Deep caries removal – Selective or stepwise?

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This review comparing stepwise removal (SWR) and selective removal (SCR) of deep carious lesions in primary and permanent teeth included 9 RCTs. The findings suggest that SCR may be more succesful than SWR but they should be interpreted cautiously because of the limited number of studies for some outcomes.

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Single or multiple visit root canal therapy?

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This Cochrane review update comparing single and multiple vist root canal treatments in patients over the age of 10 included 47 RCTs. There was no evidence to suggest that one treatment regimen (single‐visit or multiple‐visit RoCT) is more effective than the other although more patients report pain in the first week with the single visit approach.

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Alveolar osteitis – local management interventions

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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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Tooth extraction prior to head and neck radiotherapy and osteoradionecrosis risk

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28 mainly retrospective studies were included in this review which aimed to determine if tooth extraction prior to head and neck radiotherapy (RT )is associated with a reduced risk of developing osteoradionectosis (ORN). The findings showed a significant association of post-RT dental extractions with the risk of ORN development, odds ratio = 1.98 (95%CI: 1.17 to 3.35. However the certainty of the evidence was low to moderate.

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Palatally displaced canines: Procedures to promote eruption

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This Cochrane review update of interceptive procedures included 4 RCTs to promote the eruption of palatally displaced permanent canines (PDCs) involving a total of 199 patients. The findings indicate that extraction of the primary canine man increase the the proportion of erupted PDCs but the evidence is very uncertain.

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Osteoradionecrosis and tooth extraction before radiotherapy

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This review of the osteoradionecrosis rate in patients with head and neck cancer having toothth extraction performed before radiotherapy included 8 mainly retrospective studies. The pooled incidence rate was estimated at 2.2% (95% CI: 0.6% to 3.9%) although none of the studies controlled for other risk factors.

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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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Tooth extraction: Do antibiotics prevent complications?

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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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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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