1
|
Mauricio F, Mauricio-Vilchez C, Galarza-Valencia D, Alvitez-Temoche D, Espinoza-Carhuancho F, Mayta-Tovalino F. Web of Science-Based Scientometric Assessment of the Importance of Filtered Water in Dentistry: Spatiotemporal Dynamics, Emerging Patterns, and Collaboration. BIOMED RESEARCH INTERNATIONAL 2024; 2024:3279588. [PMID: 38726291 PMCID: PMC11081759 DOI: 10.1155/2024/3279588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/13/2024] [Accepted: 04/22/2024] [Indexed: 05/12/2024]
Abstract
Objective The aim of this study was to examine the characteristics of scientific production related to the use of filtered water in the field of dentistry. Material and Methods. A quantitative and descriptive observational study was carried out with a scientometric approach. Data were collected from the Web of Science (WOS) database during the period January 1991 to December 2023. A search strategy incorporating a combination of MeSH terms, including terms and thesauri related to "filtered water" and "dentistry", was used. R Studio version 4.3.2 and CiteSpace 6.2.R7 were used for data analysis. Results Over the 32-year study period, 227 scholarly papers from 134 different sources were reviewed. The literature in this field has shown an annual growth rate of 10.44%. During the year 2010, a steady movement in the number of publications and authors was observed, with considerable collaborative interaction. In the year 2020, a large interaction between publications and their citations was found. The "Citation Burst" graph identified three references that have experienced the largest "burst" of citations in an evaluated period. Lotka's law described the productivity of authors, finding that most authors have published only one paper, while a smaller number of authors have published two papers. Most authors contributed a small number of articles, while a few authors contributed a large amount of the existing literature. Conclusion A comprehensive overview of the scientific production related to the use of filtered water in dentistry over a span of 32 years is provided. The results highlight the growing interdisciplinarity and international collaboration in this field. Finally, the importance of filtered water in dentistry and its growing relevance in the scientific literature are emphasized.
Collapse
Affiliation(s)
- Franco Mauricio
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Cesar Mauricio-Vilchez
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Diego Galarza-Valencia
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Daniel Alvitez-Temoche
- Academic Department, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Fran Espinoza-Carhuancho
- Grupo de Bibliometría, Evaluación de evidencia y Revisiones Sistemáticas (BEERS), Human Medicine Career, Universidad Científica del Sur, Lima, Peru
| | | |
Collapse
|
2
|
Historical aspects about third molar removal versus retention and distal surface caries in the second mandibular molar adjacent to impacted third molars. Br Dent J 2023; 234:268-273. [PMID: 36829021 DOI: 10.1038/s41415-023-5532-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/10/2022] [Indexed: 02/26/2023]
Abstract
This paper provides an insight into the historical recommendations regarding removal of mandibular third molars, as set out by the Royal College of Surgeons of England and the National Institutes of Health in the USA, as well as regional guidance from the National Institute for Health and Care Excellence and the controversy that surrounds surgical removal of third molars. The influences of third molar management as it developed in the UK, the historical economic evaluations, and the available evidence base on third-molar removal versus retention are described. This article seeks to address the growing concerns regarding the increasing frequency of distal surface caries (DSC) in mandibular second molar teeth when the decay is associated with asymptomatic, partially erupted, mandibular third molars, especially when they are mesially or horizontally impacted. Lastly, we illustrate radiographs of patients affected by DSC and how guidance that has been issued by a guideline institution regarding third molar surgery, even though it is based on insufficient evidence, is perceived as a strictly compulsory clinical strategy, and has been used in clinical practice in the UK for more than 20 years.
Collapse
|
3
|
Seier T, Zimmermann A, Bottini GB, Steiner C, Gaggl A, Fillies T, Brandtner C. Is it safe and rational to remove both lower third molars in one session? A randomised controlled trial to compare unilateral vs bilateral third molar extractions under local anaesthesia. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
|
4
|
Maxillary Tuberosity Fractures Following Third Molar Extraction, Prevalence, and Risk Factors. J Craniofac Surg 2022; 33:e708-e712. [PMID: 35765135 DOI: 10.1097/scs.0000000000008654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the prevalence of maxillary tuberosity fractures in an adult population and to examine the different risk factors associated with these fractures. MATERIALS AND METHODS This is a retrospective study; data was collected from medical records of patients who underwent a non-surgical extraction of a maxillary third molar tooth between January 2017 and March 2019. All extractions were performed by 2 maxillofacial specialists. RESULTS A total of 403 extracted maxillary third molar teeth were included in the study. Out of them 73 cases of tuberosity fractures were recorded (18.1%). No significant difference in the number of recorded fractures was found between the 2 surgeons. The mean age of patients was 32.8 ± 11.5. In the age group of 30 years and under a fractures rate of 12.1% was recorded compared to 25.0% in the age group of over 30 (P = 0.001). Divergent or extremely curved root morphology were associated with a higher risk for fractures (30.7%) compared to convergent root morphology (13.1%) (P < 0.001). Borderline significance (P = 0.069) was observed for extractions of teeth with caries lesions (21.9%) compared to teeth with no caries lesions (14.6%). CONCLUSIONS The risk of developing a tuberosity fracture during an extraction of an upper wisdom tooth increases with age by 3.1% per year. Teeth with a caries lesion or teeth with divergent or extremely curved root morphology are associated with a higher risk for tuberosity fractures. Although, distoangular teeth had reduced risk of developing a tuberosity fractures. Data collected in this study may help to evaluate the risk factors associated with tuberosity fractures, and can assist in minimizing complications during extractions.
Collapse
|
5
|
Salas GA, Lai SA, Verdugo-Paiva F, Requena RA. Platelet-Rich Fibrin in Third Molar Surgery: Systematic Review and Meta-Analysis Protocol. Craniomaxillofac Trauma Reconstr 2022; 15:164-168. [PMID: 35633766 PMCID: PMC9133523 DOI: 10.1177/19433875211016203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2024] Open
Abstract
Objective The objective of this systematic review is to assess the effectiveness and safety of platelet-rich fibrin (PRF) in third molar surgery. Data Sources A comprehensive search strategy is meant to be used in an attempt to identify all relevant randomized controlled trials (RCTs), ongoing investigation reported in specialty congresses and trials regardless of language or publication status (published, unpublished, in press and in progress). Searches will be conducted in the Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, Embase, Lilacs, the International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, US National Institutes of Health (NIH), grey literature and in specialized congresses and conferences. Eligibility Criteria We will include randomized trials evaluating the effect of PRF on wound healing after third molar surgery. Two reviewers will independently screen each study for eligibility, data extraction and risk of bias assessment using Cochrane "risk of bias" tool. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome. Ethics and Dissemination As researchers will not access information that could lead to the identification of an individual participant, obtaining ethical approval was waived.
