Impact of different anesthetic approaches on the outcomes of temporomandibular joint arthrocentesis: a systematic review.

PURPOSE: To assess the impact of different types of anesthesia on the outcomes of arthrocentesis of the TMJ. METHODS: Electronic databases were searched to identify peer-reviewed studies, followed by reference list search and further hand-searching. Randomized clinical trials and controlled studies were considered for inclusion when comparing at least two anesthetic approaches. The risk of bias was assessed using the Cochrane risk of bias tool. RESULTS: Of a total of 506 potentially eligible studies, only a randomized controlled clinical trial and an observational study were included. The former compared some outcomes of arthrocentesis under local and general anesthesia and the latter under sedation and general anesthesia. Moreover, both studies were judged as "high risk of bias." CONCLUSIONS: In general, there appears to be a slight trend toward better outcomes of arthrocentesis for internal TMJ derangements (Wilkes grades I to III) when performed under general anesthesia; however, given that the available evidence is remarkably limited and a high risk of bias was detected within the included studies, a definitive statement cannot be made.

Autologous platelet concentrates in extraction sockets for the prevention of osteoradionecrosis: a systematic review of controlled clinical trials.

This systematic review aimed to assess whether the use of autologous platelet concentrates immediately after tooth extraction would prevent ORN in patients treated with radiotherapy (RT) for head and neck cancer (HNC). MEDLINE, Embase, Ovid, Scopus, Web of Science, CENTRAL Cochrane, and OpenGrey databases were searched (up to, and including, June 2021) by two independent reviewers to identify studies, followed by further manual search. As inclusion and exclusion criteria for the studies, only controlled clinical trials (randomized or not) were considered. The risk of bias of each included study was assessed using the Cochrane Risk of Bias Tool. Of the 129 potentially eligible studies, only 2 were included, both randomized controlled clinical trials; however, one used platelet-rich plasma and another leukocyte- and platelet-rich fibrin. Overall, both autologous platelet concentrates had no effect on the outcome assessed. The use of autologous platelet concentrates seems not to be beneficial for ORN prevention following tooth extractions in HNC patients treated with RT; however, according to the available evidence, a reliable statement cannot be made.