RESUMEN
Several regeneration techniques and materials have been proposed for the healing of bone defects after surgical endodontic treatment; however, the existing literature does not provide evidence on the most recommended techniques or materials. The aim of the present systematic review and network meta-analysis (NMA) is to summarize the clinical evidence on the efficacy of guided tissue regeneration techniques (GRTs). The PRISMA recommendations were followed. Four databases were searched up to December 2021. Randomized clinical trials (RCTs) with a minimum follow-up of 6 months were included. The risk of bias was assessed using the Cochrane Collaboration tool. A fixed effects model and frequentist approach were used in the NMA. Direct GRT technique comparisons were combined to estimate indirect comparisons, and the estimated effect size of the comparisons was analyzed using the odds ratio (OR). Inconsistency was assessed with the Q test, with a significance level of p < 0.01, and a net heat plot. A total of 274 articles was identified, and 11 RCTs (6 direct comparisons of 15 techniques) were included in the NMA, which examined 6 GRT techniques: control, Os, PL, MB, MB + Os, and MB + PL. The MB + Os group compared to the control (OR = 3.67, 95% CI: 1.36-9.90) and to the MB group (OR = 3.47, 95% CI: 1.07-11.3) showed statistically significant ORs (p Ë 0.05). The MB + Os group presented the highest degree of certainly (P-score = 0.93).
RESUMEN
A study is made of 56 patients subjected to lower molar extraction, comparing the efficacy of the Akinosi technique as an alternative to direct or conventional mandibular nerve block in two groups of 28 subjects each. The parameters evaluated were pain in response to puncture, percentage positive aspiration, latency, pain during the intervention and complications. Patient pain in response to puncture was comparatively less intense and frequent with the Akinosi technique. The latency to anesthesia was briefer with conventional mandibular block than with the Akinosi technique (2.9 versus 3.8 minutes). Pain during the intervention and the duration of the anesthetic effect were similar for both techniques. The patients anesthetized with the Akinosi technique required more buccal nerve reinforcement infiltrations to complete the procedure. The anesthetic failure rates were 10.7% and 17.8% for the conventional and Akinosi technique, respectively. It is concluded that while the Akinosi technique can be used to extract lower molars, direct mandibular block offers superior anesthetic performance.