Use of Photobiomodulation to Reduce Postoperative Pain, Edema, and Trismus After Third Molar Surgery: A Systematic Review and Meta-Analysis.

PURPOSE: Third molar extraction can cause surgical trauma, which is associated with pain, edema, trismus, and functional limitations. The aim of the present systematic review was to investigate the effects of photobiomodulation (PBM) following the extraction of impacted mandibular third molars. METHODS: An electronic search was conducted in 10 databases from inception up to October 2021 and the grey literature, with no restrictions regarding language or year of publication. Randomized controlled clinical trials (RCT) were included. Studies that were not RCTs were excluded. Reviewers independently analyzed titles and abstracts, followed by full-text analysis. This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The exposure variable was the use of PBM and the outcomes were pain, edema, and trismus. Meta-analysis was performed using a random-effects model. The estimate was calculated considering standardized mean differences (SMD) and respective 95% confidence intervals (CI) obtained for each outcome on the first, second, third and seventh postoperative days. The level of evidence was assessed using the GRADE approach. RESULTS: The search resulted in the 3,324 records. Thirty-three RCTs were included in the systematic review and 23 of these were included in the meta-analyses. The studies involved a total of 1,347 participants (56.6% female and 43.4% male) between 16 and 44 years of age. A greater reduction in pain was found in the PBM group compared to the control group on the third postoperative day (SMD: -1.09; 95% CI: -1.63; -0.55; P < .001; low certainty). Edema was discretely lower in the PBM group on the second postoperative day (SMD: -0.61; 95% CI: -1.09; -0.13; P < .001; low certainty) and trismus was discretely lower in the PBM group on the seventh postoperative day (SMD: 0.48; 95% CI: 0.00; 0.96; P < .001; very low certainty). CONCLUSION: The evidence of the effect of PBM regarding the control of pain, edema, and trismus following third molar extractions is low or very low.

Prevalence of second molar external root resorption caused by mandibular third molars: a CBCT study.

The aims of this study were to use cone beam computed tomographic (CBCT) scans to assess the prevalence of second molar external root resorption (ERR) caused by impacted mandibular third molars and to associate the location and severity of ERR with the third molar position using 2 classification systems-1 proposed by Pell and Gregory and the other proposed by Winter. In this cross-sectional study, 2 calibrated observers evaluated a total of 107 CBCT scans (71 female and 36 male patients). After the presence or absence of ERR was determined, ERR was classified according to its location (cervical, middle, apical third, or root apex) and severity (mild, moderate, or severe resorption). The data were assessed with the Pearson chi-square test, the chi-square test for linear trend, and Poisson regression analysis. The significance level was set at P < 0.05. The prevalence of second molar ERR in the sample as a whole was 47.7% (n = 51). The prevalence was significantly higher (69.4%) for male patients (P = 0.002; Pearson chi-square test). The probability that ERR would affect the second molar was 1.71 times greater when the third molar exhibited the Pell and Gregory class IC position (95% CI, 1.27-2.31) and 1.64 times greater when the third molar exhibited the Winter mesioangular position (95% CI, 1.38-1.95). There was a statistically significant association between ERR location and severity; the cervical third was the most affected by mild ERR and the middle third was the most affected by severe ERR. The prevalence of mandibular second molar ERR caused by impacted third molars is high, especially in male patients. Mandibular third molars in the Pell and Gregory class IC position or Winter mesioangular position demonstrated greater potential to result in ERR of the adjacent second molar.

Occurrence of bruxism in individuals with autism spectrum disorder: A systematic review and meta-analysis.

