Comparison of suture and sutureless techniques on postoperative complications after third molar surgery: a systematic review.

OBJECTIVE: To compare, among patients undergoing third molar surgeries, whether the use or omission of sutures improves postoperative clinical parameters. METHOD: A systematic literature review was conducted to identify randomized clinical trials in humans. The steps of this review were conducted following the PRISMA protocol. The risk of bias assessment was performed using the revised Cochrane tool (RoB 2). The RevMan software was employed for meta-analyses, and the quality of evidence was evaluated using GRADE. RESULT: A total of seven articles were included in the systematic review; however, only one article quantitatively measured bleeding, rendering meta-analysis for this outcome unfeasible. The group of patients in whom sutures were not used presented lower pain and edema on the first day (respectively: MD - 1.08; 95% CI - 1.35 to - 0.81; MD - 1.23; 95% CI - 2.34 to - 0.11) and second day (respectively: MD - 0.50; 95% CI - 0.83 to - 0.17; MD - 10.66; 95% CI - 1.16 to - 0.16) postoperatively, compared to the group where sutures were employed. The group of patients who received sutures exhibited increased trismus on the first day postoperatively (MD 1.04; 95% CI 0.67 to 1.41). CONCLUSION: The omission of postoperative sutures in third molar surgeries appears to favor pain and edema outcomes within the first 24 h after the procedure, as well as trismus within the same timeframe. CLINICAL RELEVANCE: Despite the suture being the standard conduct in tooth extractions. The omission of sutures in third molar extractions may favor inflammatory outcomes of pain, edema, and trismus in the immediate postoperative period.

Effectiveness of Cyanoacrylate in the Treatment of Dentin Hypersensitivity: A Systematic Review.

Objective: To compare the effectiveness of cyanoacrylate to other treatments or placebo in the management of dentin hypersensitivity (DH). Materials and Methods: The present review was organized based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. The search aimed to answer the following question: is cyanoacrylate effective in the treatment of DH when compared to other treatments or placebo? The following databases were used: PubMed/MEDLINE, Scopus, BVS, Web of Science, Cochrane, Clinicaltrials.gov, Portal Periódicos Capes, Google Scholar, and manual search. The evaluation process started with the information collected from the selected articles according to the Consolidated Standards of Reporting Trials (CONSORT). Results: Two randomized and five nonrandomized clinical trials were analyzed in the qualitative synthesis. The studies presented different cyanoacrylate formulations, different scales for evaluating pain, and different methods for provoking a painful stimulus. Cyanoacrylate-based products reduce DH in shorter follow-up periods and this reduction persisted throughout the study. The results varied according to the methods used to stimulate the pain. Only two articles showed a low risk of bias and a high level of scientific evidence. Conclusion: Although there is a limited number of studies in the scientific literature with appropriate methodological quality, the available evidence proves the effectiveness of cyanoacrylate in the treatment of DH. Clinical Relevance. Cyanoacrylate is easy to access, effective, easily applicable, and a low-cost product with satisfactory results.