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JBI Evid Synth ; 19(8): 2024-2031, 2021 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-33720109


OBJECTIVE: This network meta-analysis aims to rank the best postoperative drug regimen to control inflammatory complications related to mandibular third molar surgery. INTRODUCTION: Many studies of oral drugs have been proposed to control postoperative inflammatory complications after third molar surgeries with inconclusive results. A systematic review with network meta-analysis in this field may clarify the best therapeutic protocol for practice in dentistry. INCLUSION CRITERIA: This review will consider randomized clinical trials that included healthy adult patients or those who had treated and controlled systemic diseases; asymptomatic patients who were free of acute infection or inflammation at the surgical site immediately before third molar surgery; and patients submitted to surgical removal of one lower third molar at a time in which they have received oral anti-inflammatory and/or analgesics in the postoperative moment. The outcomes are pain, edema, trismus, and adverse effects. METHODS: Sources of published studies, unpublished studies, and gray literature will be searched without time or language restrictions. Titles and abstracts of all search results will be screened by two independent reviewers. The full text of potentially relevant studies will be assessed. Methodological quality of the included studies will be performed using the JBI checklist for experimental studies. Data related to specific details about the population, study methods, interventions, and outcomes will be extracted from the included studies. The findings will be presented in a narrative form and polled in network meta-analysis, when possible. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020196692.

Oral Maxillofac Surg ; 25(3): 289-301, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33398647


PURPOSE: To compare resorbable plates with titanium plates for the fixation of zygomatic fractures, taking into account postoperative complications. METHODS: This systematic review followed the guidelines of PRISMA and the recommendations of the Cochrane Handbook and was registered in PROSPERO. The electronic search was performed in the Web of Science, PubMed, Virtual Health Library, and Cochrane Library databases and in the gray literature. The study selection and the data extraction were performed by three calibrated and independent researchers. The assessment of the risk of bias in the studies was performed using the Cochrane Risk of Bias Tool for clinical trials. Meta-analyses were performed using Review Manager Software version 5.3, using the Peto's Odds Ratios (PORs), and when I2 > 30, the random effect model was used. The evaluation of the quality of the evidence was carried out through GRADE. RESULTS: A total of 2651 studies were screened and only nine were included; 7 of which were used for quantitative assessment. The follow-up time for patients ranged from 6 months to 5 years. All studies showed a low risk of bias in the "incomplete outcome data" domain. The need for plate removal (POR: 0.11, 95% CI: 0.02 to 0.81, I2 = 0%) and dehiscence (POR 0.12, 95% CI 0.02 to 0.63, I2 = not applied) was lower for the group of patients who used resorbable plates than for titanium plates. CONCLUSION: There was no difference in the occurrence of infection, diplopia, or paresthesia between the fixation methods. Resorbable plates showed better postoperative clinical performance.

Titânio , Fraturas Zigomáticas , Placas Ósseas , Fixação Interna de Fraturas , Humanos , Fraturas Zigomáticas/cirurgia
J Oral Rehabil ; 48(4): 369-374, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33206400


OBJECTIVE: The aim of this study was to compare the effectiveness of two types of treatment (counselling programme versus counselling programme plus jaw exercises) to improve the quality of life of patients with disc displacement with reduction (DDWR). MATERIALS AND METHODS: Patients were divided into two groups. The test group received guidelines for temporomandibular disorders (TMD) plus jaw exercises for DDWR, and the control group received only guidelines for TMD. The total number of investigated patients was 70, thus 35 per group. The oral health-related quality of life was assessed by the OHIP-14 questionnaire. Both groups were evaluated at the baseline and 30 days post-treatment. RESULTS: In the counselling group, there was statistically significant decrease in pain (P = .015) and social disability (P = .046) subscales. In the counselling plus jaw exercise group, there was statistically significant decrease in all subscales (P < .05). At 30 days follow-up, there was a statically significant difference between the two groups in pain (P = .004), psychological discomfort (P < .001), psychological disability (P < .001) and social disability (P = .029) subscales. CONCLUSION: The counselling programme plus jaw exercise protocol showed greater improvement in oral health-related quality of life than the group performing only the counselling programme in patients with DDWR.

Luxações Articulares , Transtornos da Articulação Temporomandibular , Aconselhamento , Terapia por Exercício , Humanos , Qualidade de Vida , Inquéritos e Questionários , Transtornos da Articulação Temporomandibular/terapia
Oral Maxillofac Surg ; 24(4): 447-453, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32617697


PURPOSE: The teeth positioning may be an important associated factor for the pericoronitis' clinical signs. Our objective was to verify the association between lower third molar position according to the Pell and Gregory classification and clinical variables in patients with pericoronitis. METHODS: Cross-sectional analysis of panoramic radiographs and medical records of patients with pericoronitis. Primary outcomes: pain and oral health-related quality of life (OHRQoL); secondary outcomes: mouth opening, edema/erythema extension, visible plaque index, bleeding on probing index, periodontal pocket probing depth, and distal alveolar bone crest height of the adjacent second molar. RESULTS: The edema/erythema extension was higher in the IIA position compared with the IA position (p = 0.03). Regarding the OHRQoL, the OHIP-14 score was 21.0 (± 9.26, range from 4 to 44). The most scored domain was physical pain (5.24), followed by psychological discomfort (4.43). Third molars in IIA position are associated with worse OHRQoL than IB and IIB positions (p = 0.03). CONCLUSIONS: There was a higher extension of edema/erythema and worse OHRQoL when the third molar was in IIA position. Prophylactic removal of mandibular third molar in position IIA may avoid the onset of mucosal edema/erythema and prevent pericoronitis from promoting impairment of individuals' quality of life.

Pericoronite , Dente Impactado , Estudos Transversais , Humanos , Mandíbula/diagnóstico por imagem , Dente Serotino/diagnóstico por imagem , Qualidade de Vida , Dente Impactado/diagnóstico por imagem
J Maxillofac Oral Surg ; 16(1): 13-21, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28286381


AIM: The aim of this systematic review and meta-analysis was to compare, in the lower third molar surgery, the osteotomy techniques with rotary instruments and piezoelectric motors. METHODS: An electronic search was conducted using the following databases: Pubmed, Web of Science, and the Cochrane Oral Health Group Trials Register. Inclusion criteria were: studies in humans, randomized or nonrandomized, comparing the extraction of third molars that required osteotomy and/or odontosection with rotary instrument and osteotomy and/or odontosection with piezoelectric motor assistance. The analysis and inclusion of articles was performed by two reviewers independently. An evaluation of the quality of articles and data extraction was carried out. RESULTS: From a total of nine hundred seventy four (974) trials, eleven articles were included in the qualitative analysis, and seven were included in the quantitative analysis. Rotary instruments were faster than the piezoelectric surgery (95 % CI 0.34 to 1.16). The piezoelectric surgery showed better results when compared with roatry instruments when trismus was assessed in 2 (95 % CI 0.65 to 1.69), 3 (95 % CI 0.63 to 1.67) and 5 (95 % CI 0.03 to 2.26) days after surgery. Seven days after surgery, there were no differences between the techniques (95 % CI (-0.022) to (-1.49)). CONCLUSION: The piezoelectric surgery was effective in reducing pain, swelling and trismus in third molar surgery, but the same requires greater surgical time than the rotary instruments.