Mandibular fractures: the influence of third molars

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This review of the effect of presences of third molars on mandibular fractures includes 35 observational studies. The findings suggest that the presence of third molars increases the change of mandibular angle fractures.

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Orthodontic extractions and third molar angulation

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This review of the effect of orthodontic extractions on the angulation of third molars included only 14 retrospective studies. This provides very low quality evidence of any effect

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Third molar removal: flap design and periodontal outcomes

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8 small RCTs were identified for this review of the effect of flap design on periodontal outcomes following third molar removal. The available evidence did not favour any particular flap design.

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Third molars: insufficient evidence for removal of impacted asymptomatic disease-free teeth

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This update of an earlier Cochrane review comparing retention or extraction of of asymptomatic disease-free impacted third molars only identified 2 studies of low to very low quality evidence providing insufficient evidence to inform practice.

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Third molar removal: antibiotics reduced risk of dry socket

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This review of antibiotic prophylaxis for the removal of third molars included 22 RCTs and suggest that antibiotic use lowered the infection risk by 60%. The number pf patients needed to treat to prevent one infection was 14 (95%CI;11-19).

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Third molars: single dose of preoperative antibiotic reduced infection

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10 RCTs were included in this review of preoperative antibiotics for removal of third molars. The use of antibiotics significantly reduced the odds of surgical site infection or alveolar osteitis (OR = 0.30; 95% CI, 0.19 to 0.47; P≤.00001)

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Prevalence of third molar impaction worldwide

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The worldwide prevalence of third molar impaction estimated from this review including 49 studies involving 83,484 individuals was 24.4% (95% CI;18.97% to 30.80%).

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Third molar removal – does piezoelectric surgery improve outcomes?

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This review of piezoelectric surgery for third molar removal included 9 studies, 6 of which were RCTs. The findings suggest that outcomes were better for piezoelectric surgery but these findings should be viewed cautiously.

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Dexamethasone reduced pain and swelling following third molar surgery

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This review included 8 RCTs involving a total of 476 patients and found that submucosal dexamethasone reduced postoperative pain and swelling. Although only one of the studies was at low risk of bias and there was a possibility of publication bias, the findings should be considered with caution.

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Available evidence for various aspects of surgical removal of third molars is very low to moderate

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The surgical removal of third molars (wisdom teeth) is one of the commonest operations performed. It is usually carried out because of infection associated with a partially erupted and impacted tooth. The aim of this update to a Cochrane review was to compare the relative benefits and risks of different techniques for undertaking various aspects [read the full story…]