The effect of salbutamol sulphate inhalation (an anti-asthmatic medication) on the surfaces of orthodontic Archwires.

OBJECTIVES: This study aimed to compare the surface roughness and friction of different orthodontic archwires after exposure to salbutamol sulphate inhalation, an anti-asthmatic medication. METHODS: Orthodontic archwires (stainless-steel [StSt], nickel-titanium [NiTi], beta-titanium [ß-Ti], and copper-NiTi [Cu-NiTi]) were equally divided into two groups. The exposed groups were subjected to 20 mg salbutamol sulphate for 21 days and kept in artificial saliva. The control groups were only kept in artificial saliva. Surface changes were visualized using scanning electron microscopy (SEM). The average surface roughness (Ra) was evaluated using atomic force microscopy (AFM), and friction resistance forces were assessed using a universal testing machine. Statistical analyses were performed using t-tests and ANOVA followed by post hoc tests. RESULTS: Salbutamol sulphate did not change the surface roughness of StSt and NiTi archwires (p > .05). However, the change in the surfaces of ß-Ti and Cu-NiTi archwires was significant (p < .001). The frictional forces of exposed StSt, NiTi, and Cu-NiTi archwires did not change (p > .05). However, the frictional forces of ß-Ti archwires increased significantly after exposure to salbutamol sulphate (p = .021). Brushing with fluoride after exposure to salbutamol sulphate increased the frictional forces of ß-Ti only (p = .002). CONCLUSIONS: Salbutamol sulphate inhalation significantly affected the surface texture of ß-Ti and Cu-NiTi orthodontic archwires and increased the friction of ß-Ti archwires. These deteriorating effects were not detected on the surface of StSt and NiTi archwires. Therefore, we suggest that ß-Ti and copper titanium archwires should be used cautiously in individuals under salbutamol sulphate inhalation treatment.

The Relationship between Maxillary Sinus Volume and Different Cephalometric Characteristics in Orthodontics.

Introduction: This study aimed to evaluate the maxillary sinus volume (MSV) in both genders in a Saudi sample and among different skeletal patterns. Materials and Methods: This retrospective cross-sectional study included 52 cone-beam computed tomography (CBCT) scans of 18 years or older individuals with complete dentition and healthy medical history. MSV was measured as the mean value of both sides in cubic millimeters (mm3) using OnDemand three-dimensional™ Dental. Cephalometric tracings were conducted on cephalograms obtained from CBCT scans. The beta, A × B, and Frankfort-mandibular plane angles were selected to determine the sagittal and vertical skeletal patterns of the study subjects. Descriptive statistics and other tests were conducted. The significance level was set at P < 0.05. Results: Fifty-two CBCT scans were included in this study (23 males and 29 females), with a mean age of 36 (±14) years. The mean MSV was 14887 (±5030.79) mm3. Males had statistically significantly larger MSV (16517 ± 5335 mm3) compared with females (13595 ± 4,452 mm3) (P = 0.036). There was no statistically significant difference in MSV among all other cephalometric measurements (P > 0.05). Conclusions: The MSV in the studied Saudi sample was larger among males. However, different skeletal patterns have no statistically significant differences in MSV.

Anthropometric and Cephalometric Facial Characteristics of Adult Saudi Patients with Skeletal Class III Malocclusions.

Objectives: We aimed to assess adult Saudi patients' facial anthropometry and cephalometric characteristics with skeletal Class III malocclusions compared to Class I malocclusion patients. Materials and Methods: Our cross-sectional study included a review of the orthodontic records of 108 patients: 54 patients with skeletal Class III malocclusions and 54 patients with skeletal Class I malocclusions, equally distributed between males and females. Using anthropometric landmarks, seven angular and eight linear measurements were recorded and compared between Class III and Class I patients. In addition, we compared three horizontal facial proportions and three horizontal neoclassical canons between the two groups. Finally, we used Student's t-tests to compare continuous variables and Chi-square tests for categorical variables. Results: Class III patients had significantly larger mandibular length, mandibular plane angle, mid- and lower-anterior face height, and posterior face height (P < 0.05) compared to Class I patients. Class III patients had significantly proclined upper incisors, retroclined lower incisors, and an obtuse interincisal angle (P < 0.05). The mouth: nose ratio differed significantly between skeletal Class III and I patients (P = 0.008). The orbital canon was valid in 14.8% of Class I and 9.3% of Class III patients, respectively. The orbitonasal proportion applied only to 31.5% and 20.4% of Class I and III patients, respectively. The naso-oral canon occurred in 18.5% and 1.9% of Class I and III patients, respectively. Conclusion: Saudis with Class III skeletal profiles have some distinctive Class III characteristics not observed in most other ethnic groups. The established horizontal facial proportions, neoclassical facial canons, and Class III skeletal profile did not apply to Saudis with skeletal Class I malocclusions, indicating that these proportions and characteristics may not be suitable as references when planning the surgical treatment for these patients.

