Dental Elf Blogs: Jan – Mar 2020

The Dental Elf

Our most popular blogs from January, February and March 2020 were about the FiCTION trial, local anaesthesia and factors associated with third molar surgical difficulty.

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Third molars: Which local anaesthetic is most suitable for inferior alveolar nerve blocks?

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This review comparing the efficacy and safety of currently available local anaesthetics for lower third molar extraction included 24 RCTs. The findings suggest that 4% articaine was the most effective and lidocaine the safest.

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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: 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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