Collapse
Affiliation(s)
- Gaston A. Salas
- Department of Research in Health Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
- Oral and Maxillofacial Surgery Program, Universidad de los Andes, Santiago, Chile
| | - Shuheng A. Lai
- Department of Research in Health Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisca Verdugo-Paiva
- Fundación Epistemonikos, Santiago, Chile
- UC Evidence Center, Cochrane Chile Associated Center, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Roberto A. Requena
- Universidad de los Andes, Santiago, Chile
- Hospital Dr. Sótero del Río, Santiago, Chile
- Instituto de Neurocirugía Dr. Asenjo, Santiago, Chile
| |
Collapse
|
6
|
Do race and ethnicity affect the age when thirds molars are extracted? J Oral Maxillofac Surg 2022; 80:1676-1685. [DOI: 10.1016/j.joms.2022.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/20/2022]
|
7
|
Quesada-Bravo FJ, García-Carricondo AR, Espín-Gálvez F, Fernández-Sánchez C, Fernández-Ginés D, Requena-Mullor MDM, Alarcón-Rodríguez R. Comparative Study between the Combination of Dexamethasone and Bupivacaine for Third Molar Surgery Postoperative Pain: A Triple-Blind, Randomized Clinical Trial. J Clin Med 2021; 10:jcm10215081. [PMID: 34768600 PMCID: PMC8584321 DOI: 10.3390/jcm10215081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/23/2021] [Accepted: 10/26/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives: To compare the possible benefits of the combination of dexamethasone–bupivacaine with articaine–epinephrine as an anaesthetic block after third molar surgery. Materials and Methods: Triple-blind, randomized, controlled, parallel, phase 3 clinical trial. Two groups: experimental (93 patients) with standard anaesthetic block: 40/0.005 mg/mL articaine–epinephrine and submucosal reinforcement with 0.8 mg dexamethasone–5% bupivacaine; and control group (91 patients) with standard block: 40/0.005 mg/mL articaine–epinephrine. The surgery consisted of the extraction of the impacted mandibular third molar by performing a procedure following the same repeatable scheme. The visual analogue scale (VAS) was used to analyse postoperative pain. Results: Groups were homogeneous, without significant differences related to epidemiological variables. Postoperative pain among the first, second, and seventh postoperative days was statistically significantly lower in the experimental group compared to the control group (p < 0.001). Drug consumption was lower in the experimental group throughout the study period (p < 0.04). Conclusion: Bupivacaine is an alternative to articaine in oral surgery, being more effective in reducing postoperative pain by reducing patients’ scores on the VAS as well as their consumption of analgesic drugs after surgery.
Collapse
Affiliation(s)
- Francisco Javier Quesada-Bravo
- Maxillofacial Surgeons of Department of Oral and Maxillofacial Surgery, Torrecardenas University Hospital, 04009 Almeria, Spain; (F.J.Q.-B.); (A.R.G.-C.); (F.E.-G.)
| | - Ana Rocío García-Carricondo
- Maxillofacial Surgeons of Department of Oral and Maxillofacial Surgery, Torrecardenas University Hospital, 04009 Almeria, Spain; (F.J.Q.-B.); (A.R.G.-C.); (F.E.-G.)
| | - Fernando Espín-Gálvez
- Maxillofacial Surgeons of Department of Oral and Maxillofacial Surgery, Torrecardenas University Hospital, 04009 Almeria, Spain; (F.J.Q.-B.); (A.R.G.-C.); (F.E.-G.)
| | - Carmen Fernández-Sánchez
- Department of Clinical Pharmacology, Torrecardenas University Complex, 04009 Almeria, Spain; (C.F.-S.); (D.F.-G.)
| | - Damaso Fernández-Ginés
- Department of Clinical Pharmacology, Torrecardenas University Complex, 04009 Almeria, Spain; (C.F.-S.); (D.F.-G.)
| | | | - Raquel Alarcón-Rodríguez
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almería, Spain;
- Correspondence: ; Tel.: +34-950-214-606
| |
Collapse
|
8
|
Peñarrocha-Diago M, Camps-Font O, Sánchez-Torres A, Figueiredo R, Sánchez-Garcés MA, Gay-Escoda C. Indications of the extraction of symptomatic impacted third molars. A systematic review. J Clin Exp Dent 2021; 13:e278-e286. [PMID: 33680330 PMCID: PMC7920557 DOI: 10.4317/jced.56887] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/21/2020] [Indexed: 12/13/2022] Open
Abstract
Background A literature review was made to determine when third molar (3M) extraction is recommended in symptomatic patients and when it is not recommended. Material and Methods A Medline (PubMed) and EMBASE search was made for articles related to indications for the extraction of 3Ms, published in the last 10 years and up until September 2018. Results The electronic search yielded 175 articles. After eliminating duplicates, a total of 173 articles were subjected to review of the title and abstract. Only 19 studies were finally included in the systematic review. There was a well documented increase in morbidity associated to impacted 3Ms (non-restorable caries, fracture, infection, periodontal disease, repeated pericoronitis, cysts and tumors), and in the presence of disease, extraction was considered to be indicated. The extraction of 3Ms with signs and/or symptoms of periodontal disease improved periodontal health at the distal surface of the second molar. Postoperative quality of life of patients with symptomatic 3Ms and with disease improved after surgical extraction. Conclusions Extraction is indicated in the presence of disease associated to an impacted 3M, whether symptomatic or not. In contrast, extraction is not indicated in the absence of infection or other associated disease conditions. Key words:Third molar, periodontal disease, periodontitis, pericoronitis, dental caries, occlusal caries, mandibular cysts, osteomyelitis, odontogenic tumor.
Collapse
Affiliation(s)
- María Peñarrocha-Diago
- DDS, MS, PhD. Assistant Professor of Oral Surgery. University of Valencia Medical and Dental School. Valencia, Spain. Researcher of the "Dental and Maxillofacial Diseases and Therapeutics" group of the Bellvitge Biomedical Research Institute (IDIBELL)
| | - Octavi Camps-Font
- DDS, MS. Associate Professor of Oral Surgery. University of Barcelona Dental School. Barcelona, Spain. Researcher of the "Dental and Maxillofacial Diseases and Therapeutics" group of the Bellvitge Biomedical Research Institute (IDIBELL)
| | - Alba Sánchez-Torres
- DDS, MS. Associate Professor of Oral Surgery. University of Barcelona Dental School. Barcelona, Spain. Researcher of the "Dental and Maxillofacial Diseases and Therapeutics" group of the Bellvitge Biomedical Research Institute (IDIBELL)
| | - Rui Figueiredo
- DDS, MS, PhD. Associate Professor of Oral Surgery. Coordinator of the Master of Oral Surgery and Buccofacial Implantology. University of Barcelona. Barcelona, Spain. Researcher of the "Dental and Maxillofacial Diseases and Therapeutics" group of the Bellvitge Biomedical Research Institute (IDIBELL)
| | - María-Angeles Sánchez-Garcés
- MD, DDS, MS, PhD, EBOS. Associate Professor of Oral Surgery. University of Barcelona Dental School. Barcelona, Spain. Subdirector of the Master of Oral Surgery and Buccofacial Implantology of the EFHRE International University / FUCSO. Researcher of the "Dental and Maxillofacial Diseases and Therapeutics" group of the Bellvitge Biomedical Research Institute (IDIBELL)
| | - Cosme Gay-Escoda
- MD, DDS, MS, PhD, EBOS, OMFS. Chairman of Oral and Maxillofacial Surgery. University of Barcelona Dental School. Barcelona, Spain. Director of the Master of Oral Surgery and Buccofacial Implantology of the EFHRE International University / FUCSO. Coordinator / Researcher of the "Dental and Maxillofacial Diseases and Therapeutics" group of the Bellvitge Biomedical Research Institute (IDIBELL)
| |
Collapse
|
9
|
Gadiwalla Y, Moore R, Palmer N, Renton T. Where is the 'wisdom' in wisdom tooth surgery? A review of national and international third molar surgery guidelines. Int J Oral Maxillofac Surg 2020; 50:691-698. [PMID: 32967788 DOI: 10.1016/j.ijom.2020.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 06/26/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
The objective of this narrative review was to identify and evaluate published international guidelines on mandibular third molars (M3M) and to assess their clinical scope and the validity of the recommendations. The search strategy used data obtained from a variety of sources including MEDLINE, national regulatory bodies, national dental and surgical colleges and associations, and military medical departments. Adherence to clinical guideline development was investigated using the AGREE II instrument (Appraisal of Guidelines for Research and Evaluation). Sixteen guidelines pertaining to M3M were included in this review. The guidelines produced by the Faculty of Dental Surgery of the Royal College of Surgeons of England (FDS RCS) and Scottish Intercollegiate Guidelines Network (SIGN) were recommended as meeting the criteria for use. Seven other guidelines were recommended but required modifications. The AGREE II instrument provides an excellent framework for guideline assessment. Unfortunately, very few guidelines scored highly across all domains and therefore were not believed to be of high quality. Due to the significant lack of structure and variable standards in guideline development, the conclusions and recommendations of these guidelines are compromised. There is a need for organizations involved in developing M3M guidelines to update guidance periodically in order to ensure that the information available to clinicians and patients is accurate and relevant to clinical practice.
