Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

369 questions · 382 findings · 20 reviews · Oral and maxillofacial surgery

No studies found 92 · 24.1%GRADE not reported 239 · 62.6%Very low 42 · 11%Low 4 · 1%Moderate 5 · 1.3%High 0 · 0%

Topical anaesthetic gel (prilocaine-lidocaine) vs Eugenol

Pain at 48 hours (VAS 0-10) · Adults (>18 years) with established dry socket following permanent tooth extraction

Topical anaesthetic gel (prilocaine-lidocaine) showed no clear difference in pain at 48 hours (VAS 0-10) compared with eugenol; GRADE not reported.

1 finding from 1 review

Chlorhexidine gel (0.2%, intrasocket) vs Chlorhexidine mouthrinse

Presence of dry socket · Adults (>18 years) having permanent tooth extraction (predominantly mandibular third molars)

Chlorhexidine gel (0.2%, intrasocket) showed no clear difference in presence of dry socket compared with chlorhexidine rinse (0.12%) (low certainty).

1 finding from 1 review

Teriparatide 56.5 microg weekly in addition to standard care vs Teriparatide 20 microg daily in addition to standard care

Healing of MRONJ (remission) · People with established (manifest) MRONJ

It is very uncertain whether teriparatide 56.5 microg weekly in addition to standard care changes healing of MRONJ (remission) compared with teriparatide 20 microg daily in addition to standard care (very low certainty).

1 finding from 1 review

Tap water irrigation (monoject syringe) vs No rinsing

Presence of dry socket · Adults (>18 years) having permanent tooth extraction (predominantly mandibular third molars)

Tap water irrigation (monoject syringe) led to lower presence of dry socket compared with no rinsing; GRADE not reported.

1 finding from 1 review

Chlorhexidine gel vs Chlorhexidine, 0.2% to 2% (solution or gel)

Presence of dry socket · Adults (>18 years) having permanent tooth extraction (predominantly mandibular third molars)

Chlorhexidine gel 1% showed no clear difference in presence of dry socket compared with chlorhexidine gel 0.2%; GRADE not reported.

1 finding from 1 review

Subperiosteal prepared (SPP) wound closure after tooth extraction vs Epiperiosteal prepared (EPP) wound closure after tooth extraction

MRONJ after tooth extraction (incidence proportion) · People on antiresorptive treatment undergoing tooth extraction (at risk of MRONJ)

Subperiosteal prepared (SPP) wound closure after tooth extraction showed no clear difference in MRONJ after tooth extraction (incidence proportion) compared with epiperiosteal prepared (EPP) wound closure after tooth extraction (low certainty).

1 finding from 1 review

Honey (Manuka, topical) vs Chlorhexidine rinse (0.2%)

Presence of dry socket · Adults (>18 years) having permanent tooth extraction (predominantly mandibular third molars)

Honey (Manuka, topical) showed no clear difference in presence of dry socket compared with chlorhexidine rinse (0.2%); GRADE not reported.

1 finding from 1 review

Chlorhexidine gel (0.2%, intrasocket) vs placebo or no treatment

Presence of dry socket · Adults (>18 years) having permanent tooth extraction (predominantly mandibular third molars)

Chlorhexidine gel (0.2%, intrasocket) probably leads to lower presence of dry socket compared with placebo or no treatment (moderate certainty).

1 finding from 1 review

Artemisia desertorum spreng (Shahaosan) vs Artemisia desertorum spreng (Yunnan)

Presence of dry socket · Adults (>18 years) having permanent tooth extraction (predominantly mandibular third molars)

Artemisia desertorum spreng (Shahaosan) showed no clear difference in presence of dry socket compared with artemisia desertorum spreng (Yunnan); GRADE not reported.

1 finding from 1 review

Dental extraction protocol with plasma rich in growth factors (PRGF) inserted into the postextraction alveolus vs Standard dental extraction protocol without PRGF

MRONJ (incidence proportion) · People with cancer treated with intravenous bisphosphonates undergoing dental extractions (at risk of MRONJ)

It is very uncertain whether dental extraction protocol with plasma rich in growth factors (PRGF)… changes MRONJ (incidence proportion) compared with standard dental extraction protocol without PRGF (very low certainty).

1 finding from 1 review

Dental examinations at three-month intervals and preventive treatments vs usual care

MRONJ (incidence rate: cases per patient-year) · Men with metastatic prostate cancer receiving intravenous zoledronic acid (at risk of MRONJ)

It is very uncertain whether dental examinations at three-month intervals and preventive treatments changes MRONJ (incidence rate: cases per patient-year) compared with standard care (very low certainty).

1 finding from 1 review

Fluoride gel (topically applied; operator- or self-applied; any fluoride agent/concentration; frequency at least once a year) vs High-content fluoride toothpaste (1350 ppm)

Adverse effects · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the jaws)
1 finding from 1 review

Hyperbaric oxygen therapy (HBO) following extractions vs penicillin G

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 hyperbaric oxygen therapy (HBO) following extractions changes incidence of ORN compared with perioperative antibiotic prophylaxis (penicillin G) following… (very low certainty).

1 finding from 1 review

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

Adverse effects (including quality of life) · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the jaws)
1 finding from 1 review

Hyperbaric oxygen therapy (HBO) following extractions vs penicillin G

Adverse effects · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the jaws)
1 finding from 1 review