AIMS: To investigate bruxism in individuals with autism spectrum disorder (ASD) and neurotypical individuals. METHODS AND RESULTS: Searches were conducted in the MedLine via Ovid, Embase via Ovid, Cochrane Database of Systematic Reviews, Scopus, Web of Science, Latin American and Caribbean Health Sciences (LILACS), Brazilian Library of Dentistry (BBO) and SciELO databases, grey literature and a hand search up to December 2020 with no restrictions imposed regarding language or year of publication (CRD42020211307). For the meta-analysis, the frequency of bruxism was extracted, with the calculation of odds ratios (OR) and 95% confidence intervals (CI) using a random effects model in RevManager. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Seventeen case-control studies were included in the qualitative synthesis and 15 were included in the meta-analysis, totaling a population of 3850 individuals. The ASD group was more likely to develop bruxism than the controls (OR: 3.80; 95% CI: 2.06-7.01). The certainty of the evidence was classified as "very low" for the occurrence of bruxism between ASD and control individuals. CONCLUSION: It is uncertain whether individuals with ASD are more likely to have bruxism than healthy controls.

The influence of facial types on the morphology and location of the greater palatine foramen: a CBCT study.

OBJECTIVE: This study aimed to assess the morphology and location of the great palatine foramen (GPF) of different facial types using cone beam computed tomography (CBCT) scans. METHODS: Sixty CBCT scans were divided into: brachyfacial (n = 20), dolichofacial (n = 20) and mesofacial (n = 20) using Ricketts' VERT index for the determination of cephalometric facial type and imported into ImageJ software. GPF shape was characterized as: round, elongated in the anteroposterior direction (EAP), or elongated in the latero-medial direction (ELM). The distances between the GPF and the palatine suture (PS), the center of the GPF and the center incisive foramen (IF), the GPF and the palatine alveolar ridge (PAR), right side GPF (GPFr) and left side (GPFl) GPFs; and the angles formed from the intersection of the GPF, IF and PS were assessed. The position of the GPF was evaluated in relation to the molars. RESULTS: GPFr and GPFl mean distances from PAR presented higher values for dolichofacial patients (p < 0.05). GPFr and GPFl location distally to the third molar (3 M) was higher for brachyfacial type, while their location distally to the second molar was higher for mesofacial and between the mesial and distal surfaces of the 3 M for dolichofacial (p < 0.05). CONCLUSIONS: The GPF was more distant from the PAR in the dolichofacial-type group. The location of the GPF in relation to the molars varied according to the facial type. However, the morphology of the GPF was similar in the three facial types, and the elongated in the anteroposterior direction morphology was more frequent.

Mandibular canal bifurcation and trifurcation: case report from a finding obtained through cone beam computed tomography / Bifurcação e trifurcação do canal mandibular: relato de caso a partir de um achado em tomografia computadorizada de feixe de cone

Aim: This case report aims to demonstrate a rare mandibular canal (MC) variation, presenting right trifurcation and left bifurcation through Cone-Beam Computed Tomography (CBCT). Case report: A 26-year-old female patient with no systemic disorders was referred for surgical removal of the lower third molars due to the presence of painful symptoms. CBCT was requested to evaluate the relationship between third molars and the mandibular canal and to guide the surgical planning. Tomographic volume was analyzed through the Sidexis software (Sirona Dental Systems, Bernsheim, Germany). During the analysis of tomographic sections, it was possible to observe the presence of bilateral MC variations. Bifurcation of the right MC and trifurcation of the left MC were observed. Conclusion: The present report highlighted the importance of CBCT for the diagnosis of anatomical changes, such as MC trifurcation.

Objetivo: Este relato tem por objetivo descrever uma rara variação do canal mandibular (CM) apresentando trifurcação direita e bifurcação esquerda, por meio da Tomografia Computadorizada de Feixe Cônico (TCFC). Relato do caso: Paciente do sexo feminino, 26 anos de idade, sem comprometimento sistêmico, foi encaminhada para remoção cirúrgica dos terceiros molares inferiores devido a presença de sintomatologia dolorosa. Foi solicitada uma TCFC para avaliar a relação entre terceiros molares e o canal mandibular, para orientar o planejamento cirúrgico. O volume tomográfico foi analisado por meio do software Sidexis (Sirona Dental Systems, Bernsheim, Alemanha). Durante a análise dos cortes tomográficos, foi possível observar a presença de variações do CM bilateralmente. Observou-se bifurcação do CM direito e trifurcação do CM esquerdo. Conclusão: O presente relato destacou a importância da TCFC para o diagnóstico das alterações anatômicas, como a trifurcação do canal mandibular.