Collapse
Affiliation(s)
- Y Gadiwalla
- Oral Surgery Department, King's College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London, SE5 9RS.
| | - R Moore
- School of Dentistry, University of Leeds, Leeds LS2 9JT
| | - N Palmer
- Health Education England-North West, Liverpool, England, UK
| | - T Renton
- Oral Surgery Department, King's College Hospital NHS Foundation Trust, Denmark Hill, Brixton, London, SE5 9RS
| |
Collapse
|
10
|
Hounsome J, Pilkington G, Mahon J, Boland A, Beale S, Kotas E, Renton T, Dickson R. Prophylactic removal of impacted mandibular third molars: a systematic review and economic evaluation. Health Technol Assess 2020; 24:1-116. [PMID: 32589125 PMCID: PMC7336222 DOI: 10.3310/hta24300] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Impacted third molars are third molars that are blocked, by soft tissue or bone, from fully erupting through the gum. This can cause pain and disease. The treatment options for people with impacted third molars are removal or retention with standard care. If there are pathological changes, the current National Institute for Health and Care Excellence guidance states that the impacted third molar should be removed. OBJECTIVE The objective of this study was to appraise the clinical effectiveness and cost-effectiveness of the prophylactic removal of impacted mandibular third molars compared with retention of, and standard care for, impacted third molars. METHODS Five electronic databases were searched (1999 to 29 April 2016) to identify relevant evidence [The Cochrane Library (searched 4 April 2016 and 29 April 2016), MEDLINE (searched 4 April 2016 and 29 April 2016), EMBASE (searched 4 April 2016 and 29 April 2016), EconLit (searched 4 April 2016 and 29 April 2016) and NHS Economic Evaluation Database (searched 4 April 2016)]. Studies that compared the prophylactic removal of impacted mandibular third molars with retention and standard care or studies that assessed the outcomes from either approach were included. The clinical outcomes considered were pathology associated with retention, post-operative complications following extraction and adverse effects of treatment. Cost-effectiveness outcomes included UK costs and health-related quality-of-life measures. In addition, the assessment group constructed a de novo economic model to compare the cost-effectiveness of a prophylactic removal strategy with that of retention and standard care. RESULTS The clinical review identified four cohort studies and nine systematic reviews. In the two studies that reported on surgical complications, no serious complications were reported. Pathological changes due to retention of asymptomatic impacted mandibular third molars were reported by three studies. In these studies, the extraction rate for retained impacted mandibular third molars varied from 5.5% to 31.4%; this variation can be explained by the differing follow-up periods (i.e. 1 and 5 years). The findings from this review are consistent with the findings from previous systematic reviews. Two published cost-effectiveness studies were identified. The authors of both studies concluded that, to their knowledge, there is currently no economic evidence to support the prophylactic removal of impacted mandibular third molars. The results generated by the assessment group's lifetime economic model indicated that the incremental cost-effectiveness ratio per quality-adjusted life-year gained for the comparison of a prophylactic removal strategy with a retention and standard care strategy is £11,741 for people aged 20 years with asymptomatic impacted mandibular third molars. The incremental cost per person associated with prophylactic extraction is £55.71, with an incremental quality-adjusted life-year gain of 0.005 per person. The base-case incremental cost-effectiveness ratio per quality-adjusted life-year gained was found to be robust when a range of sensitivity and scenario analyses were carried out. LIMITATIONS Limitations of the study included that no head-to-head trials comparing the effectiveness of prophylactic removal of impacted mandibular third molars with retention and standard care were identified with the assessment group model that was built on observational data. Utility data on impacted mandibular third molars and their symptoms are lacking. CONCLUSIONS The evidence comparing the prophylactic removal of impacted mandibular third molars with retention and standard care is very limited. However, the results from an exploratory assessment group model, which uses available evidence on symptom development and extraction rates of retained impacted mandibular third molars, suggest that prophylactic removal may be the more cost-effective strategy. FUTURE WORK Effectiveness evidence is lacking. Head-to-head trials comparing the prophylactic removal of trouble-free impacted mandibular third molars with retention and watchful waiting are required. If this is not possible, routine clinical data, using common definitions and outcome reporting methods, should be collected. STUDY REGISTRATION This study is registered as PROSPERO CRD42016037776. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 30. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Juliet Hounsome
- Liverpoool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Gerlinde Pilkington
- Liverpoool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - James Mahon
- Coldingham Analytical Services, Berwickshire, UK
| | - Angela Boland
- Liverpoool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Sophie Beale
- Liverpoool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Eleanor Kotas
- Liverpoool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| | - Tara Renton
- Oral Surgery, Dental Hospital, King's College London, London, UK
| | - Rumona Dickson
- Liverpoool Reviews and Implementation Group, University of Liverpool, Liverpool, UK
| |
Collapse
|
11
|
Ghaeminia H, Nienhuijs ME, Toedtling V, Perry J, Tummers M, Hoppenreijs TJ, Van der Sanden WJ, Mettes TG. Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth. Cochrane Database Syst Rev 2020; 5:CD003879. [PMID: 32368796 PMCID: PMC7199383 DOI: 10.1002/14651858.cd003879.pub5] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Prophylactic removal of asymptomatic disease-free impacted wisdom teeth is the surgical removal of wisdom teeth in the absence of symptoms and with no evidence of local disease. Impacted wisdom teeth may be associated with pathological changes, such as pericoronitis, root resorption, gum and alveolar bone disease (periodontitis), caries and the development of cysts and tumours. When surgical removal is performed in older people, the risk of postoperative complications, pain and discomfort is increased. Other reasons to justify prophylactic removal of asymptomatic disease-free impacted third molars have included preventing late lower incisor crowding, preventing damage to adjacent structures such as the second molar or the inferior alveolar nerve, in preparation for orthognathic surgery, in preparation for radiotherapy or during procedures to treat people with trauma to the affected area. Removal of asymptomatic disease-free wisdom teeth is a common procedure, and researchers must determine whether evidence supports this practice. This review is an update of an review originally published in 2005 and previously updated in 2012 and 2016. OBJECTIVES To evaluate the effects of removal compared with retention (conservative management) of asymptomatic disease-free impacted wisdom teeth in adolescents and adults. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 10 May 2019), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2019, Issue 4), MEDLINE Ovid (1946 to 10 May 2019), and Embase Ovid (1980 to 10 May 2019). The US National Institutes of Health Trials Registry (ClinicalTrials.gov)and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. . SELECTION CRITERIA We included randomised controlled trials (RCTs), with no restriction on length of follow-up, comparing removal (or absence) with retention (or presence) of asymptomatic disease-free impacted wisdom teeth in adolescents or adults. We also considered quasi-RCTs and prospective cohort studies for inclusion if investigators measured outcomes with follow-up of five years or longer. DATA COLLECTION AND ANALYSIS Eight review authors screened search results and assessed the eligibility of studies for inclusion according to the review inclusion criteria. Eight review authors independently and in duplicate conducted the risk of bias assessments. When information was unclear, we contacted the study authors for additional information. MAIN RESULTS This review update includes the same two studies that were identified in our previous version of the review: one RCT with a parallel-group design, which was conducted in a dental hospital setting in the United Kingdom, and one prospective cohort study, which was conducted in the private sector in the USA. Primary outcome No eligible studies in this review reported the effects of removal compared with retention of asymptomatic disease-free impacted wisdom teeth on health-related quality of life Secondary outcomes We found only low- to very low-certainty evidence of the effects of removal compared with retention of asymptomatic disease-free impacted wisdom teeth for a limited number of secondary outcome measures. One prospective cohort study, reporting data from a subgroup of 416 healthy male participants, aged 24 to 84 years, compared the effects of the absence (previous removal or agenesis) against the presence of asymptomatic disease-free impacted wisdom teeth on periodontitis and caries associated with the distal aspect of the adjacent second molar during a follow-up period of three to over 25 years. Very low-certainty evidence suggests that the presence of asymptomatic disease-free impacted wisdom teeth may be associated with increased risk of periodontitis affecting the adjacent second molar in the long term. In the same study, which is at serious risk of bias, there is insufficient evidence to demonstrate a difference in caries risk associated with the presence or absence of impacted wisdom teeth. One RCT with 164 randomised and 77 analysed adolescent participants compared the effect of extraction with retention of asymptomatic disease-free impacted wisdom teeth on dimensional changes in the dental arch after five years. Participants (55% female) had previously undergone orthodontic treatment and had 'crowded' wisdom teeth. No evidence from this study, which was at high risk of bias, was found to suggest that removal of asymptomatic disease-free impacted wisdom teeth has a clinically significant effect on dimensional changes in the dental arch. The included studies did not measure any of our other secondary outcomes: costs, other adverse events associated with retention of asymptomatic disease-free impacted wisdom teeth (pericoronitis, root resorption, cyst formation, tumour formation, inflammation/infection) and adverse effects associated with their removal (alveolar osteitis/postoperative infection, nerve injury, damage to adjacent teeth during surgery, bleeding, osteonecrosis related to medication/radiotherapy, inflammation/infection). AUTHORS' CONCLUSIONS Insufficient evidence is available to determine whether asymptomatic disease-free impacted wisdom teeth should be removed or retained. Although retention of asymptomatic disease-free impacted wisdom teeth may be associated with increased risk of periodontitis affecting adjacent second molars in the long term, the evidence is very low certainty. Well-designed RCTs investigating long-term and rare effects of retention and removal of asymptomatic disease-free impacted wisdom teeth, in a representative group of individuals, are unlikely to be feasible. In their continuing absence, high quality, long-term prospective cohort studies may provide valuable evidence in the future. Given the current lack of available evidence, patient values should be considered and clinical expertise used to guide shared decision-making with people who have asymptomatic disease-free impacted wisdom teeth. If the decision is made to retain these teeth, clinical assessment at regular intervals to prevent undesirable outcomes is advisable.
Collapse
Affiliation(s)
- Hossein Ghaeminia
- Department of Oral and Maxillofacial Surgery, Rijnstate Hospital Arnhem, Arnhem, Netherlands
| | - Marloes El Nienhuijs
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, Netherlands
| | - Verena Toedtling
- Department of Oral and Maxillofacial Surgery, Division of Dentistry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - John Perry
- Hospital Dental Department, Canterbury District Health Board, Christchurch, New Zealand
| | - Marcia Tummers
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Center, Nijmegen, Netherlands
| | - Theo Jm Hoppenreijs
- Department of Oral and Maxillofacial Surgery, Rijnstate Hospital, Arnhem, Netherlands
| | - Wil Jm Van der Sanden
- Department of Quality and Safety of Oral Health Care, College of Dental Science, Radboud University Medical Center, Nijmegen, Netherlands
| | - Theodorus G Mettes
- School of Dentistry, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| |
Collapse
|
12
|
Al Ali S, Jaber M. Correlation of panoramic high-risk markers with the cone beam CT findings in the preoperative assessment of the mandibular third molars. J Dent Sci 2019; 15:75-83. [PMID: 32257003 PMCID: PMC7109491 DOI: 10.1016/j.jds.2019.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/17/2019] [Indexed: 01/24/2023] Open
Abstract
Background/purpose Preoperative radiographic examination of mandibular third molars (MTM) is essential to prevent inferior alveolar nerve (IAN) injury. The aim of this study was to assess the panoramic radiography (PAN) signs considered as indicators of increased risk of IAN injury and to correlate them with the cone beam CT (CBCT) findings. Materials and methods 58 patients who had MTMs extraction between January 2012 and January 2018. OPG were evaluated for the following signs: interruption of the roof of the canal, root darkening, roots deflection and narrowing, canal deviation, superimposition between the MTM roots and mandibular canal. Loss of canal cortication, root grooving, thinning and perforation of lingual cortex were assessed in CBCT images. Chi-square test and multivariate logistic regression tests were used to test the relationship between PAN signs and CBCT findings. Results A total of 79 MTMs were examined. Loss of canal cortication in CBCT was seen in 22 (27.8%) of the cases. Root darkening in PAN images was the most frequent radiographic sign. Canal deviation and interruption of white line in PAN demonstrated a statistically significant correlation with the loss of canal cortication between the MTM and the mandibular canal on CBCT images (p = 0.004 and p = 0.012, respectively). No statistically significant association was observed for the other PAN signs and CBCT findings. Conclusion Canal deviation and interruption of white lines were associated with loss of canal cortication on CBCT, indicating a direct contact between the roots and the mandibular canal which required a further assessment prior to the extraction.
Collapse
Affiliation(s)
- Shaima Al Ali
- Department of Oral Surgery, Hamdan Bin Mohamed College of Dental Medicine, United Arab Emirates
| | - Mohamed Jaber
- College of Dentistry, Ajman University, United Arab Emirates
| |
Collapse
|
13
|
The use of a tetracycline drain reduces alveolar osteitis: a randomized prospective trial of third molar surgery under local anesthetics and without the use of systemic antibiotics. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:205-212. [DOI: 10.1016/j.oooo.2018.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 10/03/2018] [Accepted: 12/07/2018] [Indexed: 11/17/2022]
|
14
|
Lieblich SE, Danesi H. Liposomal Bupivacaine Use in Third Molar Impaction Surgery: INNOVATE Study. Anesth Prog 2018; 64:127-135. [PMID: 28858553 DOI: 10.2344/anpr-64-02-03] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The analgesic efficacy and safety of liposomal bupivacaine (LB) in third molar extraction was evaluated in this phase 3, double-blind, placebo-controlled study of subjects undergoing bilateral third molar extraction. Subjects were randomized 2 : 1 to infiltration with LB (133 mg/10 mL) or placebo, and received opioid rescue medication as needed. Primary efficacy measure was cumulative area under the curve (AUC) of numeric rating scale (NRS) pain severity scores through 48 hours (AUC of NRS0-48) postsurgery. Other measures included AUC of NRS0-24, AUC of NRS0-72, and AUC of NRS0-96, and incidence of adverse events. There were 150 subjects in the primary efficacy population (n = 99 LB, n = 51 placebo) and 89 in the per-protocol population (n = 59 LB, n = 30 placebo). Least-squares mean for AUC of NRS0-48 was 172.3 LB versus 194.7 placebo (P = .227) in the primary efficacy population and 120.8 LB versus 183.3 placebo (P = .023) in the per-protocol population. At all time points, between-group differences in AUC of NRS scores were significant in the per-protocol population (LB lower than placebo, P < .05) but not in the primary efficacy population. The adverse event profile was similar between groups. LB produced significantly lower cumulative pain scores versus placebo at all time points in the per-protocol analysis but not in the primary efficacy analysis because of protocol violations. This study indicates significant improvement in pain scores in the third molar model, but because of extensive protocol violations additional studies are warranted to demonstrate effectiveness.
