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Ding Y, Zhu Z, Zhang X, Wang J. Novel Functional Dressing Materials for Intraoral Wound Care. Adv Healthc Mater 2024:e2400912. [PMID: 38716872 DOI: 10.1002/adhm.202400912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/05/2024] [Indexed: 05/22/2024]
Abstract
Intraoral wounds represent a particularly challenging category of mucosal and hard tissue injuries, characterized by the unique structures, complex environment, and distinctive healing processes within the oral cavity. They have a common occurrence yet frequently inflict significant inconvenience and pain on patients, causing a serious decline in the quality of life. A variety of novel functional dressings specifically designed for the moist and dynamic oral environment have been developed and realized accelerated and improved wound healing. Thoroughly analyzing and summarizing these materials is of paramount importance in enhancing the understanding and proficiently managing intraoral wounds. In this review, the particular processes and unique characteristics of intraoral wound healing are firstly described. Up-to-date knowledge of various forms, properties, and applications of existing products are then intensively discussed, which are categorized into animal products, plant extracts, natural polymers, and synthetic products. To conclude, this review presents a comprehensive framework of currently available functional intraoral wound dressings, with an aim to provoke inspiration of future studies to design more convenient and versatile materials.
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Affiliation(s)
- Yutang Ding
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Zhou Zhu
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xin Zhang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Jian Wang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
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Zhang L, Li L. The effect of primary closure versus secondary closure techniques on postoperative wound pain in patients undergoing mandibular surgery: A meta-analysis. Int Wound J 2024; 21:e14753. [PMID: 38531356 DOI: 10.1111/iwj.14753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 03/28/2024] Open
Abstract
This research is intended to explore the influence of second and first degree closure methods on the degree of wound pain and swelling of the face following the removal of the mandible. For the purpose of this study, three data sets, including PubMed and Embase, were selected. A separate statistical analysis was conducted on the choice of the trial, the collection of data and the risk of bias. Differences between trials were analysed with a chi-square approach, with data analyses dependent on I2. A sensitivity analysis was conducted, and a possible publication bias was evaluated. Ultimately, nine qualifying trials were chosen out of an original pool of 1922 related trials following an in-depth evaluation under the eligibility and exclusion criteria, as well as a follow-up screening. The results indicated that there was no statistically significant change in the degree of post-operation pain after 1 day operation between one or secondary closures of treatment (MD, -0.46; 95% CI, -0.93, 0.01, p = 0.06); the results showed that there were no statistically significant differences in post-operation wound pain after 3 days in two group (MD, -0.15; 95% CI, -0.68, 0.37, p = 0.56); the results showed that there were no statistically different effects on the post-operation wound pain after the 7th day in two groups (MD, -0.14; 95% CI, -0.31, 0.03, p = 0.1). The results showed that there were no statistically different effects on the post-operation wound pain after the 1 day in two groups (MD, -0.26; 95% CI, -0.38, -0.13, p < 0.0001); on the 3rd day after surgery, the face was significantly smaller swelling in the secondary closure of closure compared with the first-stage closure group (MD, -0.70; 95% CI, -1.40, -0.00, p = 0.05). While there is no obvious effect on post-operation wound pain in patients with mandibular surgery, there is significant difference in post-operation face swelling. The findings do not support a preference for any of these methods.
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Affiliation(s)
- Lina Zhang
- Department of Stomatology, No. 215 Hospital of Shaanxi Provincial Nuclear Industry, Xianyang, China
| | - Lei Li
- Department of Oral & Maxillofacial Surgery, No. 215 Hospital of Shaanxi Provincial Nuclear Industry, Xianyang, China
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Mahardawi B, Jiaranuchart S, Rochanavibhata S, Siriwat K, Mattheos N, Pimkhaokham A. Cyanoacrylate tissue adhesive versus silk sutures for mandibular third molar surgery: a systematic review and meta-analysis. Clin Oral Investig 2024; 28:180. [PMID: 38418796 DOI: 10.1007/s00784-024-05578-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/24/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Cyanoacrylate tissue adhesive has been presented as an alternative to sutures and several studies have compared them. The objective of this meta-analysis was to evaluate the effect of cyanoacrylate tissue adhesive on postoperative pain and swelling, following mandibular third molar surgery. MATERIALS AND METHODS Database search was conducted in MEDLINE/PubMed and Scopus, along with extensive search in the grey literature, including randomized and non-randomized clinical trials that applied cyanoacrylate adhesive for closing mandibular third molar surgical sites and compared it with silk sutures, assessing postoperative pain and swelling. The search ended on September 22, 2023. RESULTS Of 886 identified articles, six were included and meta-analyzed. Applying cyanoacrylate demonstrated a reduction in the overall postoperative pain (SMD = -0.57, 95% CI -1.00 to -0.15, p = 0.009). A similar outcome was noted when pain was evaluated on the first and last postoperative days, based on controlled clinical trials (SMD = -0.47, 95% CI -0.92 to -0.03, p = 0.04), and randomized trials (SMD = -0.97, 95% CI -1.31 to -0.62, p < 0.00001). Patients/sides received cyanoacrylate showed a decrease in postoperative swelling (SMD = -0.26, 95% CI -0.51 to -0.01, p = 0.04). Following the GRADE rating system, the quality of evidence on pain and swelling was judged as moderate and low, respectively. CONCLUSIONS The use of cyanoacrylate adhesive may offer benefit in reducing postoperative pain and swelling following mandibular third molar surgery. Nevertheless, this should be further investigated, considering the low number of included reports. CLINICAL RELEVANCE The current results could help clinicians who perform this procedure to manage postoperative pain and swelling more effectively.