Management of Concomitant Intrusion and Complicated Crown-Root Fracture Injury of Maxillary Central Incisors in a Child.

Dental intrusions are a severe type of injury because they impact the neurovascular supply of the tooth as well as the supporting tissues which predispose the tooth to necrosis and root resorption. Management of these injuries requires repositioning of the teeth under close monitoring to avoid complications. The management becomes more comprehensive when an intrusion is combined with other injuries, such as a crown-root fracture. This case report represents a 4-year follow-up of a child who suffered from a concomitant injury of intrusion and complicated crown-root fracture to the maxillary immature permanent central incisors. The management involved a multidisciplinary approach including endodontics, pedodontics, orthodontics, periodontics, and prosthodontics. Given the guidelines of dental trauma and the circumstances of the case, the fractured teeth were root canal treated, filled with a bioceramic plug and gutta-percha, and then restored with posts/cores and temporary crowns. The intrusion was managed initially by passive eruption followed by an active orthodontic eruption, after which the teeth were restored with permanent ceramic crowns. Throughout the course of treatment, the teeth showed no complications of root resorption or ankylosis, although one tooth developed a periapical infection which was managed by apical surgery. At the 4-year follow-up, the teeth revealed healthy periodontium and good esthetics.

Comparison of occlusal bite force distribution in subjects with different occlusal characteristics.

OBJECTIVE: To analyze bite force distribution in subjects with different occlusal characteristics. METHODS: This prospective study included 132 candidates (50 males, 82 females) seeking orthodontic treatment, who were divided into four groups based on Angle's classification of malocclusion. T-Scan® III Version 7.0 was used to record their relative distribution of bite forces, which were compared using gender, Angle's occlusal classification, overjet, overbite, space analysis, sagittal, and transverse skeletal relations variables. RESULTS: ANOVA revealed significant differences in posterior/anterior bite force ratios between sagittal dental and skeletal relationships, overjet, and overbite groups (p < 0.05). No significant difference was found between different space analysis and transverse relationship groups (p > 0.05) or between genders (p > 0.05). CONCLUSION: Subjects with Class III, decreased overjet and decreased overbite displayed higher bite force in posterior teeth compared to other groups. This feature must be considered when evaluating patients with dental and periodontal pathologies that might be affected by excessive tooth stress, especially in subjects with oral parafunctions and bruxism.

Factors influencing the orthodontic treatment plan in Class II malocclusion.

INTRODUCTION: This study aimed to investigate the influence of orthodontists' demographics and patient characteristics on the orthodontic treatment plan decision for borderline Class II Division 1 malocclusion in growing patients. METHODS: An electronic survey was distributed to orthodontists through the American Association of Orthodontists. Participating orthodontists were asked to select their preferred orthodontic treatment plan for 3 patients with borderline Class II Division 1 malocclusion. The survey also included questions about the patient-related factors contributing to the treatment decision for each patient. RESULTS: A total of 113 orthodontists completed the survey. United States-trained orthodontists were more likely to select growth modification and nonextraction relative to extraction (odds ratio, 3.50; 95% confidence interval, 1.01-12.12; odds ratio, 3.59; 95% confidence interval, 1.18-10.91, respectively). Clinicians with >15 years of experience were 72% less likely to prefer nonextraction relative to extraction in 1 patient and were 67% less likely to prefer growth modification relative to extraction in another patient. Working solely in private practice was associated with higher, but not statistically significant, odds of growth modification and nonextraction. The practice location was also associated with treatment plan decisions; however, findings were inconsistent between the patients. CONCLUSIONS: The orthodontist's experience, place of education, location, and type of practice appear to influence the preferred treatment plan for Class II malocclusion. Overall, the patient's profile and age were the most considered patient-related factors for growth modification, whereas the patient's profile, amount of crowding, and smile esthetics were the most considered factors for preferring extraction and nonextraction treatment modalities.