Collapse
Affiliation(s)
- Stuart E Lieblich
- Clinical Professor, University of Connecticut School of Dental Medicine, Division of Oral and Maxillofacial Surgery, Avon, Connecticut
| | | |
Collapse
|
15
|
Hanna K, Sambrook P, Armfield JM, Jamieson L, Brennan DS. Third molor extractions among Australian adults: findings from the 2013 National Dental Telephone Interview Survey. Int Dent J 2018; 68:77-83. [PMID: 29034476 PMCID: PMC9378918 DOI: 10.1111/idj.12330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To identify, over the previous 12 months, whether: (i) dental insurance is associated with a higher number of third molar extractions (TME); (ii) single versus multiple TME is associated with self-rated oral health; and (iii) TME when 18-25 years of age is associated with fewer days absent from work because of dental problems. METHODOLOGY Australia's 2013 National Dental Telephone Interview Survey, which included: socio-demographics; and number of extractions, reasons for extractions, self-rated oral health and days absent from work because of dental problems, all in the past 12 months. RESULTS The majority of TME recipients were female [56.6%, standard error (SE) = 6.0%], 18-25 years of age (63.0%, SE = 5.4%), held a tertiary qualification (73.9%, SE = 5.4%), had a total annual household income of ≥$60,000 (58.3%, SE = 6.4%), were dentally insured (52.6%, SE = 6.2%) and received multiple TME (60.9%, SE = 8.5%). Number of TME was associated with having dental insurance [B = 0.97: 95% confidence interval (95% CI): 0.5-1.5] and days of work absence because of dental problems (B = 1.10; 95% CI: 0.26-1.94). Receiving single TME versus multiple TME was not associated with self-rated oral health (B = -0.25; 95% CI: -0.76 to 0.25). Receiving TME when 18-25 years of age versus when older than 25 years of age was not associated with days absent from work because of dental problems (B = 0.48; 95% CI: -0.37 to 2.33). CONCLUSION Dental insurance was associated with a higher TME count without improving self-reported oral health in the short-term. Using age as a justification for prophylactic TME might be questionable because, receiving TME when 18-25 years of age versus when older than 25 years of age did not reduce days absent from work because of dental problems.
Collapse
Affiliation(s)
- Kamal Hanna
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Paul Sambrook
- Oral and Maxillofacial Surgery Unit, Adelaide Dental Hospital, The University of Adelaide, Adelaide, SA, Australia
| | - Jason M. Armfield
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - David S. Brennan
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| |
Collapse
|
16
|
Baensch F, Kriwalsky MS, Kleffmann W, Kunkel M. Third Molar Complications in the Elderly—A Matched-Pairs Analysis. J Oral Maxillofac Surg 2017; 75:680-686. [DOI: 10.1016/j.joms.2016.11.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 11/19/2016] [Accepted: 11/22/2016] [Indexed: 11/29/2022]
|
17
|
Zhang W, Dai YB, Wan PC, Xu DD, Guo Y, Li Z. Relationship between post-extraction pain and acute pulpitis: a randomised trial using third molars. Int Dent J 2016; 66:325-329. [DOI: 10.1111/idj.12249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
|
18
|
Ghaeminia H, Perry J, Nienhuijs MEL, Toedtling V, Tummers M, Hoppenreijs TJM, Van der Sanden WJM, Mettes TG. Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth. Cochrane Database Syst Rev 2016:CD003879. [PMID: 27578151 DOI: 10.1002/14651858.cd003879.pub4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Prophylactic removal of asymptomatic disease-free impacted wisdom teeth is surgical removal of wisdom teeth in the absence of symptoms and with no evidence of local disease. Impacted wisdom teeth may be associated with pathological changes, such as pericoronitis, root resorption, gum and alveolar bone disease (periodontitis), caries and the development of cysts and tumours. When surgical removal is carried out in older people, the risk of postoperative complications, pain and discomfort is increased. Other reasons to justify prophylactic removal of asymptomatic disease-free impacted third molars have included preventing late lower incisor crowding, preventing damage to adjacent structures such as the second molar or the inferior alveolar nerve, in preparation for orthognathic surgery, in preparation for radiotherapy or during procedures to treat people with trauma to the affected area. Removal of asymptomatic disease-free wisdom teeth is a common procedure, and researchers must determine whether evidence supports this practice. This review is an update of an existing review published in 2012. OBJECTIVES To evaluate the effects of removal compared with retention (conservative management) of asymptomatic disease-free impacted wisdom teeth in adolescents and adults. SEARCH METHODS We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 24 May 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 4), MEDLINE Ovid (1946 to 24 May 2016) and Embase Ovid (1980 to 24 May 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing and unpublished studies to 24 May 2016. We imposed no restrictions on language or date of publication in our search of electronic databases. SELECTION CRITERIA Studies comparing removal (or absence) with retention (or presence) of asymptomatic disease-free impacted wisdom teeth in adolescents or adults. We included randomised controlled trials (RCTs) with no restriction on length of follow-up, if available. We considered quasi-RCTs and prospective cohort studies for inclusion if investigators measured outcomes with follow-up of five years or longer. DATA COLLECTION AND ANALYSIS Eight review authors screened search results and assessed the eligibility of studies for inclusion according to the review inclusion criteria. Eight review authors independently conducted risk of bias assessments in duplicate. When information was unclear, we contacted study authors for additional information. MAIN RESULTS This review includes two studies. The previous review included one RCT with a parallel-group design, which was conducted in a dental hospital setting in the United Kingdom; our new search for this update identified one prospective cohort study conducted in the private sector in the USA. Primary outcome No eligible studies in this review reported the effects of removal compared with retention of asymptomatic disease-free impacted wisdom teeth on health-related quality of life Secondary outcomes We found only low to very low quality evidence of the effects of removal compared with retention of asymptomatic disease-free impacted wisdom teeth for a limited number of secondary outcome measures.One prospective cohort study, reporting data from a subgroup of 416 healthy male participants, aged 24 to 84 years, compared the effect of the absence (previous removal or agenesis) against the presence of asymptomatic disease-free impacted wisdom teeth on periodontitis and caries associated with the distal of the adjacent second molar during a follow-up period of three to over 25 years. Very low quality evidence suggests that the presence of asymptomatic disease-free impacted wisdom teeth may be associated with increased risk of periodontitis affecting the adjacent second molar in the long term. In the same study, which is at serious risk of bias, there is insufficient evidence to demonstrate a difference in caries risk associated with the presence or absence of impacted wisdom teeth.One RCT with 164 randomised and 77 analysed adolescent participants compared the effect of extraction with retention of asymptomatic disease-free impacted wisdom teeth on dimensional changes in the dental arch after five years. Participants (55% female) had previously undergone orthodontic treatment and had 'crowded' wisdom teeth. No evidence from this study, which was at high risk of bias, was found to suggest that removal of asymptomatic disease-free impacted wisdom teeth has a clinically significant effect on dimensional changes in the dental arch.The included studies did not measure our other secondary outcomes: costs, other adverse events associated with retention of asymptomatic disease-free impacted wisdom teeth (pericoronitis, root resorption, cyst formation, tumour formation, inflammation/infection) and adverse effects associated with their removal (alveolar osteitis/postoperative infection, nerve injury, damage to adjacent teeth during surgery, bleeding, osteonecrosis related to medication/radiotherapy, inflammation/infection). AUTHORS' CONCLUSIONS Insufficient evidence is available to determine whether or not asymptomatic disease-free impacted wisdom teeth should be removed. Although asymptomatic disease-free impacted wisdom teeth may be associated with increased risk of periodontitis affecting adjacent second molars in the long term, the evidence is of very low quality. Well-designed RCTs investigating long-term and rare effects of retention and removal of asymptomatic disease-free impacted wisdom teeth, in a representative group of individuals, are unlikely to be feasible. In their continuing absence, high quality, long-term prospective cohort studies may provide valuable evidence in the future. Given the lack of available evidence, patient values should be considered and clinical expertise used to guide shared decision making with patients who have asymptomatic disease-free impacted wisdom teeth. If the decision is made to retain asymptomatic disease-free impacted wisdom teeth, clinical assessment at regular intervals to prevent undesirable outcomes is advisable.