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Affiliation(s)
- Basel Mahardawi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Sirimanas Jiaranuchart
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Sunisa Rochanavibhata
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Kiti Siriwat
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330, Thailand.
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Karimi M, Mosaddad SA, Aghili SS, Dortaj H, Hashemi SS, Kiany F. Attachment and proliferation of human gingival fibroblasts seeded on barrier membranes using Wharton's jelly-derived stem cells conditioned medium: An in vitro study. J Biomed Mater Res B Appl Biomater 2024; 112:e35368. [PMID: 38247251 DOI: 10.1002/jbm.b.35368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/12/2023] [Accepted: 12/02/2023] [Indexed: 01/23/2024]
Abstract
The effect of Wharton's jelly mesenchymal stem cells conditioned medium (WJMSCs-CM) and zinc oxide nanoparticles (ZnO-NPs) on cultured human gingival fibroblasts on various barrier membranes was investigated in this study. In this study, human gingival fibroblasts were prepared and cultured on three membranes: collagen membrane, acellular dermal matrix (ADM) with ZnO-NPs, and ADM without ZnO-NPs. WJMSCs-CM was given to the testing groups, while control groups received the same membranes without WJMSCs-CM. Following 48 and 72 h, 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) tests were performed to assess cell survival. Cell proliferation on the membranes was also evaluated using 4',6-diamidino-2-phenylindole (DAPI) staining after 48 and 72 h. Field emission scanning electron microscopy was used to determine membrane surface structure and cell adhesion. Nanoparticles were also subjected to an energy-dispersive x-ray analysis to identify their chemical structure. Two-way analysis of variance was used to conduct the statistical analysis. The p-value ≤.05 was considered significant. When ADM-ZnO-NPs were combined with CM, fibroblast viability, and adhesion significantly differed from ADM-ZnO-NPs alone. DAPI results confirmed cell proliferation in all six groups on both experiment days. The abundance and concentrated distribution of cells during cell proliferation were found in CM-containing membranes, specifically the ADM-ZnO-NPs membrane, demonstrating the improved biocompatibility of the ADM-ZnO-NPs membrane for cell proliferation. The other groups did not significantly differ from one another. WJMSCs-CM positively affected the viability and proliferation of gingival fibroblasts, but only marginally. Under certain conditions, ZnO-NPs below a specific concentration increased the biocompatibility of the membranes.
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Affiliation(s)
- Mohammadreza Karimi
- Student Research Committee, Department of Periodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Ali Mosaddad
- Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hengameh Dortaj
- Department of Tissue Engineering, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyedeh-Sara Hashemi
- Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farin Kiany
- Oral and Dental Disease Research Center, Department of Periodontology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Kokash M, Darwich K, Ataya J. The effect of hyaluronic acid addition to collagen in reducing the trismus and swelling after surgical extraction of impacted lower third molars: a split-mouth, randomized controlled study. Clin Oral Investig 2023; 27:4659-4666. [PMID: 37256430 DOI: 10.1007/s00784-023-05092-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/22/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Removal of impacted third molars is associated with postoperative complications such as pain, swelling, ecchymosis, trismus, infection, and hematoma. Thus, contemporary surgery aims to reduce complications by applying collagen or hyaluronic acid in the socket after extracting the impacted mandibular third molars. This study aimed to study the efficacy of hyaluronic acid (HA) addition to collagen, compared to collagen application alone, on the magnitude of swelling and trismus following impacted mandibular third molar surgery. METHODS AND MATERIALS A total of 40 impacted molars of 20 participants who had completely bilateral impacted lower third molars were enrolled in this split-mouth, randomized, clinical trial. Randomization was carried out by two opaque envelops; two materials were applied topically in the socket collagen alone or with hyaluronic. The postoperative mouth-opening limitation and swelling rate were assessed on the third and seventh days after the extraction. RESULTS The mean age was 22.7 ± 3.079 years (75% female and 25% male). Regarding the rate of trismus, the test sides had less values than the control sides on 3rd days (44.03 ± 12.8 vs. 52.14 ± 13.7) and 7th days (19.22 ± 12.8 vs. 32.45 ± 15.3) postoperatively but the difference is only significant on the seventh day (P = 0.005). The swelling scores of the hyaluronic acid addition group were significantly lesser than those of the collagen alone group on the third and the seventh day (P < 0.05) except for the lateral canthus to the angulus mandibulae on the third day (P = 0.133). CONCLUSION Adding hyaluronic acid to collagen could effectively reduce the severity of facial swelling and trismus following surgical extraction of impacted lower third molars. STATEMENT OF CLINICAL RELEVANCE Swelling and trismus are the most sequela following impacted third molar surgical extraction. This study showed that applying hyaluronic acid with collagen can reduce the severity of facial swelling and trismus which could be useful in surgeons' daily practice. We should mention that this original article has a preprint edition (44).
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Affiliation(s)
- Moemeneh Kokash
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Khaldoun Darwich
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Jawdat Ataya
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Damascus University, Damascus, Syria.