Oral myofunctional therapy for the treatment of temporomandibular disorders: A systematic review.

Objective: To investigate the role of oral myofunctional therapy for the treatment of temporomandibular disorders.Methods: A search of the literature was carried out looking for randomized controlled trials performed on humans and written in English, Italian, French, and Arabic.Results: Four randomized controlled trials were found and evaluated by using the Study Quality Assessment Tool of the National Institute for Health and Clinical Excellence.Oral myofunctional therapy was shown to be effective for the treatment of temporomandibular disorders, alone or associated with other treatments, in three out of four studies, with significant reduction of pain intensity when compared to other conservative treatments and no treatment.Discussion: Even though scientific evidence is weak, oral myofunctional therapy appears to be effective for the treatment of temporomandibular disorders with favorable cost-benefit and risk-benefit ratios.

Clinical manifestations of gastrointestinal diseases in the oral cavity.

AIM: In this review, several gastrointestinal diseases that dentists may encounter in practice are highlighted and discussed. MATERIALS AND METHODS: Using MEDLINE (PubMed), a comprehensive review of gastrointestinal diseases and their oral cavity manifestations was performed. RESULTS: Many gastrointestinal diseases present with oral symptoms that are detectable by dentists and dental hygienists. Often, oral manifestations of the disease may appear before systemic signs and symptoms. Managing patients with these conditions requires dentists to adjust their treatment and/or involve other health professionals. CONCLUSION: Care must be taken when providing periodontal therapy or dental implants to patients suffering gastrointestinal diseases who are at high risk of bleeding, infection, or malnutrition, for example. Also, pharmacological therapy for these patients may need to be customized.

Morphological features of Class I, II and III malocclusions of Saudi adolescents.

AIMS: This cross-sectional study compared and contrasted the morphological characteristics of Class I, II and III malocclusions in an adolescent Saudi population. METHODS: Adolescent Saudis with Angle's Class I, II and III malocclusions were selected from orthodontic patients' records. Angular and linear measurements were compared between the three groups. Cephalometric analysis was performed using the VistadentOC® software. Multifactorial ANOVA for angular and linear measurements between and within groups. RESULTS: Orthodontic records of 300 patients were included. There was no significant difference between and within groups in age and distribution of Angle's classification, p > 0.05. Multifactorial ANOVA showed that there were significant interactions between gender and malocclusions in skeletal, dental and soft tissue measurements, p < 0.05. There were significant differences in the sagittal and vertical skeletal measurements between groups, p < 0.05. The dental measurements were also significantly different in most of the measurements (p < 0.05). Moreover, there were significantly different readings among the groups in the soft tissue analysis. CONCLUSION: Morphological characteristics of adolescent Saudis show unique differences between gender and malocclusions, more so in Class III malocclusions. Class II and III malocclusions also show skeletal differences amongst the groups.

Mandibular symphysis dimensions in different sagittal and vertical skeletal relationships.

BACKGROUND: The aim of this cross-sectional study was to compare the dimensions of mandibular symphysis (MS) between gender and the different sagittal and vertical skeletal relationships. MATERIAL AND METHODS: Pre-treatment records of orthodontic patients were divided according to gender, sagittal (Class I, II and III) and vertical (decreased, average and increased mandibular plane [MP] angle) skeletal relationships. Measurements of MS parameters were performed on lateral cephalograms using IMAGEJ software. Comparisons between MS parameters and gender and the different skeletal relationships was performed using multifactorial and one-way ANOVA, and independent sample t-tests. RESULTS: A total of 104 records (25 males and 79 females) fulfilled the inclusion criteria. Males had significantly greater MS surface area, dentoalveolar length, skeletal symphysis length, total symphysis length, vertical symphysis dimension and symphysis convexity (p < 0.05). Skeletal Class II patients had significantly greater dentoalveolar and skeletal symphysis lengths while Class III had greater chin length, vertical symphysis dimension and symphysis convexity (p < 0.05). Patients with decreased vertical dimension had greater skeletal symphysis length (p = 0.026) and those with an average vertical relationship had greater chin length (p < 0.001). CONCLUSIONS: The morphology of the mandibular symphysis is affected by gender, sagittal and vertical skeletal patterns. Males had increased mandibular symphysis surface area and linear dimensions. Class II patients had greater dentoalveolar length. Chin length was greater in patients with an average MP angle.