Collapse
Affiliation(s)
- Hossein Ghaeminia
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein Zuid 14, Nijmegen, Netherlands, 6525 GA
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Ghaeminia H, Hoppenreijs TJM, Xi T, Fennis JP, Maal TJ, Bergé SJ, Meijer GJ. Postoperative socket irrigation with drinking tap water reduces the risk of inflammatory complications following surgical removal of third molars: a multicenter randomized trial. Clin Oral Investig 2016; 21:71-83. [PMID: 26922634 PMCID: PMC5203820 DOI: 10.1007/s00784-016-1751-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 02/10/2016] [Indexed: 11/24/2022]
Abstract
Objectives The primary aim of the present study was to evaluate the effectiveness of postoperative irrigation of the socket with drinking tap water on inflammatory complications following lower third molar removal. Material and methods A multicenter randomized controlled trial was carried out from June 2013 to June 2014. In one arm of the study, patients were instructed to irrigate the tooth socket and surgical site with a Monoject® Curved 412 Tip Syringe (Tyco/healthcare-Kendall, Mansfield, MA, USA) with tap water. In a second arm of the study, the standard postoperative instructions did not include irrigation instructions. The incidences of alveolar osteitis and wound infection were recorded for each group and analyzed by the Fisher’s exact test. Results A total of 280 patients with 333 mandibular third molars were analyzed. According to the intention-to-treat (ITT) analysis, inflammatory complications occurred in 18 cases in the Monoject® group (11.4 %) compared to 34 cases (19.1 %) in the control group (p = 0.04). These complications were associated with significant worse outcomes regarding quality of life, pain, and trismus and caused significantly more missed days of work or study. Female gender, age >26, bone removal, deep impacted third molars, less experienced surgeons, and a high amount of debris at the surgical site were also identified as risk factors for developing inflammatory complications following lower third molar removal. Conclusion Irrigation of the surgical site with drinking tap water using a curved syringe following removal of third molars is effective in reducing the risk of inflammatory complications. Clinical relevance Water is a very accessible, cost-effective irrigant without side effects and the results from this study have proven that it can be used to reduce the risk of inflammatory complications and associated morbidity following lower third molar removal.
Collapse
Affiliation(s)
- H Ghaeminia
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
| | - Th J M Hoppenreijs
- Department of Oral and Maxillofacial Surgery, Rijnstate Hospital Arnhem, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands
| | - T Xi
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - J P Fennis
- Department of Oral and Maxillofacial Surgery, Rijnstate Hospital Arnhem, Wagnerlaan 55, 6815 AD, Arnhem, The Netherlands
| | - T J Maal
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - S J Bergé
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.,Oral and Maxillofacial Surgery, ZBC Private Clinic Nijmegen, Groenewoudseweg 315, 6524 TX, Nijmegen, The Netherlands
| | - G J Meijer
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.,Implantology & Periodontology, Radboud University Medical Center, Phillips van Leydenlaan 25, 6525 EX, Nijmegen, The Netherlands
| |
Collapse
|
20
|
Øyri H, Bjørnland T, Barkvoll P, Jensen JL. Mandibular third molar surgery in 396 patients at a Norwegian university clinic: Morbidity recorded after 1 week utilizing an e-infrastructure for clinical research. Acta Odontol Scand 2015; 74:148-54. [PMID: 26689106 DOI: 10.3109/00016357.2015.1092051] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate morbidity 1 week after mandibular third molar (3M) surgery in the authors' department. MATERIALS AND METHODS A prospective 1-year clinical study of patients followed up for 1 week after 3M surgery was performed. Consecutive patients of 18 years or older having 3M surgery under local anaesthesia were included. Patients not able to attend a follow-up appointment after 1 week were excluded. Demographic data, indication for surgery and clinical findings were recorded. Outcome variables were days requiring analgesic, days absent from work/school and complications. All data recording was performed utilizing an e-infrastructure for clinical research (InReach, University Health Network, www.uhnsl.com). RESULTS Three hundred and ninety-six patients were examined 1 week after surgery. Mean number of days requiring analgesics was 3.8 and mean number of days absent from work/school after surgery was 0.6. Minor complications were reported by 7% of patients. Female patients reported more days requiring analgesics compared to male patients. Smokers had a higher odds ratio for being absent ≥ 3 days. Prophylactic removal of 3Ms was associated with fewer days requiring analgesics and days absent from work/school as compared to teeth with local disease. CONCLUSION Overall morbidity after 3M surgery was low. Compared to patients subjected to therapeutic removal of 3Ms, patients undergoing prophylactic removal seem to have less pain and a faster return to normal activities.
Collapse
Affiliation(s)
- Hauk Øyri
- a Department of Oral Surgery and Oral Medicine , Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo , Norway
| | - Tore Bjørnland
- a Department of Oral Surgery and Oral Medicine , Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo , Norway
| | - Pål Barkvoll
- a Department of Oral Surgery and Oral Medicine , Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo , Norway
| | - Janicke Liaaen Jensen
- a Department of Oral Surgery and Oral Medicine , Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo , Norway
| |
Collapse
|
21
|
Gocmen G, Gonul O, Oktay NS, Yarat A, Goker K. The antioxidant and anti-inflammatory efficiency of hyaluronic acid after third molar extraction. J Craniomaxillofac Surg 2015; 43:1033-7. [PMID: 26027861 DOI: 10.1016/j.jcms.2015.04.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 04/23/2015] [Accepted: 04/23/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Hyaluronic acid (HA) has a number of clinical applications in current practice. Therefore, correlation of HA with free radicals and inflammatory cells is clinically important. The purpose of this study is to measure the efficacy of high molecular weight HA on the oxidative stress of oral wounds (glutathione (GSH) and lipid peroxidation (LPO) levels), the inflammatory reaction (leucocytes, collagen and angiogenesis content), pain (visual analogue scale (VAS) records) and trismus (maximum interincisal opening (MIO) records) after third molar (M3) extraction. PATIENTS AND METHODS 40 patients were included in this study. 0.2 ml 0.8% HA was applied immediately after surgery within the HA group (n = 20). Nothing was applied to the control group (n = 20). The primary outcome variables were the changes in the inflammatory reaction (leucocyte, angiogenesis and collagen content), oxidative stress (GSH, LPO) and clinical parameters (VAS, MIO). Results were compared immediately after extraction (T0) and 1 week after surgery (T1). Bivariate analyses were used to assess the differences between the HA and control groups for each study variable. RESULTS There was a statistically significant difference of leucocyte infiltration and angiogenesis between the groups at T1. The HA group showed less leucocyte infiltration and more angiogenesis than the control group. There was no statistically significant difference in oxidative stress, VAS or MIO levels between the groups. CONCLUSION Our results confirm the hypothesis that HA has an anti-inflammatory effect following M3 extraction. However, the oxidative stress levels and clinical outcomes were similar after one week. Further studies examining these parameters at different times are necessary.