- Medical Education Programme, Syrian Virtual University, Damascus, Syria.
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Kilinc A, Ataol M. Effects of collagen membrane on bone level and periodontal status of adjacent tooth after third molar surgery: a randomized controlled trial. Head Face Med 2023; 19:13. [PMID: 36966313 PMCID: PMC10039521 DOI: 10.1186/s13005-023-00351-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 02/09/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND The periodontal status and distal bone level of the adjacent second molar can be negatively affected by the surgical extraction of an impacted lower third molar. Absorbable materials have some benefits, including enhancing primary wound coverage and promoting wound healing through isolation, clotting, wound stabilization and haemostasis. This study set out to compare primary and secondary healing and collagen-membrane-based primary healing after surgical removal of partially erupted impacted third molars (3Ms), evaluating the distal alveolar bone level (ABL) and periodontal status of the adjacent second molars (2Ms). METHODS Patients who met the inclusion criteria were randomized into three groups: secondary healing (n = 28), primary healing (n = 27) and membrane-based primary healing (n = 29). Digital panoramic radiographs were obtained preoperatively (T1) and three months postoperatively (T2). The distances between the cemento-enamel junctions and the alveolar bone crests on the distal aspects of the adjacent 2Ms were measured using calibrated radiograph measurement software. The pocket depth and plaque index measurements were performed preoperatively and three months postoperatively. The periodontal plaque index (PPI) scores were registered on the distal aspects of the 2Ms, and the mean values were used. RESULTS Three of the applied healing types positively affected periodontal pocket depth (PPD) and periodontal index values (p < 0.05). In terms of the ABL of the adjacent 2Ms, primary healing (p < 0.05) and membrane-based primary healing (p < 0.05) had superior results to secondary healing. CONCLUSION Membrane use is promising for the distal bone gain and periodontal status of the adjacent 2M. TRIAL REGISTRATION This clinical study was registered by the Australian New Zealand Clinical Trials Registry, with the trial number ACTRN12618001551280.
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Affiliation(s)
- Adnan Kilinc
- Private Kılınç Dental Clinic, 25040, Erzurum, Turkey
| | - Mert Ataol
- Private Zoom Dental Clinic, 06530, Ankara, Turkey.
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Azab M, Ibrahim S, Li A, Khosravirad A, Carrasco-Labra A, Zeng L, Brignardello-Petersen R. Efficacy of secondary vs primary closure techniques for the prevention of postoperative complications after impacted mandibular third molar extractions: A systematic review update and meta-analysis. J Am Dent Assoc 2022; 153:943-956.e48. [PMID: 36030117 DOI: 10.1016/j.adaj.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/15/2022] [Accepted: 04/27/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aim of this systematic review was to determine whether secondary closure (SC) or primary closure (PC) is better at preventing postoperative complications after impacted mandibular third-molar extraction. TYPES OF STUDIES REVIEWED The authors sought randomized controlled trials comparing the effects of PC and SC on pain, swelling, trismus, infection, and bleeding after impacted mandibular third-molar extraction. Screening, data extraction, and risk of bias assessments were conducted independently and in duplicate. The reviewers pooled results across studies using a random-effects meta-analysis and assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS This review identified 785 unique citations and included 40 trials. Compared with PC, SC was found to have trivial benefits for pain at day 7 and trismus within 1 week (moderate certainty). The incidence of infection and bleeding did not differ importantly between techniques (moderate certainty). However, SC is probably associated with less swelling on day 1 (standardized mean difference, -0.98; 95% CI, -1.22 to -0.73; moderate certainty) and day 3 (standardized mean difference, -0.87; 95% CI, -1.16 to -0.59; moderate certainty). There was very low certainty evidence for pain on days 1 and 3 and low certainty evidence for swelling on day 7. CONCLUSIONS AND PRACTICAL IMPLICATIONS Clinicians choosing between closure techniques should be aware that SC probably imparts an important benefit only for swelling at days 1 and 3. There seems to be a trivial difference between the techniques in other outcomes.
