Complications in the treatment with alveolar extraosseous distractors. Literature review

BACKGROUND: To review the literature that analyses the types and frequency of complications associated with the use of extraosseous alveolar distraction from 2007 to 2013. MATERIAL AND METHODS: Review of the literature in PubMed, using these keywords; alveolar ridge, alveolar distraction osteogenesis, complication, literature review. Inclusion criteria were: articles published between 2007 and 2013 that included the distraction protocol, the complications encountered and the time when they occurred. RESULTS: According to the above criteria, 12 articles were included in this review, where 334 extraosseous distractors were placed and 395 complications were encountered, of which 19 (4.81%) were intraoperative, 261 (66.07%) postoperative and 115 (29.11 %) were postdistraction. The most common complication was the incorrect distraction vector found in 105 cases (26.58%), in 23 cases (5.82%) there were severe complications, of which 14 (3.54%) were mandibular fracture and 9 (2.27%) were fractures of the distractor elements. CONCLUSIONS: According to this review, although alveolar distraction is a safe and predictable technique, it can cause complications; however, they are usually minor and easily resolved without affecting the treatment outCome

Actitud terapéutica ante los terceros molares: ¿exodoncia o vigilancia? / Therapeutic approach to third molars ¿Extraction or surveillance?

Uno de los desafíos a los que se enfrenta a diario un cirujano bucal o maxilofacial es el manejo terapéutico de los terceros molares asintomáticos y libres de patología. Hasta la fecha existe una falta de información concluyente, problemas en la interpretación de la bibliografía reciente, así como diferentes puntos de vista entre profesionales a la horade responder si es mejor realizar la exodoncia a tiempo o mantener una actitud expectante. El objetivo de este trabajo es revisar la bibliografía reciente referente a la toma de decisiones terapéuticas en estos casos y discutir sobre los aspectos de consenso y las controversias. Además, buscar evidencia científica que justifique la exodoncia profiláctica del tercer molar. A día de hoy continúala controversia sobre el manejo terapéutico óptimo de un tercer molar asintomático y libre de patología. En la presente revisión no se ha encontrado evidencia científica que justifique la exodoncia profiláctica del tercermolar. Se necesita mucha más evidencia científica, así como el diseño de estudios clínicos aleatorizados que permitan compararlas consecuencias a corto y largo plazo de la vigilancia activa y de la exodoncia de los terceros molares

The therapeutic management of asymptomatic and disease free third molars is one of the challenges faced daily by an oral and maxillofacial surgeon. To date there is a lack of conclusive information, problems in the interpretation of the recent literature, as well as different views among professionals when asked if it is better to perform a prophylacticor maintain an expectant attitude. The objective is to review the recent literature on the therapeutic decisions in these cases and discuss aspects of consensus and controversies. Search scientific evidence to support prophylactic third molar extraction. At present controversy continues regarding the optimal therapeutic management of an asymptomatic and disease free third molar. Conclusive evidence has not been found to justify prophylactic third molar extraction in the present review. Much more scientific evidence as well as the design of randomized clinical studies comparing the short-and long-term active surveillance and the extraction of third molars is needed