Collapse
Affiliation(s)
- Gokhan Gocmen
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Guzelbahce Buyukciftlik Sokak No. 6, 34365, Istanbul, Turkey.
| | - Onur Gonul
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Guzelbahce Buyukciftlik Sokak No. 6, 34365, Istanbul, Turkey
| | - Nihal Sehkar Oktay
- Department of Biochemistry, Faculty of Dentistry, Marmara University, Guzelbahce Buyukciftlik Sokak No. 6, 34365, Istanbul, Turkey
| | - Aysen Yarat
- Department of Biochemistry, Faculty of Dentistry, Marmara University, Guzelbahce Buyukciftlik Sokak No. 6, 34365, Istanbul, Turkey
| | - Kamil Goker
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Marmara University, Guzelbahce Buyukciftlik Sokak No. 6, 34365, Istanbul, Turkey
| |
Collapse
|
22
|
Rakhshan V. Common risk factors for postoperative pain following the extraction of wisdom teeth. J Korean Assoc Oral Maxillofac Surg 2015; 41:59-65. [PMID: 25922816 PMCID: PMC4411729 DOI: 10.5125/jkaoms.2015.41.2.59] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 12/04/2014] [Accepted: 12/11/2014] [Indexed: 12/01/2022] Open
Abstract
The extraction of third molars is a common task carried out at dental/surgery clinics. Postoperative pain is one of the two most common complications of this surgery, along with dry socket. Knowledge of the frequent risk factors of this complication is useful in determining high-risk patients, planning treatment, and preparing the patients mentally. Since the risk factors for postoperative pain have never been summarized before while the risk factors for dry socket have been highly debated, this report summarizes the literature regarding the common predictors of postextraction pain. Except for surgical difficulty and the surgeon's experience, the influences of other risk factors (age, gender and oral contraceptive use) were rather inconclusive. The case of a female gender or oral contraceptive effect might mainly be associated with estrogen levels (when it comes to dry socket), which can differ considerably from case to case. Improvement in and unification of statistical and diagnostic methods seem necessary. In addition, each risk factor was actually a combination of various independent variables, which should instead be targeted in more comprehensive studies.
Collapse
Affiliation(s)
- Vahid Rakhshan
- Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran. ; Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
23
|
Sobouti F, Rakhshan V, Chiniforush N, Khatami M. Effects of laser-assisted cosmetic smile lift gingivectomy on postoperative bleeding and pain in fixed orthodontic patients: a controlled clinical trial. Prog Orthod 2014; 15:66. [PMID: 25487965 PMCID: PMC4259980 DOI: 10.1186/s40510-014-0066-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background and objective Diode lasers are becoming popular in gingival treatment following orthodontic treatments. Despite their merit and clinical implications, postoperative pain and bleeding after surgery with diode lasers are not assessed except in few controversial studies. Method This controlled clinical trial was conducted on 30 healthy orthodontic patients aged 17–29 years, needing esthetic-only gingivectomy in the anterior maxilla. The patients were randomly divided into two groups of 15 each: experimental (laser-assisted surgery) and control (traditional surgery using scalpels). The bleeding rate following the surgery was assessed using the bleeding criteria established by the World Health Organization. The postsurgical pain level was recorded using visual analog scales immediately after the surgery and in patients who consumed analgesics, also 2 h after the analgesic consumption. The data were analyzed using the independent-samples t, Mann-Whitney U, and chi-square tests (α = 0.05). Results The average bleeding rates were 1.15 and 0.36 in the conventional and laser groups, respectively (Mann-Whitney U P < 0.05). Experimental patients had no postsurgical pain (VAS1 and VAS2 = 0). In the control group, the average VAS1 pain was 5.2 out of 10. The difference between VAS1 values in the control/experimental groups was significant (Mann-Whitney U P < 0.001). Conclusion 940-nm diode laser seems promising in reducing postoperative bleeding and pain of patients needing cosmetic smile lift surgeries.
Collapse
Affiliation(s)
| | | | | | - Maziar Khatami
- Department Of Periodontics, Dental Faculty, Mazandaran University of Medical Sciences, Sari, Iran.
| |
Collapse
|
24
|
Bouloux GF, Busaidy KF, Beirne OR, Chuang SK, Dodson TB. What is the risk of future extraction of asymptomatic third molars? A systematic review. J Oral Maxillofac Surg 2014; 73:806-11. [PMID: 25631864 DOI: 10.1016/j.joms.2014.10.029] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 09/28/2014] [Accepted: 10/24/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of our report was to determine clinically whether young adults who elect to retain their asymptomatic third molars (M3s) have a risk of undergoing 1 or more M3 extractions in the future. MATERIALS AND METHODS To address our clinical question, we designed and implemented a systematic review. The studies included in the present review were prospective, had a sample size of 50 subjects or more with at least 1 asymptomatic M3, and had at least 12 months of follow-up data available. The primary study variables were the follow-up duration (in years) and the number of M3s extracted by the end of the follow-up period or the number of subjects who required at least one M3 extraction. The annual and cumulative incidence rates of M3 removal were estimated. RESULTS Seven studies met the inclusion criteria. The samples sizes ranged from 70 to 821 subjects, and the follow-up period ranged from 1 to 18 years. The mean incidence rate for M3 extraction of previously asymptomatic M3s was 3.0% annually (range 1 to 9%). The cumulative incidence rate for M3 removal ranged from 5% at 1 year to 64% at 18 years. The reasons for extraction were caries, periodontal disease, and other inflammatory conditions. CONCLUSIONS The cumulative risk of M3 extraction for young adults with asymptomatic M3s is sufficiently high to warrant its consideration when reviewing the risks and benefits of M3 retention as a management strategy.
Collapse
Affiliation(s)
- Gary F Bouloux
- Associate Professor and Residency Program Director, Division of Oral and Maxillofacial Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, GA.
| | - Kamal F Busaidy
- Associate Professor, Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Texas Health Sciences Center, Houston, TX
| | - O Ross Beirne
- Professor, Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA
| | - Sung-Kiang Chuang
- Associate Professor, Department of Oral and Maxillofacial Surgery, Harvard University School of Dental Medicine, Boston, MA
| | - Thomas B Dodson
- Professor and Chair, Department of Oral and Maxillofacial Surgery; Associate Dean for Hospital Affairs, University of Washington School of Dentistry, Seattle, WA
| |
Collapse
|
25
|
Haraji A, Rakhshan V. Chlorhexidine gel and less difficult surgeries might reduce post-operative pain, controlling for dry socket, infection and analgesic consumption: a split-mouth controlled randomised clinical trial. J Oral Rehabil 2014; 42:209-19. [PMID: 25251411 DOI: 10.1111/joor.12230] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2014] [Indexed: 12/01/2022]
Abstract
Reports on post-surgical pain are a few, controversial and flawed (by statistics and analgesic consumption). Besides, it is not known if chlorhexidine can reduce post-extraction pain adjusting for its effect on prevention of infection and dry socket (DS). We assessed these. A total of 90 impacted mandibular third molars of 45 patients were extracted. Intra-alveolar 0·2% chlorhexidine gel was applied in a split-mouth randomised design to one-half of the sockets. None of the included patients took antibiotics or analgesics afterwards. In the first and third post-operative days, DS formation and pain levels were recorded. Predictive roles of the risk factors were analysed using fixed-effects (classic) and multilevel (mixed-model) multiple linear regressions (α = 0·05, β≤0·1). In the first day, pain levels were 5·56 ± 1·53 and 4·78 ± 1·43 (out of 10), respectively. These reduced to 3·22 ± 1·41 and 2·16 ± 1·40. Pain was more intense on the control sides [both P values = 0·000 (paired t-test)]. Chlorhexidine had a significant pain-alleviating effect (P = 0·0001), excluding its effect on DS and infection. More difficult surgeries (P = 0·0201) and dry sockets were more painful (P = 0·0000). Age had a marginally significant negative role (P = 0·0994). Gender and smoking had no significant impact [P ≥ 0·7 (regression)]. The pattern of pain reduction differed between dry sockets and healthy sockets [P = 0·0102 (anova)]. Chlorhexidine can reduce pain, regardless of its infection-/DS-preventive effects. Simpler surgeries and sockets not affected by alveolar osteitis are less painful. Smoking and gender less likely affect pain. The role of age was not conclusive and needs future studies.