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Daly BJ, Sharif MO, Jones K, Worthington HV, Beattie A. Local interventions for the management of alveolar osteitis (dry socket). Cochrane Database Syst Rev 2022; 9:CD006968. [PMID: 36156769 PMCID: PMC9511819 DOI: 10.1002/14651858.cd006968.pub3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Alveolar osteitis (dry socket) is a complication of dental extractions more often involving mandibular molar teeth. It is associated with severe pain developing 2 to 3 days postoperatively with or without halitosis, a socket that may be partially or totally devoid of a blood clot, and increased postoperative visits. This is an update of the Cochrane Review first published in 2012. OBJECTIVES: To assess the effects of local interventions used for the prevention and treatment of alveolar osteitis (dry socket) following tooth extraction. SEARCH METHODS An Information Specialist searched four bibliographic databases up to 28 September 2021 and used additional search methods to identify published, unpublished, and ongoing studies. SELECTION CRITERIA We included randomised controlled trials of adults over 18 years of age who were having permanent teeth extracted or who had developed dry socket postextraction. We included studies with any type of local intervention used for the prevention or treatment of dry socket, compared to a different local intervention, placebo or no treatment. We excluded studies reporting on systemic use of antibiotics or the use of surgical techniques because these interventions are evaluated in separate Cochrane Reviews. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. We followed Cochrane statistical guidelines and reported dichotomous outcomes as risk ratios (RR) and calculated 95% confidence intervals (CI) using random-effects models. For some of the split-mouth studies with sparse data, it was not possible to calculate RR so we calculated the exact odds ratio (OR) instead. We used GRADE to assess the certainty of the body of evidence. MAIN RESULTS We included 49 trials with 6771 participants; 39 trials (with 6219 participants) investigated prevention of dry socket and 10 studies (with 552 participants) looked at the treatment of dry socket. 16 studies were at high risk of bias, 30 studies at unclear risk of bias, and 3 studies at low risk of bias. Chlorhexidine in the prevention of dry socket When compared to placebo, rinsing with chlorhexidine mouthrinses (0.12% and 0.2% concentrations) both before and 24 hours after extraction(s) substantially reduced the risk of developing dry socket with an OR of 0.38 (95% CI 0.25 to 0.58; P < 0.00001; 6 trials, 1547 participants; moderate-certainty evidence). The prevalence of dry socket varies from 1% to 5% in routine dental extractions to upwards of 30% in surgically extracted third molars. The number of patients needed to be treated (NNT) with chlorhexidine rinse to prevent one patient having dry socket was 162 (95% CI 155 to 240), 33 (95% CI 27 to 49), and 7 (95% CI 5 to 10) for control prevalence of dry socket 0.01, 0.05, and 0.30 respectively. Compared to placebo, placing chlorhexidine gel intrasocket after extractions reduced the odds of developing a dry socket by 58% with an OR of 0.44 (95% CI 0.27 to 0.71; P = 0.0008; 7 trials, 753 participants; moderate-certainty evidence). The NNT with chlorhexidine gel (0.2%) to prevent one patient developing dry socket was 180 (95% CI 137 to 347), 37 (95% CI 28 to 72), and 7 (95% CI 5 to 15) for control prevalence of dry socket of 0.01, 0.05, and 0.30 respectively. Compared to chlorhexidine rinse (0.12%), placing chlorhexidine gel (0.2%) intrasocket after extractions was not superior in reducing the risk of dry socket (RR 0.74, 95% CI 0.46 to 1.20; P = 0.22; 2 trials, 383 participants; low-certainty evidence). The present review found some evidence for the association of minor adverse reactions with use of 0.12%, 0.2% chlorhexidine mouthrinses (alteration in taste, staining of teeth, stomatitis) though most studies were not designed explicitly to detect the presence of hypersensitivity reactions to mouthwash as part of the study protocol. No adverse events were reported in relation to the use of 0.2% chlorhexidine gel placed directly into a socket. Platelet rich plasma in the prevention of dry socket Compared to placebo, placing platelet rich plasma after extractions was not superior in reducing the risk of having a dry socket (RR 0.51, 95% CI 0.19 to 1.33; P = 0.17; 2 studies, 127 participants; very low-certainty evidence). A further 21 intrasocket interventions to prevent dry socket were each evaluated in single studies, and there is insufficient evidence to determine their effects. Zinc oxide eugenol versus Alvogyl in the treatment of dry socket Two studies, with 80 participants, showed that Alvogyl (old formulation) is more effective than zinc oxide eugenol at reducing pain at day 7 (mean difference (MD) -1.40, 95% CI -1.75 to -1.04; P < 0.00001; 2 studies, 80 participants; very low-certainty evidence) A further nine interventions for the treatment of dry socket were evaluated in single studies, providing insufficient evidence to determine their effects. AUTHORS' CONCLUSIONS Tooth extractions are generally undertaken by dentists for a variety of reasons, however, all but five studies included in the present review included participants undergoing extraction of third molars, most of which were undertaken by oral surgeons. There is moderate-certainty evidence that rinsing with chlorhexidine (0.12% and 0.2%) or placing chlorhexidine gel (0.2%) in the sockets of extracted teeth, probably results in a reduction in dry socket. There was insufficient evidence to determine the effects of the other 21 preventative interventions each evaluated in single studies. There was limited evidence of very low certainty that Alvogyl (old formulation) may reduce pain at day 7 in patients with dry socket when compared to zinc oxide eugenol.
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Affiliation(s)
- Blánaid Jm Daly
- Special Care Dentistry, Division of Child & Public Health, Dublin Dental University Hospital, Trinity College Dublin, Dublin 2, Ireland
| | | | | | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Anna Beattie
- School of Dental Science, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
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A Narrative Review on the Effectiveness of Bone Regeneration Procedures with OsteoBiol® Collagenated Porcine Grafts: The Translational Research Experience over 20 Years. J Funct Biomater 2022; 13:jfb13030121. [PMID: 35997459 PMCID: PMC9397035 DOI: 10.3390/jfb13030121] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/10/2022] [Accepted: 08/17/2022] [Indexed: 11/17/2022] Open
Abstract
Over the years, several bone regeneration procedures have been proposed using natural (autografts, allografts, and xenografts) and synthetic (i.e., metals, ceramics, and polymers) bone grafts. In particular, numerous in vitro and human and animal in vivo studies have been focused on the discovery of innovative and suitable biomaterials for oral and maxillofacial applications in the treatment of severely atrophied jaws. On this basis, the main objective of the present narrative review was to investigate the efficacy of innovative collagenated porcine bone grafts (OsteoBiol®, Tecnoss®, Giaveno, Italy), designed to be as similar as possible to the autologous bone, in several bone regeneration procedures. The scientific publications were screened by means of electronic databases, such as PubMed, Scopus, and Embase, finally selecting only papers that dealt with bone substitutes and scaffolds for bone and soft tissue regeneration. A total of 201 papers have been detected, including in vitro, in vivo, and clinical studies. The effectiveness of over 20 years of translational research demonstrated that these specific porcine bone substitutes are safe and able to improve the biological response and the predictability of the regenerative protocols for the treatment of alveolar and maxillofacial defects.
