What is the risk of future extraction of asymptomatic third molars? A systematic review.

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.

Corticosteroids decrease pain, swelling and trismus.

Data Sources: PubMed, Scopus, Medline and Cochrane Oral Health Group's Trials Register, CENTRAL. Limited to English language.

Study Selection: Randomised control trials comparing preoperative steroids (in any formulation, dose or route) with placebo or no treatment in patients of any age, having extraction of one or more impacted third molars (under local or general anaesthesia or with intravenous sedation).

Buprenorphine therapy: an increasing challenge in oral and maxillofacial surgery.

Suboxone is a 4:1 mixture of buprenorphine and naloxone and Subutex is buprenorphine alone. The high affinity μ-receptor binding of buprenorphine (Suboxone and Subutex) renders other opioids ineffective. Inadequate procedural sedation, inadequate analgesia, and significant drug interactions complicate the treatment of patients taking Suboxone or Subutex.

Radiographic tips on predicting inferior alveolar nerve exposure.

Subjects: The study included 230 patients (60% female) with a total of 423 wisdom tooth extractions. The patients were treated by 2 oral surgeons between July 1998 and July 2002 in the Oral and Maxillofacial Surgery Unit of the Massachusetts General Hospital in Boston, Massachusetts.

Gold Standard: The authors reported that the extraction was inspected for evidence of inferior alveolar nerve (IAN) exposure under direct vision using a headlight.

The relationship of denosumab pharmacology and osteonecrosis of the jaws.

Denosumab is a new bone antiresorptive agent that has received approval by the Food and Drug Administration for use in patients with osteoporosis and metastatic cancer to the bones. Like the bisphosponates that are used as antiresorptive medications, denosumab has been associated with osteonecrosis of the jaws (ONJ). However, because the pharmacodynamics and pharmacokinetics of denosumab differ from that of the bisphosphonates, ONJ related to denosumab may resolve more rapidly with a drug holiday than bisphosphonate-related osteonecrosis of the jaws (BRONJ).

Laryngeal mask airways have a lower risk of airway complications compared with endotracheal intubation: a systematic review.

Purpose: The purpose of the present study was to determine whether, in patients undergoing general anesthesia, those provided with a laryngeal mask airway (LMA) have a lower risk of airway-related complications than those undergoing endotracheal intubation.

Materials And Methods: A systematic review of randomized prospective controlled trials was done to compare the risk of airway complications with an LMA versus an endotracheal tube (ETT) in patients receiving general anesthesia. Two independent reviewers identified 29 randomized prospective controlled trials that met the predetermined inclusion and exclusion criteria.

Open reduction with internal fixation of moderately displaced mandible fractures is not a cost-effective alternative to closed reduction with maxillomandibular fixation.

Article Title And Bibliographic Information: Do the benefits of rigid internal fixation of mandible fractures justify the added costs? Results from a randomized controlled trial. Shetty V, Atchison K, Leathers R, Black E, Zigler C, Belin TR. J Oral Maxillofac Surg 2008;66(11):2203-12.

Off-label use of recombinant human bone morphogenetic protein-2 (rhBMP-2) for reconstruction of mandibular bone defects in humans.

Purpose: The off-label use of recombinant human bone morphogenetic protein-2 (rhBMP-2) for the treatment of mandibular bone defects was evaluated in 5 patients. The rhBMP-2 was used as an alternative to autogenous bone grafting.

Patients And Methods: A total of 5 patients had mandibular defects reconstructed with rhBMP-2, 1.

Walker repair of the temporomandibular joint: a retrospective evaluation of 117 patients.

Purpose: This study evaluated the outcome of a high condylar shave with meniscal repositioning (Walker repair) in patients with internal derangement of the temporomandibular joint (TMJ). Changes in incisal opening, pain level, chewing ability, and preoperative TMJ symptoms (tinnitus, vertigo, and crepitus) were evaluated.

Patients And Methods: A retrospective evaluation of 202 patients undergoing the Walker repair was completed using a questionnaire.

Prevention of alveolar osteitis with chlorhexidine: a meta-analytic review.

Objective: The objective of this study was to assess if chlorhexidine (CHX) rinse decreases the occurrence of alveolar osteitis (AO) following third molar removal.

Study Design: A literature search identified 7 randomized prospective clinical trials reporting incidence of AO following removal of mandibular third molars. Studies were combined into 2 groups and summary relative risks were calculated for each group.

A comparative study of 2 imaging techniques for the diagnosis of condylar fractures in children.

Purpose: We sought to compare the sensitivity and specificity of panoramic radiographs with those of coronal computed tomography (CT) scans in the diagnosis of mandibular condylar fractures in the pediatric population.

Methods: Medical, dental, and radiographic records of patients who presented between 1995 and 2000 were evaluated for injuries involving the mandibular condyle. The sample included 22 males and 15 females with ages ranging from 2 to 15 years (mean, 8 years).

Venous cannulation and topical ethyl chloride in patients receiving nitrous oxide.

The purpose of this study was to evaluate the effect of ethyl chloride spray on the anxiety and pain associated with placing an intravenous catheter in patients sedated with nitrous oxide. Eighty-eight patients scheduled for dental surgery with a combination of intravenous and nitrous oxide sedation were randomly assigned to have ethyl chloride spray or a placebo, water spray, applied before cannulation of a vein. Anxiety and pain were reported using a 10.

Comparing efficacy and safety of four intravenous sedation regimens in dental outpatients.

Background: Management of patients' fear and anxiety during dental treatment is a primary concern of dental practitioners. Pharmacological strategies used in outpatient dental settings must be both safe and effective. Regimens of intravenously administered sedative drugs were evaluated in a collaborative, multicenter study of outpatients undergoing removal of impacted third molars.

Lingual flap retraction and prevention of lingual nerve damage associated with third molar surgery: a systematic review of the literature.

Objective: Lingual nerve damage sometimes occurs after the removal of third molars. The use of a lingual retractor has been advocated to protect the lingual nerve. A systematic review of the literature was undertaken to evaluate the incidence of lingual nerve damage after third molar surgery and the effect of a lingual retractor on nerve damage.