Pulp volume changes after piezocision-assisted tooth movement: a randomized clinical trial.

BACKGROUND: Orthodontic treatment may result in undesirable side effects, such as root resorption and a decrease in the size of the pulp tissue which could be associated with the duration of the orthodontic treatment. Piezocision-assisted tooth movement was introduced as a minimally invasive surgical procedure to shorten orthodontic treatment time. This prospective randomized clinical trial was aimed to compare the pulp volume changes of maxillary anterior teeth after en-masse retraction with or without piezocision-assisted orthodontics. METHODS: Patients who required orthodontic treatment with bilateral maxillary first premolar extractions and en-masse retraction were recruited. Patients were randomly divided into extraction with piezocision, or only extraction, serving as controls. Pulp volume and root length changes of the maxillary six anterior teeth were measured and compared between the two groups using a 3-Dimensional analytical software. Paired and independent sample t-tests were used to compare within and between groups. Bivariate correlation was done between the mean change in pulp volume and its corresponding root length. The significance level was set at α = 0.05. RESULTS: A total of 23 patients were included, 12 in the piezocision, and 11 in the control group. At the end of the en-masse retraction phase, (mean = 122.74 ± 3.06 days) pulp volume was significantly decreased in all six anterior teeth in both groups (P < 0.01). The decrease in pulp volume was not statistically different between both groups, (P > 0.05). There was a statistically significant but moderate correlation only between the pulp volume change of the right canine and its root length, r = 0.44, P = 0.034. CONCLUSIONS: The effect of piezocision-assisted orthodontic tooth movement on the pulp volume was comparable to the conventional orthodontic treatment. The degree of change in pulp volume does not appear to be related to the amount of root resorption. Trial registration NCT03180151. Registered December 25, 2016, retrospectively registered, https://clinicaltrials.gov/ct2/show/record/NCT03180151 .

Tooth loss as a potential risk factor for deficient sleep: an analysis of a nationally representative sample of adults in the USA.

PURPOSE: Sleep deficiency is implicated as a risk factor for several systemic conditions. Loss of teeth has a profound effect on the individual's physiologic and psychologic health and quality of life. This study aimed to assess the association between tooth loss and sleep duration and determine if anterior and/or posterior tooth loss is a significant predictor. METHODS: A total of 22,483 individuals ≥ 18 years who participated in the United States National Health and Nutrition Examination Survey (NHANES) 2005-2016 cycles were included. Multinomial logistic regression adjusted for age, gender, race/ethnicity, smoking, diabetes, body mass index, socioeconomic level, education, alcohol, and depression was performed to examine the association between sleep duration and tooth loss. RESULTS: Compared to individuals with > 20 remaining teeth, those who were completely edentulous, had 1-10 or 11-20 teeth remaining were more likely to be in the deficient sleep category (OR [95% CI] = 1.59 [1.35-1.87], 1.29 [1.07-1.54], and 1.26 [1.11-1.43], respectively). When the numbers of both missing anterior and posterior teeth were entered in the model, only posterior teeth were significant. There was a 4% increase in the odds of being in the deficient sleep category for each missing posterior tooth (OR [95% CI] = 1.04 [1.02-1.05]). CONCLUSIONS: Tooth loss was significantly associated with deficient sleep and posterior tooth loss appeared to be the main contributor. Although further research is needed to clarify the nature of this association, our results suggest that improving oral health might have an impact on overall health and quality of life.

Depression is related to edentulism and lack of functional dentition: An analysis of NHANES data, 2005-2016.

OBJECTIVE: Depression and tooth loss are significant health problems that affect individuals' functionality and quality of life. Comorbidity between depression and oral diseases has been reported. The aim of this study was to investigate the association between depression and tooth loss in a US representative adult sample. METHODS: This study included data from 22,532 adults ≥18 years by combining six 2-year cross-sectional cycles of the National Health and Nutrition Examination Survey (NHANES) administered between 2005 and 2016. Data were analyzed using descriptive statistics and multinomial logistic regression adjusted for gender, age, race/ethnicity, smoking, education, socioeconomic status, body mass index, diabetes, and alcohol intake. RESULTS: Of the total sample, 4.5 percent were edentulous, 10.3 percent were lacking functional dentition (1-19 remaining teeth) and 85.2 percent had functional dentition (≥20 remaining teeth); among whom, the prevalence of depression was 12.4, 11.7, and 5.9 percent, respectively. Compared to individuals without depression, those with depression were more likely to be edentulous or lacking functional dentition versus having functional dentition (adjusted odds ratios (95% CI): 1.48 (1.16-1.89) and 1.43 (1.18-1.75), respectively). CONCLUSIONS: Depression was associated with edentulism and a lack of functional dentition. Further longitudinal and interventional studies are needed to elucidate the nature and direction of the relationship between depression and tooth loss.