Laser therapy as treatment for oral paresthesia arising from mandibular third molar extraction.

Oral paresthesia is a localized condition of sensory abnormality that occurs in the presence of injury in one of the nerves in the region after certain dental procedures. The aim of this study was to present a case report of a patient who received low-level laser therapy as treatment for inferior alveolar nerve paresthesia due to mandibular third molar extraction surgery. A 25-year-old female patient reported lack of sensitivity for 6 months in various regions of the bucomaxillofacial complex after surgery. Laser therapy (808 ± 10nm, 100 mW, 3J per point and 30 seconds per point) was indicated twice a week. The degree of sensitivity was evaluated using a Visual Analog Scale (VAS) and with the aid of a microbrush. Prior to laser therapy, the patient reported VAS = 10, i.e., total lack of sensitivity. After 72 hours of the first session, the patient reported improvement of sensitivity in the chin (VAS = 5) and oral regions (VAS = 5), reporting recovery of sensitivity and that the area of paresthesia decreased. After 8 sessions, the patient reported total recovery of sensitivity in the chin, oral and gum regions (VAS = 0), with paresthesia being limited only to the left lower lip region and below it. After 26 sessions, the patient reported recovery of sensitivity in all affected regions (VAS = 0), with positive responses to the brush touch. Within the parameters used, laser therapy was effective in the treatment of inferior alveolar nerve paresthesia after third molar tooth extraction. Key words:Lasers, paresthesia, oral surgery, low-level laser therapy.

Signs of the proximity of third molar roots to the mandibular canal: an observational study in panoramic radiographs.

The objectives of this study were to assess the relationship between mandibular third molars and the mandibular canal, establishing which radiographic signs are most prevalent in predicting contact between these structures, and to associate these signs and the proximity with the position of the third molar according to the classifications of Pell & Gregory and Winter. A retrospective, cross-sectional observational study was carried out on panoramic radiographs. From a dataset of 3289 images, a convenience sample of 1548 panoramic radiographs with a total of 2639 third molars was selected for evaluation. The inclusion criteria were patients of both sexes who had at least 1 totally formed mandibular third molar that was adjacent to a second molar. Radiographs were excluded if they were of poor quality or revealed evidence of cystic or tumoral processes or extensive caries. Seven radiographic signs were used to determine if there was contact between the third molar and mandibular canal. A proximity to the mandibular canal was verified for 1677 (63.5%) of 2639 third molars. The most frequent radiographic signs of proximity were darkened roots (767 teeth [29.1%]) and discontinuity of the mandibular canal (757 teeth [28.7%]). Third molar/mandibular canal proximity was found significantly more frequently in female patients and in patients aged 24 years and younger (P < 0.001). The tooth positions most frequently associated with proximity between the third molar and the mandibular canal were position C (highest point of the third molar located at or below the cervical margin of the second molar) and the mesioangular position (long axis of the third molar angled mesially toward the second molar).

Brazilian Scientific Research about Acupuncture in Dentistry: Bibliometric Analysis of the Papers Presented at SBPqO Meetings / A Pesquisa Científica Brasileira Sobre Acupuntura na Odontologia: Análise Bibliométrica dos Trabalhos Apresentados nas Reuniões da SBPqO

The aim of this study was to investigate the Brazilian scientific production about acupuncture in dentistry, outlining the profile of the works about the subject presented at the Meetings of the Brazilian Society of Dental Research (SBPqO). It was a cross-sectional study, with a quantitative approach, based on secondary data. An analysis of all abstracts presented in the last ten SBPqO Meetings (2009-2018) published in the annals of the event was carried out. For the research the location of the term "acupuntura" or "acupuncture" among the abstracts was realized and the following information was collected: type of institution that carried out the research (public or private), Brazilian region where it was realized, area or specialty of dentistry and whether it involved humans or animals. Of the 26,514 dental research abstracts published in the annals, only 27 papers were experimental studies or systematic reviews about the subject. Of the total, 23 (85.2%) were developed in public institutions, 15 (55.6%) did not receive financial support 20 (74.1%) were carried out in humans and 13 (48.2%) were developed in the Southeast region. Regarding the dental specialty, the majority (70.4%) investigated acupuncture in "Temporomandibular Dysfunction and Orofacial Pain". Therefore, it can be concluded that few acupuncture studies in dentistry have been developed in the last ten years in Brazil, according to the papers presented at the SBPqO Meetings. Thus, it is suggested that research on the subject be carried out and widely disseminated between the academic and professional milieu. (AU)