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Effect of Intraoral Drainage after Impacted Mandibular Third Molar Extraction on Non-Infectious Postoperative Complications. J Clin Med 2021; 10:jcm10204705. [PMID: 34682828 PMCID: PMC8540334 DOI: 10.3390/jcm10204705] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/29/2021] [Accepted: 10/11/2021] [Indexed: 11/17/2022] Open
Abstract
Surgical removal of mandibular third molars is associated with non-infectious postoperative complications, including pain, swelling, trismus. Intraoral drains are noteworthy because of their ease of application, availability, and effectiveness. This study aimed to evaluate the use of latex and calcium–sodium alginate mouth flat drains on the severity of postoperative complications such as pain, trismus, and edema after surgical removal of mandibular third molars. Ninety patients who underwent surgical removal of wisdom teeth were studied. The patients were divided into three groups. Group A—with a latex flat drain, group B—with a sodium–calcium alginate (Kaltostat) flat drain, and group C—with a wound closed with knotted sutures. Patients were assessed for pain on a VAS scale every day from surgery to postoperative day 7. Before the procedure and on postoperative days 1, 2, and 7, the pain level, edema, and trismus were measured, respectively. Intraoral drainage with a flat drain after mandibular third molar removal does not significantly reduce pain, as measured by the VAS scale, or postoperative swelling, as measured by lines between craniometric points. Intraoral drainage with a latex drain after mandibular third molar removal does not significantly reduce trismus, while intraoral drainage with a calcium–sodium alginate drainage bag significantly increases trismus.
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Ghosh A, Aggarwal VR, Moore R. Aetiology, Prevention and Management of Alveolar Osteitis-A Scoping Review. J Oral Rehabil 2021; 49:103-113. [PMID: 34625985 DOI: 10.1111/joor.13268] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/09/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alveolar osteitis (AO) is a poorly understood, common, painful complication following exodontia. It is sometimes managed by inappropriate prescription of antibiotics which contributes to the global threat of antimicrobial resistance. Use of intra-alveolar chlorhexidine also presents a serious risk of anaphylaxis to the patient. OBJECTIVE This scoping review aims to investigate the aetiology, prevention and management of AO and highlight the extent of inappropriate prescribing and intra-alveolar chlorhexidine use. DESIGN A scoping review was undertaken using the PRISMA guidelines. Medline, Ovid and Pubmed were searched between 2010 and 2020, from which 63 studies were selected for review that related to the aetiology, prevention or management of AO. Data were analysed for frequency of studies reporting information on risk factors for aetiology, prevention strategies and management including inappropriate management using antibiotic prescribing and intra-alveolar chlorhexidine. RESULTS Impaired immune response, surgical technique and age were identified as significant factors in the development of AO, while there is conflicting evidence regarding the effects of smoking and gender. With regard to prevention, the use of prophylactic antibiotics is not supported within the literature. Saline irrigation and eugenol pastes used preventively have been shown to be cheap and effective alternatives to chlorhexidine with no adverse effects. Hyaluronic acid and low-level laser therapies showed a significant reduction in pain and soft-tissue inflammation in the management of AO compared to Alveogyl. CONCLUSIONS Further understanding of the pathophysiology of AO is needed, in addition to large high-quality RCTs or long-term observational studies into the aetiology, prevention, and management of AO to produce up-to-date evidence-based clinical guidelines. Clinicians should also be mindful of their contribution to growing antimicrobial resistance and avoid inappropriate prescribing of antibiotics. Saline should replace chlorhexidine as the intra-alveolar irrigant of choice.
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Affiliation(s)
- Anna Ghosh
- Department of Oral and Maxillofacial Surgery, Hull Royal Infirmary, Hull, United Kingdom of Great Britain and Northern Ireland
| | - Vishal R Aggarwal
- Department of Academic Oral Surgery & Oral Medicine, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
| | - Richard Moore
- Lecturer in Oral Surgery, Department of Academic Oral Surgery & Oral Medicine, University of Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
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Elmowitz JS, Shupak RP. Pharmacological and Non-Pharmacological Methods of Postoperative Pain Control Following Oral and Maxillofacial Surgery: A Scoping Review. J Oral Maxillofac Surg 2021; 79:2000-2009. [PMID: 34097866 DOI: 10.1016/j.joms.2021.04.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE To conduct a scoping review regarding current pharmacological and non-pharmacological methods of postoperative pain control following oral and maxillofacial surgery. MATERIALS AND METHODS PubMed was used to conduct research for this study. Identification criteria included surgery: patients undergoing the extraction of third molars; therapy: pharmacological or non-pharmacological methods; and outcomes: postoperative pain control. The search included full-text RCTs published after October 13, 2014, that were electronically accessible on PubMed and in the English language. After assessing quality, a scoping review was performed. RESULTS Thirty-five RCTs were evaluated, which included a total of 3,791 subjects. The studies evaluated patients' postoperative pain by either utilizing a visual analogue scale (VAS), measuring the time between surgery and when rescue analgesics were used, measuring the amount of rescue analgesics used, or by distributing questionnaires. CONCLUSION COX-2 inhibitors may provide greater analgesic effects compared to traditional nonsteroidal anti-inflammatory drugs (NSAIDs). Additionally, although the supplementation of an opioid analgesic to a NSAID regimen provides an increase in pain control, it does not further reduce pain levels in a patient alternating between ibuprofen and acetaminophen. Other methods of postoperative pain control mentioned in this review should be further explored in studies that contain larger sample sizes and that evaluate side effects of the treatment.