Effect of piezocision corticotomy on en-masse retraction.

OBJECTIVES: To compare the amount of en-masse retraction with or without piezocision corticotomy, to assess the type of tooth movement, to evaluate root integrity after retraction, and to record reported pain levels. MATERIALS AND METHODS: This randomized, controlled clinical trial included 26 orthodontic patients requiring premolar extraction. The patients were divided into two groups: (1) an extraction with piezocision corticotomy group (PCG) and (2) an extraction-only group, which served as the control group (CG). Cone-beam computed tomography images were acquired before and 4 months after the initiation of en-masse retraction utilizing miniscrews. The following variables were assessed: the amount of en-masse retraction, incisor inclination, incisor and canine root resorption, and patient-reported pain. RESULTS: Twelve and 11 participants completed the entire study in the PCG and CG, respectively. The amount of en-masse retraction was significantly greater in the PCG compared to the CG (mean = 4.8 ± 0.57 mm vs 2.4 ± 0.33 mm, respectively [P < .001]). There was also significantly less tipping and root resorption of incisors in the PCG (P < .05). The reported pain was significantly higher on the first day in the PCG compared to the CG (P < .001); however, it became similar between the groups after 24 hours. CONCLUSIONS: Piezocision corticotomy enhanced the amount of en-masse retraction two times more with less root resorption. However, future studies are required to assess the long-term effects of this technique.

Occlusion time, occlusal balance and lateral occlusal scheme in subjects with various dental and skeletal characteristics: A prospective clinical study.

OBJECTIVES: To analyse occlusion time, occlusal balance and lateral occlusal scheme in subjects with various dental and skeletal characteristics. METHODS: A total of 132 subjects (50 males and 82 females) seeking orthodontic treatment were included in this prospective study. Using the T-Scan III version 7.0 (Tekscan Inc, South Boston, MA, USA), the occlusion time, occlusal balance and lateral occlusal schemes were recorded and compared with gender, Angle's occlusal classification, overjet, overbite, space analysis, skeletal and transverse relations. ANOVA, t test and contingency tables analyses were performed. Statistical significance was set at P < .05. RESULTS: Occlusion time was significantly shorter in subjects with balanced occlusion (0.18 seconds, P < .001), Class I normal occlusion (0.35 seconds, P = .028) and Class I skeletal profile (0.37 seconds, P = .002). Occlusion time was significantly longer in subjects with decreased overjet (0.60 seconds, P = .003). There were significant associations between the distribution of occlusal balance and Angles' classes of occlusion, skeletal relationship, overjet, overbite and space analysis (P < .05). Lateral occlusal schemes were only associated with Angle's classes of occlusion and skeletal relationship (P < .05). CONCLUSIONS: Patients with Class I occlusion showed the least occlusion time, the most balanced occlusion and a higher frequency of canine guidance. Nonetheless, potentially balanced occlusion and group function were highly prevalent in all groups; therefore, ideal occlusion must be considered an ideal to inspire and aim for, but cannot be considered an essential requirement of every dental treatment.

Anatomical consideration for optimal position of orthodontic miniscrews in the maxilla: a CBCT appraisal.

