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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 METHODS: Sources of published studies, unpublished studies, and gray literature will be searched without time or language restrictions.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
Phytother Res ; 33(3): 473-481, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30484910


The aim of this systematic review was to evaluate the clinical evidences of the bromelain in minimizing inflammatory parameters such as pain, edema, and trismus after lower third molar surgeries. An electronic search was conducted in six databases through November 2017. The eligibility criteria included randomized and non-randomized clinical trials and/or comparative studies that used bromelain after lower third molar surgeries. The search strategy resulted in 117 articles. Following the selection process, seven studies were included in the systematic review and four in the meta-analysis. In terms of the risk of bias analysis, all the evaluated studies were classified as low or unclear risk of bias in the following criteria: selection bias, detection bias, and reporting bias. The final quantitative analysis of the variables showed that the use of bromelain resulted in greater reduction of pain levels (mean difference [MD]: -0.38; 95% confidence interval [CI; -0.66 to -0.09]), edema (MD: -0.34; 95% CI [ -0.68 to -0.01]), and trismus (MD: -2.01; 95% CI [ -3.99 to -0.02]) among the analyzed groups. The results suggest that the bromelain appears to be effective in the control of pain, edema, and trismus after lower third molar surgeries; however, further high-quality studies are needed to confirm this finding.

Bromelaínas/uso terapêutico , Edema/tratamento farmacológico , Inflamação/tratamento farmacológico , Dor Pós-Operatória/tratamento farmacológico , Extração Dentária/efeitos adversos , Trismo/tratamento farmacológico , Edema/etiologia , Humanos , Inflamação/etiologia , Dente Serotino/efeitos dos fármacos , Dente Serotino/cirurgia , Dor Pós-Operatória/etiologia , Resultado do Tratamento , Trismo/etiologia
J Craniomaxillofac Surg ; 46(1): 168-172, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29208487


OBJECTIVE: To compare the mechanical resistance of conventional plates with a modified Y-plate in mandibular condyle fracture. MATERIALS AND METHODS: 40 synthetic hemi-mandibular polyurethane replicates were used. Two groups of fixing materials were included: 20 mandibles fixed with 40 straight plates with four roles each (2.0 mm system) and 20 mandibles fixed with 20 Y-shaped plates (2.0 mm system and 1.5 mm thickness). The samples were submitted to linear loading in the following directions: 10 mandibles from each group from lateral to medial and 10 mandibles from each group from anterior to posterior. A universal loading machine, Instron Universal 4411, was used to performed the tests, and the resistance of each fixed mandible was assessed at displacements of 1 mm, 3 mm, and 5 mm. The t-test for independent samples was performed. The p value was set at <0.05. RESULTS: The worst mechanical resistance was found in the Y-plates loaded from anterior to posterior. The best mechanical resistance was in two straight hole plates loaded from lateral to medial. The Y-plates and two straight hole plates showed similar resistance when a lateral to medial load was applied. CONCLUSION: There was no difference between the plates when lateral to medial loading was tested.

Placas Ósseas , Fixação Interna de Fraturas , Côndilo Mandibular/lesões , Fraturas Mandibulares/cirurgia , Humanos , Modelos Anatômicos , Desenho de Prótese