Gap finder

Search review questions

Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.

Limit to evidence status or GRADE (optional)

866 questions in 43 reviews · Oral and maxillofacial surgery

current versions
No studies 188 · 21.7%Ungraded 548 · 63.3%Very low 81 · 9.4%Low 37 · 4.3%Moderate 8 · 0.9%High 4 · 0.5%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

QuestionEffectEvidenceStatus / GRADE
Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Standard care (usual local haemostatic measures: gelatin sponge and sutures, or dry gauze compression)
Number of participants with postoperative bleedings requiring intervention · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and… · 7 days
Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing minor oral… (2018) · Cochrane
RD 0.02 [-0.07, 0.11]2 studies · 125 participantsModerate
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… · 5 years (long-term)
Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients (2018) · Cochrane
MD 4.80 [0.41, 9.19]1 study · 16 participantsVery low
Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo (placebo solution/mouthwash)
Number of minor postoperative bleeding episodes · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and… · 7 days
Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing minor oral… (2018) · Cochrane
RD -0.06 [-0.33, 0.20]2 studies · 128 participantsUngraded
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… · 17 months (mean)
Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients (2018) · Cochrane
RR 0.11 [0.01, 1.85]1 study · 22 participantsVery low
Extraction of a maxillary first permanent molar vs Extraction of a mandibular first permanent molar
Spontaneous post-extraction space closure · Children aged 5 to 15 years undergoing first permanent molar extraction · Maxilla versus mandible (spontaneous space closure)
Consequences of early extraction of compromised first permanent molar: a systematic review. (2018)
OR 2.06 [0.46, 9.28]3 studies · 107 participantsUngraded
Maxillary distraction osteogenesis vs Orthognathic surgery (conventional Le Fort I osteotomy)
Clinical morbidities (adverse effects) · Adolescents or adults (15 years or older) with an established diagnosis of complete cleft lip and alveolar process, or… · 12 months
Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients (2018) · Cochrane
SoF (Very Low): Clinical morbidities assessed with questionnaires, follow-up 12 months; risk with orthognathic surgery 3/14; risk with maxillary distraction osteogenesis 3/15; relative effect -; 29 participants (1…1 study · 29 participantsVery low
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
Consequences of early extraction of compromised first permanent molar: a systematic review. (2018)
Normando and Cavacami: decreased GnSN angle (P = 0.05), counter-clockwise rotation of the occlusal plane (mean 5.6 vs 12.6 degrees, P = 0.0001), and decreased lower anterior face height (P = 0.048). Table 3: Category…1 studyUngraded
Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo (placebo solution/mouthwash)
Bleeding duration (minutes, all types of bleeding, minor and major) · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and…
Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing minor oral… (2018) · Cochrane
no estimate extracted0 studiesNo studies
Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo (placebo solution/mouthwash)
Side effects or other adverse events requiring withdrawal · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and… · 7 days
Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing minor oral… (2018) · Cochrane
RD 0.00 [-0.04, 0.04]2 studies · 128 participantsModerate
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… · up to 2 years (significant at 3 months)
Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients (2018) · Cochrane
Results text (Ungraded; not in SoF): social self-esteem (subset of the Culture-Free Self-Esteem Inventory, CFSEI) - DO participants had lower social self-esteem in the first three months postoperatively, with a…1 study · 30 participantsUngraded
Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo (placebo solution/mouthwash)
Change in haemoglobin level from baseline · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and…
Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing minor oral… (2018) · Cochrane
no estimate extracted0 studiesNo studies
Antifibrinolytic agents (tranexamic acid (TXA) or epsilon aminocaproic acid (EACA)) vs Placebo, no intervention, or usual care
Outcome NR · People on continuous direct oral anticoagulant (DOAC) treatment undergoing oral or dental procedures
Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing minor oral… (2018) · Cochrane
no estimate extracted0 studiesNo studies
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
Consequences of early extraction of compromised first permanent molar: a systematic review. (2018)
Root closure and eruption of the second permanent molar were accelerated on the extraction side versus the non-extraction side (Telli and Aytan; not statistically tested). Table 3: Category III, Class C.1 studyUngraded