Collapse
Affiliation(s)
- A Haraji
- Department of Oral and Maxillofacial Surgery, Dental Branch, Islamic Azad University, Tehran, Iran
| | | |
Collapse
|
26
|
Adverse events during the removal of impacted maxillary third molars. Int J Oral Maxillofac Surg 2014; 43:1142-7. [DOI: 10.1016/j.ijom.2014.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Revised: 02/06/2014] [Accepted: 04/01/2014] [Indexed: 11/22/2022]
|
27
|
Petrosyan V, Ameerally P. Changes in demographics of patients undergoing third molar surgery in a hospital setting between 1994 and 2012 and the influence of the National Institute for Health and Care Excellence guidelines. J Oral Maxillofac Surg 2013; 72:254-8. [PMID: 24246253 DOI: 10.1016/j.joms.2013.09.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 08/23/2013] [Accepted: 09/17/2013] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate changes in demographics of patients undergoing third molar surgery (TMS). MATERIALS AND METHODS This retrospective study used the World Health Organization's International Classification of Diseases, Tenth Revision codes F091 and F093 to generate data on patients (N = 10,447) undergoing TMS from 1994 through 2012 at the authors' institution. The data is described in terms of mean, median, mode and were analyzed using analysis of variance and the Student t test. RESULTS Fewer female patients were treated after implementation of the National Institute for Health and Care Excellence (NICE) guidelines. The mean patient age increased from 29 years (1994) to 36 years (2012), with the median increasing from 27 to 31 years (P < .001). There was a significant difference in the age of patients treated before and after the introduction of the NICE guidelines (P < .001). CONCLUSIONS The increase in age appears to be influenced by the NICE guidelines. Given the increased risk of complications in older patients, consideration should be given to the removal of a similarly impacted, asymptomatic, contralateral third molar without obvious radiographic relation to the inferior dental canal, if a young patient is undergoing general anesthesia.
Collapse
Affiliation(s)
- Vahe Petrosyan
- Career Development Trainee, Department of Oral and Maxillofacial Surgery, Northampton General Hospital, Northampton, UK.
| | - Phillip Ameerally
- Consultant, Department of Oral and Maxillofacial Surgery, Northampton General Hospital, Northampton, UK
| |
Collapse
|
28
|
|
29
|
Pogrel MA. What Is the Effect of Timing of Removal on the Incidence and Severity of Complications? J Oral Maxillofac Surg 2012; 70:S37-40. [DOI: 10.1016/j.joms.2012.04.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 04/20/2012] [Indexed: 11/26/2022]
|
30
|
Mettes TDG, Ghaeminia H, Nienhuijs MEL, Perry J, van der Sanden WJM, Plasschaert A. Surgical removal versus retention for the management of asymptomatic impacted wisdom teeth. Cochrane Database Syst Rev 2012:CD003879. [PMID: 22696337 DOI: 10.1002/14651858.cd003879.pub3] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The prophylactic removal of asymptomatic impacted wisdom teeth is defined as the (surgical) removal of wisdom teeth in the absence of local disease. Impacted wisdom teeth may be associated with pathological changes, such as inflammation of the gums around the tooth, root resorption, gum and alveolar bone disease, damage to the adjacent teeth and the development of cysts and tumours. Other reasons to justify prophylactic removal have been to prevent late incisor crowding. When surgical removal is carried out in older patients, following the development of symptoms, the risk of postoperative complications, pain and discomfort increases. Nevertheless, in most developed countries prophylactic removal of trouble-free wisdom teeth, either impacted or fully erupted, has long been considered as 'appropriate care' and is a very common procedure. There is a need to determine whether there is evidence to support this practice. OBJECTIVES To evaluate the effects of prophylactic removal of asymptomatic impacted wisdom teeth in adolescents and adults compared with the retention (conservative management) of these wisdom teeth. SEARCH METHODS The following electronic databases were searched: the Cochrane Oral Health Group's Trials Register (to 30 March 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 1), MEDLINE via OVID (1950 to 30 March 2012), and EMBASE via OVID (1980 to 30 March 2012). There were no restrictions on language or date of publication. SELECTION CRITERIA All randomised controlled trials (RCTs) on adolescents and adults comparing the effect of prophylactic removal of asymptomatic impacted wisdom teeth with no-treatment (retention). DATA COLLECTION AND ANALYSIS Six review authors screened the results of the search and assessed whether trials met the inclusion criteria for the review. Data extraction and risk of bias assessment were conducted in duplicate and independently by six review authors. Where information was unclear, authors of studies were contacted for additional information. MAIN RESULTS No RCTs were identified that compared the removal of asymptomatic wisdom teeth with retention and reported quality of life. One RCT on adolescents was identified that compared the removal of impacted mandibular wisdom teeth with retention and only examined the effect on late lower incisor crowding. This study at high risk of bias provided no evidence that extraction of wisdom teeth had an effect on lower incisor crowding over 5 years. AUTHORS' CONCLUSIONS Insufficient evidence was found to support or refute routine prophylactic removal of asymptomatic impacted wisdom teeth in adults. A single trial comparing removal versus retention found no evidence of a difference on late lower incisor crowding at 5 years, however no other relevant outcomes were measured.Watchful monitoring of asymptomatic third molar teeth may be a more prudent strategy.
Collapse
Affiliation(s)
- Theodorus Dirk G Mettes
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands.
| | | | | | | | | | | |
Collapse
|
31
|
Pitak-Arnnop P, Pausch NC. Female and older adult patients (age ≥ 21 Years) had slower recovery after third-molar surgery compared with males and younger adults in a US study. J Evid Based Dent Pract 2011; 11:196-9. [PMID: 22078833 DOI: 10.1016/j.jebdp.2011.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Recovery after third-molar surgery: the effects of age and sex. Phillips C, Gelesko S, Proffit WR, White RP Jr. Am J Orthod Dentofacial Orthop 2010;138(6):700.e1-8 REVIEWERS Poramate Pitak-Arnnop, DDS, PGDipClinSc (OMS), MSc, PhD, DSc Niels Christian Pausch, MD, DMD, PhD. PURPOSE/QUESTION To assess the effects of age and gender on quality-of-life recovery after third-molar surgery in patients treated in either community practices or academic centers. SOURCE OF FUNDING The Oral and Maxillofacial Surgery Foundation, the American Association of Oral and Maxillofacial Surgeons, and the Dental Foundation of North America. TYPE OF STUDY/DESIGN Cohort study. LEVEL OF EVIDENCE Level 2: Limited-quality, patient-oriented evidence. STRENGTH OF RECOMMENDATION GRADE Not applicable.
Collapse
Affiliation(s)
- Poramate Pitak-Arnnop
- Department of Oral, Craniomaxillofacial and Facial Plastic Surgery, Scientific Unit for Clinical and Psychosocial Research, Evidence-Based Surgery and Ethics in Oral and Maxillofacial Surgery, Faculty of Medicine, University Hospital of Leipzig, Leipzig, Germany.
| | | |
Collapse
|