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Toledano-Osorio M, Toledano M, Manzano-Moreno FJ, Vallecillo C, Vallecillo-Rivas M, Rodriguez-Archilla A, Osorio R. Alveolar Bone Ridge Augmentation Using Polymeric Membranes: A Systematic Review and Meta-Analysis. Polymers (Basel) 2021; 13:1172. [PMID: 33917475 PMCID: PMC8038790 DOI: 10.3390/polym13071172] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/16/2021] [Accepted: 04/01/2021] [Indexed: 02/06/2023] Open
Abstract
Alveolar bone ridge resorption occurred after natural teeth loss and it can restrict the possibility of dental implants placement. The use of bone regenerative procedures is frequently required. The existing evidence regarding the efficacy of horizontal bone ridge augmentation trough guided bone regeneration (GBR) using polymeric membranes was stated. A systematic review and meta-analysis were performed. Electronic and manual literature searches were conducted. Screening process was done using the National Library of Medicine (MEDLINE by PubMed), Embase, and the Cochrane Oral Health. Included articles were randomized controlled trials and observational studies. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). If I2 > 50% a random-effects model was applied. It was found that the mean of horizontal bone gain was 3.95 mm, ranging from 3.19 to 4.70 mm (confidence interval 95%). Heterogeneity is I2 = 99% (confidence interval 95%) and significance of the random-effects model was p < 0.001. The complications rate was 8.4% and membrane exposure was the most frequent. Through this study, we were able to conclude that the existing scientific evidence suggests that GBR using polymeric membranes is a predictable technique for achieving horizontal bone augmentation, thus, permitting a proper further implant placement.
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Affiliation(s)
- Manuel Toledano-Osorio
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
- Medicina Clínica y Salud Pública PhD Programme, University of Granada, 18071 Granada, Spain
| | - Manuel Toledano
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
| | - Francisco Javier Manzano-Moreno
- Biomedical Group (BIO277), Department of Stomatology, School of Dentistry, University of Granada, 18071 Granada, Spain;
- Instituto Investigación Biosanitaria, ibs. Granada, 18071 Granada, Spain
| | - Cristina Vallecillo
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
| | - Marta Vallecillo-Rivas
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
| | - Alberto Rodriguez-Archilla
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
| | - Raquel Osorio
- Colegio Máximo de Cartuja s/n, Faculty of Dentistry, University of Granada, 18071 Granada, Spain; (M.T.-O.); (C.V.); (M.V.-R.); (A.R.-A.); (R.O.)
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Toledano M, Asady S, Toledano-Osorio M, García-Godoy F, Serrera-Figallo MA, Benítez-García JA, Osorio R. Differential Biodegradation Kinetics of Collagen Membranes for Bone Regeneration. Polymers (Basel) 2020; 12:polym12061290. [PMID: 32512861 PMCID: PMC7362079 DOI: 10.3390/polym12061290] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/21/2020] [Accepted: 06/02/2020] [Indexed: 02/07/2023] Open
Abstract
Native collagen-based membranes are used to guide bone regeneration; but due to their rapid biodegradation, this treatment is often unpredictable. The purpose of this study was to investigate the biodegradability of natural collagen membranes. Three non-cross-linked resorbable collagen barrier membranes were tested: Derma Fina (porcine dermis), Evolution Standard (equine pericardium) and Duo-Teck (equine lyophilized collagen felt). 10 × 10 mm2 pieces of membranes were submitted to three different degradation procedures: (1) hydrolytic degradation in phosphate buffer solution, (2) enzyme resistance, using a 0.25% porcine trypsin solution, and (3) bacterial (Clostridium histolyticum) collagenase resistance test. Weight measurements were performed with an analytic microbalance. Thickness was measured with a digital caliper. Membranes were analyzed at different time-points, up to 21 d of immersion. A stereomicroscope was used to obtain membranes’ images. ANOVA and Student Newman Keuls were used for mean comparisons (p < 0.05), except when analyzing differences between time-points within the same membrane and solution where pair-wise comparisons were applied (p < 0.001). Derma Fina attained the highest resistance to all degradation challenges. Duo-Teck was the most susceptible membrane to degradation, complete degradation occurred as soon as 8 h. The bacterial collagenase solution performed as the most aggressive test as all membranes presented 100% degradation before 21 d.