Any surgical or non-surgical technique or material used for the treatment of post-extraction bleeding vs Another active intervention, placebo, or no treatment
Patient-reported outcomes related to pain or discomfort during the procedure · People of any age and either gender with post-extraction bleeding, regardless of type of teeth (anterior or posterior,…
Interventions for treating post‐extraction bleeding (2018) · Cochrane
No data are available as no RCTs have been conducted on interventions to treat post-extraction bleeding0 studiesNo studies
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
Consequences of early extraction of compromised first permanent molar: a systematic review. (2018)
OR 2.86 [1.37, 5.96]2 studiesUngraded
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… · 2 years
Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients (2018) · Cochrane
Results text (Ungraded; not in SoF): both groups showed notable positive soft tissue changes of the upper lip and nose after maxillary advancement (39 participants). Between-group soft tissue differences at 2 years…1 study · 39 participantsUngraded
Any surgical or non-surgical technique or material used for the treatment of post-extraction bleeding vs Another active intervention, placebo, or no treatment
Adverse events · People of any age and either gender with post-extraction bleeding, regardless of type of teeth (anterior or posterior,…
Interventions for treating post‐extraction bleeding (2018) · Cochrane
No data are available as no RCTs have been conducted on interventions to treat post-extraction bleeding0 studiesNo studies
Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo (placebo solution/mouthwash)
Major bleeding requiring transfusion of packed red blood cells · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and… · 7 days
Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing minor oral… (2018) · Cochrane
RD -0.00 [-0.05, 0.04]2 studies · 128 participantsUngraded
Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo (placebo solution/mouthwash)
Number of immediate and delayed postoperative bleeding episodes requiring intervention · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and… · Immediate (<24 h) and delayed (24 h to 10 days); bleeds occurred 1, 3 or 5 days postoperatively
Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing minor oral… (2018) · Cochrane
RD -0.22 [-0.35, -0.10]1 study · 89 participantsUngraded
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… · 17 months (mean)
Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients (2018) · Cochrane
RR 1.28 [0.65, 2.52]1 study · 21 participantsVery low
Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo (placebo solution/mouthwash)
Any postoperative complication except bleeding (e.g. wound infection) · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and… · 7 days
Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing minor oral… (2018) · Cochrane
RD -0.02 [-0.07, 0.03]2 studies · 128 participantsUngraded
Intervention NR
Caries and/or fillings in adjacent teeth · Occlusal surfaces (extraction vs FPM present; more decayed/filled with extraction)
Consequences of early extraction of compromised first permanent molar: a systematic review. (2018)
OR 1.64 [1.35, 2.1]1 studyUngraded
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… · 2 years
Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients (2018) · Cochrane
MD 2.95 [0.14, 5.76]1 study · 30 participantsVery low
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… · 2 years
Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients (2018) · Cochrane
MD 4.40 [0.24, 8.56]1 study · 39 participantsVery low
Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo (placebo solution/mouthwash)
Number of participants with postoperative bleedings requiring intervention · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and… · 7 days
Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing minor oral… (2018) · Cochrane
RD -0.25 [-0.36, -0.14]2 studies · 128 participantsModerate
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 · Proximal surfaces (extraction vs FPM present; fewer decayed/filled with extraction)
Consequences of early extraction of compromised first permanent molar: a systematic review. (2018)
OR 0.48 [0.33, 0.69]1 studyUngraded
Any surgical or non-surgical technique or material used for the treatment of post-extraction bleeding vs Another active intervention, placebo, or no treatment
Treatment-associated average cost · People of any age and either gender with post-extraction bleeding, regardless of type of teeth (anterior or posterior,…
Interventions for treating post‐extraction bleeding (2018) · Cochrane
No data are available as no RCTs have been conducted on interventions to treat post-extraction bleeding0 studiesNo studies
Early extraction of a compromised first permanent molar vs Non-extraction (retained first permanent molar) or contralateral non-extraction side