BACKGROUND: Orthodontic miniscrews are commonly used as temporary anchorage devices. Bone thickness and bone depth are important factors when placing miniscrews. There are no studies to assess the maxillary bone thickness for optimum miniscrew placement in a Saudi population. OBJECTIVE: Assess the proximity of the maxillary sinus and nasal cavity in areas where miniscrews are usually inserted using cone beam computed tomography (CBCT). DESIGN: Retrospective, cross-sectional. SETTING: Department of maxillofacial radiology in a Saudi dental school. PATIENTS AND METHODS: Using CBCT images, we measured the distance between the maxillary sinus and nasal cavity to the palatal bone, buccal intra-radicular and infrazygomatic crest areas. Mean values (SD) were compared at various locations, including by gender, and correlation with age was calculated. MAIN OUTCOME MEASURE: Mean bone thickness at commonly used sites for orthodontic miniscrew placements in the maxilla. Secondary outcome was the insertion angle in the infrazygomatic crest area. SAMPLE SIZE: CBCT images of 100 patients (50 males and 50 females). RESULTS: The mean (standard deviation) age for the sample was 25.4 (6.5) years with no significant difference between males and females. In the palate, the distance to the nasal cavity and maxillary sinus was greater anteriorly and decreased significantly posteriorly (P<.001). Buccally, the interdental bone depth was significantly greater between the second premolar and first molar (11.96 mm) compared to between the central and lateral incisors (7.53 mm, P<.001). The mean bone thickness of the infrazygomatic crest area at a 45° insertion angle was 4.94 mm compared to 3.90 at a 70° insertion angle (P<.001). No correlation was found between age and bone thickness. CONCLUSION: The distance to the nasal cavity and maxillary sinus was greater in the anterior than posterior areas. There is minimal risk of injuring the maxillary sinus or nasal cavity using the buccal approach. Caution is needed when placing miniscrews in the infrazygomatic crest area. LIMITATIONS: Cross-sectional study from one center; hence, findings cannot be generalized to other populations. CONFLICT OF INTEREST: None.

Granulomatous diseases: Oral manifestations and recommendations.

Granulomatous diseases may present with oral manifestations that are detectable by dental care providers. In certain cases, oral manifestations may precede systemic signs and symptoms. Dentists managing patients with these conditions may modify the dental treatment plan and possibly retain the support of other health professionals. This review gives an update on granulomatous diseases that can be faced by the dental practitioner.

Prevalence and morphological variations of maxillary sinus septa in different age groups: a CBCT analysis.

BACKGROUND: There are limited data from Saudi Arabia on the prevalence and characteristics of maxillary sinus septa. OBJECTIVE: Determine the prevalence and morphological characteristics of septa in the maxillary sinus and their relationship to gender and age using cone beam computed tomography (CBCT). DESIGN: Cross-sectional SETTING: CBCT images acquired from the maxillofacial radiology department in a dental school. PATIENT AND METHODS: CBCT scans of 1010 maxillary sinuses from 505 patients were analyzed to determine the prevalence, location, type, and orientation of maxillary sinus septa. Descriptive statistics, chi-square tests and t tests were used to analyze the data. MAIN OUTCOME MEASURES: The prevalence, location, type, and orientation of maxillary sinus septa. SAMPLE SIZE: 1010 sinuses from 505 patients. RESULT: Approximately 46% of the studied patients had maxillary septa, which were present in 370 (37%) sinuses. About 64% of the septa were present on the right side and 85.7% of all septa were mediolater-ally oriented. The mean height of the septa was 6.06 mm (0.84) in the right sinuses and 5.70 mm (0.93) in the left sinuses. Multiple septa were found in 101 patients (20%). Among males, 58.5% had septa compared to 34% of females (P<.001.) A significant positive association was found between age and the presence and number of septa, P<.001. CONCLUSIONS: Maxillary sinus septa were highly prevalent with various heights and directions among the studied sample. Careful assessment of different anatomic variation must be conducted prior to any maxillary sinus augmentation, particularly in older patients. LIMITATIONS: Cross-sectional evaluation of CBCT images from one dental school patient population; thus, the findings cannot be generalized to other populations. CONFLICT OF INTEREST: None.

Efficacy and safety of acetaminophen and caffeine for the management of acute dental pain: A systematic review.

AIM: Because the use of non-steroidal anti-inflammatory drugs and opioids has several restrictions, this review evaluates the efficacy and safety of acetaminophen and caffeine for the management of dental pain. METHODS: A search of the literature was carried out looking for randomized controlled trials on the use of acetaminophen and caffeine for the management of dental pain, performed on humans and written in English, Italian, French or Arabic languages. The following databases were searched: PubMed, The Cochrane Central Register of Controlled Trials (CENTRAL), Ovid Medline and Scopus. RESULTS: Three controlled clinical trials were retrieved and evaluated by using the Study Quality Assessment Tool of the National Institute for Health and Clinical Excellence. CONCLUSION: The use of acetaminophen and caffeine appears to be effective in achieving good control of acute dental pain compared to placebo and other analgesic medications, but clinical recommendations cannot be made for the limited number of studies assessed.