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Evidence found and GRADE certainty

486 questions · 503 findings · 36 reviews · Oral and maxillofacial surgery · related questions CL0289

No studies found 116 · 23.1%GRADE not reported 303 · 60.2%Very low 66 · 13.1%Low 12 · 2.4%Moderate 2 · 0.4%High 4 · 0.8%

PRP (platelet-rich plasma) in cellulose foam placed in extraction socket vs placebo, no treatment or surveillance only

Incidence of ORN · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the jaws)

It is very uncertain whether PRP (platelet-rich plasma) in cellulose foam placed in extraction… changes incidence of ORN compared with no treatment/placebo (cellulose foam only) placed in extraction socket (very low certainty).

1 finding from 1 review

Combined HBO and perioperative antibiotics prior to dental implant therapy vs antibiotics alone

Incidence of ORN · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the jaws)

It is very uncertain whether combined HBO and perioperative antibiotics prior to dental implant… changes incidence of ORN compared with antibiotics alone prior to dental implant therapy (very low certainty).

1 finding from 1 review

Bilateral extraction of compromised mandibular first permanent molars vs Age- and gender-matched non-extraction controls

Lower incisor inclination (lingual tipping and retrusion) · Children (approximately 11 years or older) with compromised mandibular first permanent molars

Bilateral lower first permanent molar extraction was associated with lingual tipping and retrusion of the lower incisors in one case-control study; ungraded.

1 finding from 1 review

Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)

Long-term skeletal relapse/stability (horizontal movement of A-point) · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or complete unilateral…

It is very uncertain whether maxillary distraction osteogenesis changes long-term skeletal relapse/stability (horizontal movement of A-point) compared with orthognathic surgery (conventional Le Fort I osteotomy) (very low certainty).

1 finding from 1 review

Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)

Speech: resonance (hypernasality) (deterioration/improvement) · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or complete unilateral…

It is very uncertain whether maxillary distraction osteogenesis changes speech: resonance (hypernasality) (deterioration/improvement) compared with orthognathic surgery (conventional Le Fort I osteotomy) (very low certainty).

1 finding from 1 review

Extraction of a maxillary first permanent molar vs Extraction of a mandibular first permanent molar

Spontaneous space closure · Children aged 5 to 15 years undergoing first permanent molar extraction

Spontaneous post-extraction space closure did not differ significantly between the maxilla and mandible (pooled OR 2.06, 95% CI 0.46 to 9.28; 3 studies; I2 = 72%); ungraded.

1 finding from 1 review

Bilateral extraction of compromised mandibular first permanent molars vs Age- and gender-matched non-extraction controls

Skeletal development (occlusal plane rotation, facial height) · Children (approximately 11 years or older) with compromised mandibular first permanent molars

Bilateral lower first permanent molar extraction was associated with counter-clockwise rotation of the occlusal plane and a mild decrease in lower anterior face height in one case-control study; ungraded.

1 finding from 1 review

Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)

Psychological status: social self-esteem (Culture-Free Self-Esteem Inventory subset); also general self-esteem and Social Avoidance and Distress Scale · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or complete unilateral…
1 finding from 1 review

Antifibrinolytic agents (tranexamic acid (TXA) or epsilon aminocaproic acid (EACA)) vs Placebo, no intervention, or usual care

Outcome not reported · People on continuous direct oral anticoagulant (DOAC) treatment undergoing oral or dental procedures

The review found no eligible studies for this question.

1 finding from 1 review

Early extraction of a compromised first permanent molar vs Contralateral non-extraction side (same patient)

Development and eruption of the second permanent molar · Children aged 5 to 15 years with a compromised first permanent molar

Root closure and eruption of the second permanent molar appeared accelerated on the extraction side in a single case-control study; ungraded and not statistically tested.

1 finding from 1 review

Early extraction of a compromised mandibular first permanent molar vs Contralateral non-extraction side (same patient)

Development and eruption of the third molar · Children aged 5 to 15 years with a compromised first permanent molar

Development and eruption of the third molar appeared accelerated after early first permanent molar extraction in two studies (e.g., eruption OR 2.86, 95% CI 1.37 to 5.96); ungraded.

1 finding from 1 review

Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)

Midfacial soft tissue changes (facial profile landmarks: pronasale, subnasale, stomion superius, labrale superius) · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or complete unilateral…

Maxillary distraction osteogenesis showed no clear difference in midfacial soft tissue changes (facial profile landmarks: pronasale,… compared with orthognathic surgery (conventional Le Fort I osteotomy); GRADE not reported.

1 finding from 1 review

Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)

Velopharyngeal function (complete velopharyngeal closure; deterioration/improvement) · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or complete unilateral…

It is very uncertain whether maxillary distraction osteogenesis changes velopharyngeal function (complete velopharyngeal closure;… compared with orthognathic surgery (conventional Le Fort I osteotomy) (very low certainty).

1 finding from 1 review

Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)

Psychological status: satisfaction with life (Satisfaction With Life Scale, SWLS) · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or complete unilateral…

It is very uncertain whether maxillary distraction osteogenesis changes psychological status: satisfaction with life (Satisfaction With Life… compared with orthognathic surgery (conventional Le Fort I osteotomy) (very low certainty).

1 finding from 1 review

Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)

Maxillary advancement (midfacial hard tissue change; Subspinale A-point) · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or complete unilateral…

It is very uncertain whether maxillary distraction osteogenesis changes maxillary advancement (midfacial hard tissue change; Subspinale… compared with orthognathic surgery (conventional Le Fort I osteotomy) (very low certainty).

1 finding from 1 review

Early extraction of a compromised first permanent molar vs Teeth in the same arch/patient with the first permanent molar present

Caries and/or fillings in adjacent teeth · Children aged 5 to 15 years with a compromised first permanent molar

One study found fewer decayed or filled proximal surfaces but more decayed or filled occlusal surfaces in arches with an extracted first permanent molar; ungraded.

1 finding from 1 review

Early extraction of a compromised first permanent molar vs Non-extraction (retained first permanent molar) or contralateral non-extraction side

Spontaneous space closure · Children aged 5 to 15 years with a compromised first permanent molar

Early extraction of a compromised first permanent molar is followed by variable spontaneous closure of the post-extraction space (about 45.5% to 85.2% of cases); certainty was not GRADE-rated (Shekelle category III).

1 finding from 1 review

Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)

Speech: nasal emission · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or complete unilateral…

Maxillary distraction osteogenesis showed no clear difference in speech: nasal emission compared with orthognathic surgery (conventional Le Fort I osteotomy); GRADE not reported.

1 finding from 1 review

Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation

Clinical stability of osteotomy segments (VAS 0 to 10) · Adults (>16 years old) undergoing orthognathic surgery
1 finding from 1 review
  • Resorbable versus titanium plates for orthognathic surgery 2017 · Cochrane All outcomes
    0 to 24 months (by period)
    Clinical stability of osteotomy segments (Cheung 2004), self-assessed on a VAS (0=very mobile, 10=no mobility) by postoperative period, titanium vs resorbable mean (SD): 0 to 2 weeks 8.10 (1.79) vs 8.47 (2.18), P=0.48;…
    1 study · 60 participants
    GRADE not reported

Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation

Patient satisfaction (VAS 0 to 10) · Adults (>16 years old) undergoing orthognathic surgery

It is very uncertain whether resorbable (bioresorbable) plates or screws for fixation changes patient satisfaction (VAS 0 to 10) compared with titanium plates or screws for fixation (very low certainty).

1 finding from 1 review