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Affiliation(s)
- Manuel Toledano
- Faculty of Dentistry, Dental Materials Section, University of Granada, Colegio Máximo de Cartuja s/n, 18071 Granada, Spain; (M.T.); (S.A.); (J.A.B.-G.); (R.O.)
| | - Samara Asady
- Faculty of Dentistry, Dental Materials Section, University of Granada, Colegio Máximo de Cartuja s/n, 18071 Granada, Spain; (M.T.); (S.A.); (J.A.B.-G.); (R.O.)
| | - Manuel Toledano-Osorio
- Faculty of Dentistry, Dental Materials Section, University of Granada, Colegio Máximo de Cartuja s/n, 18071 Granada, Spain; (M.T.); (S.A.); (J.A.B.-G.); (R.O.)
- Correspondence: ; Tel.: +34-958-243-789
| | - Franklin García-Godoy
- College of Dentistry, Health Science Center, University of Tennessee, 875 Union Avenue, Memphis, TN 381632110, USA;
| | | | - José A. Benítez-García
- Faculty of Dentistry, Dental Materials Section, University of Granada, Colegio Máximo de Cartuja s/n, 18071 Granada, Spain; (M.T.); (S.A.); (J.A.B.-G.); (R.O.)
| | - Raquel Osorio
- Faculty of Dentistry, Dental Materials Section, University of Granada, Colegio Máximo de Cartuja s/n, 18071 Granada, Spain; (M.T.); (S.A.); (J.A.B.-G.); (R.O.)
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15
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Kim JW, Seong TW, Cho S, Kim SJ. Randomized controlled trial on the effectiveness of absorbable collagen sponge after extraction of impacted mandibular third molar: split-mouth design. BMC Oral Health 2020; 20:77. [PMID: 32183831 PMCID: PMC7079387 DOI: 10.1186/s12903-020-1063-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 03/04/2020] [Indexed: 12/22/2022] Open
Abstract
Background The purpose of this study was to compare the effectiveness of absorbable collagen sponge insertion in tooth extraction sites for socket healing of the impacted mandibular third molar. Methods Thirty-six patients with bilateral mandibular impacted third molars based on Pell-Gregory and Winter classification were included in this study. This study was a randomized clinical trial utilizing a split-mouth design with one side assigned as collagen sponge insertion and the other side assigned as the control. Post-operative clinical complications, periodontal integrities, and radiographic outcomes were assessed at 1, 2, and 14-weeks post operatively. Results Five patients were excluded during the follow-up period due to loss of follow-up. The study was conducted on 31 patients in total. The mean VAS score of collagen sponge insertion side at 1 week post operation was 1.42 ± 1.26, which was significantly lower than the control side (P < 0.05). The mean probing depth of collagen sponge insertion side at 2-week post operation was 5.55 ± 2.28 mm, which was significantly lower than the control side (7.13 ± 1.86; P < 0.05). Other various measurements including radiographic outcomes showed no significant group differences. Conclusions Placement of collagen sponge after extraction of mandibular impacted third molar reduced early stage post-operative complications and enhanced initial healing of soft tissues and periodontal defects. Trial registration This study was retrospectively registered at the WHO ICTRP platform and Clinical Research Information Service, KCT0003363. Registered 21 Sep 2018.
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Affiliation(s)
- Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Tae-Whan Seong
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Sura Cho
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Sun-Jong Kim
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, South Korea.
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曹 畅, 王 菲, 王 恩, 刘 宇. [Application of β-TCP for bone defect restore after the mandibular third molars extraction: A splitmouth clinical trial]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2020; 52:97-102. [PMID: 32071470 PMCID: PMC7439054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Indexed: 11/13/2023]
Abstract
OBJECTIVE To evaluate the effect of bone defect regeneration and the periodontal status of the second molars after mandibular third molars extraction using β-tertiary calcium phosphate (β-TCP) in the test side compared with the spontaneously healed side. To the bone defect of mandibular second molars as a result of surgical removal of impacted mandibular third molars is a common phenomenon, many research shows that the mandibular second molars alveolar bone regeneration was about 1.5 mm and the periodontal pocket >7 mm was greater than 43.3% after mandibular third molars extraction. There has been significant progress researches in the repair of bone defect after the third molar removal, and bone graft filling was one of the effective methods. The bone graft substitutes include autogenous bone, allograft bone, xenograft bone and synthetic bone. METHODS A split mouth, randomized clinical study was designed. Fifteen patients with mandibular third molars in the same jaw planned to be extracted were enrolled in the study. One of the sockets of each patient was randomly selected and filled with easy-graftTMCLASSIC (test group). The contralateral socket was left to heal spontaneously (control group). cone beam computed tomography (CBCT) scans were performed the day after the extraction and after 6 months. The horizontal dimensional changes of the sockets were recorded. The newly formed bone volume in the bone was analyzed by CBCT, and the probing depth (PD) was recorded. Student's t test was used to evaluate the difference between the two groups for each parameter, and the P value lower than 0.05 was considered to be statistically significant. RESULTS Fifteen patients (30 sockets) completed the flow-up, and all the 30 sockets healed uneventfully. After 6 months' healing, the new bone volume fraction of the test group was 63.3%±2.2%, while the new bone volume fraction of the control group was 50.1%±1.9%. The vertical dimensional increment of the test group was (5.53±0.39) mm, while the vertical change of the control group was (1.53±0.27) mm. The distal buccal site PD of the second molar was (3.0±0.7) mm in the test group, and (6.5±0.8) mm in the control group. Statistically significant differences were detected between the two groups. CONCLUSION The randomized controlled clinical trial showed that the application of β-TCP for bone defect repair after the mandibular third molars extraction resulted in more vertical bone regeneration and less probing depth when compared with what was spontaneously healed.
