This review comparing the effectiveness of articaine and lidocaine for lower third molar surgery included 14 RCTs. The findings suggest that articaine is superior to lidocaine for use in lower third molar however the available are small so additional larger high quality studies would be helpful to strengthen the evidence.
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This review of coronectomy versus extraction of third molars in patients at increased risk of inferior alveolar nerve (IAN) injuries included 42 observational studies. The findings indicate lower a reduction in the odds of IAN sensory loss in favour of coronectomy and an increase in the odds of surgical reintervention.
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This review of antibiotic prophylactic treatments in relation to the risk of developing dry socket (DS) and site-specific infection (SSI) after lower third molar extraction included 16 RCTs. Antibiotic did reduce the risk of DS and SSI in health patients but the number needed to treat (NNT) was high so the use should be considered only after a careful assessment of an individual patient’s risk.
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This review assess of listening to music to reduce preoperative anxiety and pain during third molar extractions included 5 RCTs. The findings suggest reducction in preoperative anxiety but the quality and number of studies is limited.
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This review and infection of dry socket after third molar surgery identified 58 RCTs of whihc 34 contributed to a meta-analyses. The findings indicated that metronidazle and amoxicillin did reduce infection but the findings were of low certainty.
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This review comparing the anaesthetic efficacy of intraosseous injection(IO) and conventional inferior alveolar nerve block (INAB) in mandibular third molar surgery included 4 small RCTs. The findings suggest no significant difference between IO and INAB techniques.
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This review of the effect of pre-emptive ibuprofen on post-operative pain after lower third molar surgery included 5 RCTs. Only one of the included studies was at low risk of bias so there is insufficient evidence to support the routine use of pre-emptive ibuprofen to reduce post-operative pain after lower third molar removal
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This review of the effectiveness of Er:YAG lasers in reducing pain, oedema and trismus compared to rotary instruments for the removal of impacted lower third molars included 6 small studies only one of which was at low risk of bias. The findings suggest a reduction in swelling and a small reduction in pain however the findings should be viewed cautiously because of the limited amount and quality of the evidence.
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This review of platelet-rich fibrin (PRF) to reducedpostoperative complications following lower third molar surgery included 6 RCTs.
The findings are consistent to other reviews finding that PRF derivative may lead to improvements in postoperative outcomes from third molar surgery but the amount of evidence is limited.
This review of the effectiveness of leukocyte-and platelet-rich fibrin (L-PRF) and advanced-platelet-rich fibrin (A-PRF) in mandibular third molar extraction included 10 RCTs. While the findings suggest some benefits the studies are small and limited in number so the findings should be interpreted cautiously.
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