O objetivo desse estudo foi investigar a produção científica brasileira sobre a acupuntura na odontologia, traçando o perfil dos trabalhos sobre a temática apresentados nas Reuniões da Sociedade Brasileira de Pesquisa Odontológica (SBPqO). Tratou-se de um estudo transversal, com abordagem quantitativa, a partir de dados secundários. Realizou-se uma análise de todos os resumos apresentados nas últimas dez Reuniões da SBPqO (2009-2018) publicados nos anais do evento. Para pesquisa procedeu-se a localização do termo "acupuntura" ou "acupuncture" entre os resumos e foram colhidas as seguintes informações: tipo de instituição que realizou a pesquisa (pública ou privada), região rasileira onde foi realizada, recebimento de auxílio financeiro, área ou especialidade da odontologia e se envolvia humanos ou animais. Dos 26.514 resumos de pesquisa odontológica publicados em anais, apenas 27 trabalhos tratavam de estudos experimentais ou revisões sistemáticas sobre a temática. Do total, 23 (85,2%) foram desenvolvidos em instituições públicas, 15 (55,6%) não receberam auxílio financeiro, 20 (74,1%) foram realizados em humanos e 13 (48,2%) desenvolvidos na região Sudeste do Brasil. Com relação a especialidade odontológica, a maioria (70,4%) pesquisou sobre a acupuntura na "Disfunção Temporomandibular e Dor Orofacial". Os achados do presente estudo indicam que poucas pesquisas abordando a acupuntura na odontologia foram desenvolvidas nos últimos dez anos no Brasil, de acordo com os trabalhos apresentados nas Reuniões da SBPqO. Diante disso, sugere-se que pesquisas sobre o tema sejam realizadas e amplamente divulgadas entre o meio acadêmico e profissionais. (AU)

Tratamento de grandes cistos radiculares por meio da técnica de descompressão e posterior enucleação: relato de dois casos / Treatment of large radicular cysts by decompression technique and subsequent enucleation: two case reports

O cisto radicular é o cisto odontogênico mais comum, podendo ser denominado de cisto radicular, cisto periapical ou cisto periodontal apical, geralmente assintomáticos e diagnosticados durante as investigações radiológicas de rotina. O tratamento de cistos radiculares inclui o tratamento endodôntico não cirúrgico convencional quando a lesão é localizada, ou tratamento cirúrgico como a enucleação, marsupialização ou descompressão quando lesão é extensa. Este trabalho teve o objetivo de apresentar dois relatos de casos, que utilizaram como tratamento de cisto radicular a descompressão com posterior enucleação. Conclui-se que a técnica da descompressão como tratamento inicial dos cistos radiculares se mostrou eficaz tanto na maxila como na mandíbula, por reduzir consideravelmente o tamanho da lesão, proporcionando neoformação óssea e viabilizando a enucleação total da lesão.

The root cyst is the most common odontogenic cyst, and can be called root cyst, periapical cyst or apical periodontal cyst, usually asymptomatic and diagnosed during routine radiological investigations. Treatment of root cysts includes conventional non-surgical endodontic treatment when injury is localized or surgical treatment such as enucleation, marsupialization or decompression when injury is extensive. The objective of the paper has been present two case reports, which used as a treatment for root cyst de compression with subsequent enucleation. It was concluded that the decompression technique as initial treatment of the root cysts was effective both in the maxilla and in the mandible, because it considerably reduced the size of the lesion, providing bone formation and enabling the total enucleation of the lesion.