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Affiliation(s)
- 畅 曹
- />北京大学口腔医学院·口腔医院,口腔颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 菲 王
- />北京大学口腔医学院·口腔医院,口腔颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 恩博 王
- />北京大学口腔医学院·口腔医院,口腔颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 宇 刘
- />北京大学口腔医学院·口腔医院,口腔颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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曹 畅, 王 菲, 王 恩, 刘 宇. [Application of β-TCP for bone defect restore after the mandibular third molars extraction: A splitmouth clinical trial]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2020; 52:97-102. [PMID: 32071470 PMCID: PMC7439054 DOI: 10.19723/j.issn.1671-167x.2020.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To evaluate the effect of bone defect regeneration and the periodontal status of the second molars after mandibular third molars extraction using β-tertiary calcium phosphate (β-TCP) in the test side compared with the spontaneously healed side. To the bone defect of mandibular second molars as a result of surgical removal of impacted mandibular third molars is a common phenomenon, many research shows that the mandibular second molars alveolar bone regeneration was about 1.5 mm and the periodontal pocket >7 mm was greater than 43.3% after mandibular third molars extraction. There has been significant progress researches in the repair of bone defect after the third molar removal, and bone graft filling was one of the effective methods. The bone graft substitutes include autogenous bone, allograft bone, xenograft bone and synthetic bone. METHODS A split mouth, randomized clinical study was designed. Fifteen patients with mandibular third molars in the same jaw planned to be extracted were enrolled in the study. One of the sockets of each patient was randomly selected and filled with easy-graftTMCLASSIC (test group). The contralateral socket was left to heal spontaneously (control group). cone beam computed tomography (CBCT) scans were performed the day after the extraction and after 6 months. The horizontal dimensional changes of the sockets were recorded. The newly formed bone volume in the bone was analyzed by CBCT, and the probing depth (PD) was recorded. Student's t test was used to evaluate the difference between the two groups for each parameter, and the P value lower than 0.05 was considered to be statistically significant. RESULTS Fifteen patients (30 sockets) completed the flow-up, and all the 30 sockets healed uneventfully. After 6 months' healing, the new bone volume fraction of the test group was 63.3%±2.2%, while the new bone volume fraction of the control group was 50.1%±1.9%. The vertical dimensional increment of the test group was (5.53±0.39) mm, while the vertical change of the control group was (1.53±0.27) mm. The distal buccal site PD of the second molar was (3.0±0.7) mm in the test group, and (6.5±0.8) mm in the control group. Statistically significant differences were detected between the two groups. CONCLUSION The randomized controlled clinical trial showed that the application of β-TCP for bone defect repair after the mandibular third molars extraction resulted in more vertical bone regeneration and less probing depth when compared with what was spontaneously healed.
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Affiliation(s)
- 畅 曹
- />北京大学口腔医学院·口腔医院,口腔颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 菲 王
- />北京大学口腔医学院·口腔医院,口腔颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 恩博 王
- />北京大学口腔医学院·口腔医院,口腔颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 宇 刘
- />北京大学口腔医学院·口腔医院,口腔颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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Efficacy of secondary closure technique after extraction of third molars: a meta-analysis. Br J Oral Maxillofac Surg 2019; 57:977-984. [PMID: 31540844 DOI: 10.1016/j.bjoms.2019.08.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 08/29/2019] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to assess the influence of two suture methods on the postoperative complications of extraction of mandibular third molars (M3M). We searched the MEDLINE (PubMed), Cochrane Library, and Web of Science databases until 18 May 2018 for randomised controlled trials (RCT) that evaluated the influence of any suture techniques on postoperative complications after the removal of impacted M3M. Pain, facial swelling, and trismus were measured for both the early stage (2-3 days) and late stage (5-7 days) after extraction. We identified 655 records, of which five were assessed for eligibility. All trials included had a moderate risk of bias. The analysis showed that the patients whose wounds had been closed primarily had significantly more pain than those whose wounds were closed secondarily (a wedge of mucosa) during the early stage (standardised mean difference (SMD), -0.49; 95% CI -0.71 to -0.27; P<0.0001) and the late stage (SMD -0.36; 95% CI -0.54 to -0.19; P<0.0001) after the removal of impacted M3M. Patients whose wounds were closed secondarily had less swelling (mm) at the postoperative early stage (SMD -1.12; 95% CI -1.57 to -0.66; P<0.00001) and late stage (SMD -0.51; 95% CI -0.68 to -0.33; P<0.00001). There was more trismus in the primary closure group than in the secondary group during both stages. Our findings suggest that secondary closure causes less pain, facial swelling, and trismus in both early and late stages of surgical removal of impacted M3M, and therefore it improves the quality of life by reducing postoperative discomfort.
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Camps-Font O, Caro-Bonfill C, Sánchez-Garcés MÀ, Gay-Escoda C. Periodontal Regenerative Therapy for Preventing Bone Defects Distal to Mandibular Second Molars After Surgical Removal of Impacted Third Molars: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Oral Maxillofac Surg 2018; 76:2482-2514. [DOI: 10.1016/j.joms.2018.07.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 07/22/2018] [Accepted: 07/22/2018] [Indexed: 12/15/2022]
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