Post-extraction space (spontaneous space closure / decrease in space) · Children aged 5 to 15 years with a compromised first permanent molar
Consequences of early extraction of compromised first permanent molar: a systematic review. (2018)
Spontaneous space closure ranged from 45.5% to 85.2% overall (maxilla 33.3% to 94%, mandible 50% to 75%). Table 3 conclusion: early extraction of compromised FPM leads to decrease in post extraction space (Category III…6 studiesUngraded
Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo (placebo solution/mouthwash)
Amount of postoperative blood loss (mL) · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and…
Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing minor oral… (2018) · Cochrane
no estimate extracted0 studiesNo studies
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… · 17 months
Maxillary distraction osteogenesis versus orthognathic surgery for cleft lip and palate patients (2018) · Cochrane
RR 3.00 [0.14, 66.53]1 study · 22 participantsUngraded
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Exposure of the plate (adverse effect) · Adults (>16 years old) undergoing orthognathic surgery · Up to 3 years postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
Both titanium and resorbable groups experienced two plate exposures which occurred between the third and ninth month, with plate exposure rates of 1.02% for the titanium group and 1.21% for the resorbable group. All…1 study · 60 participantsUngraded
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Occurrence of sinus tract (adverse effect) · Adults (>16 years old) undergoing orthognathic surgery · Up to 3 years postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
Five patients (three in the titanium group and two in the resorbable group) developed a non-infected sinus tract. The sinus tracts arose earlier in the titanium group (sixth week) than in the resorbable group (third…1 study · 60 participantsUngraded
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 · 0 to 24 months (by period)
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
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 participantsUngraded
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 · 4 to 6 months
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
MD 0.17 [-0.67, 1.01]1 study · 60 participantsVery low
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Postoperative pain during the immediate recovery period (VAS 0 to 10) · Adults (>16 years old) undergoing orthognathic surgery · 2 weeks (immediate recovery period)
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
MD -0.77 [-1.92, 0.38]1 study · 60 participantsVery low
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Costs (fixation materials, hospital bed days, retreatment) · Adults (>16 years old) undergoing orthognathic surgery · Up to 3 years postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
None of the studies reported on the cost incurred in the treatment.0 studiesNo studies
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Analgesic medication used (type, dose, frequency) · Adults (>16 years old) undergoing orthognathic surgery · Up to 3 years postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
No data available for this outcome.0 studiesNo studies
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Re-operation and revision rate / plate removal (adverse effect) · Adults (>16 years old) undergoing orthognathic surgery · Up to 3 years postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
Plate removal rates were 1.53% (3/196) of the titanium plates and 3.63% (6/165) of the resorbable ones. Out of a total of nine, two in each group were removed because of plate exposure, one patient in the titanium and…1 study · 60 participantsUngraded
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Status of occlusion (e.g. ANB, Angle's classification, Wits analysis) · Adults (>16 years old) undergoing orthognathic surgery · Up to 3 years postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
Weidner 2005 provided analyses of mean changes in ANB from scanned radiographs. The ANB data were incomplete for many of the five time periods and were reported as 'grad' rather than the conventionally accepted…1 study · 43 participantsUngraded
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Need for retreatment or replacement of fixation due to failure of the fixation · Adults (>16 years old) undergoing orthognathic surgery · Mean 1 year
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
SoF row (Resorbable plates compared to titanium plates for stabilization after orthognathic surgery). Need for retreatment or replacement of fixation due to failure of the fixation (plates failed or removed in each…1 study · 60 participantsVery low
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Wound dehiscence (adverse effect) · Adults (>16 years old) undergoing orthognathic surgery · Up to 3 years postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
Three patients (10%) in the titanium group and two patients (6.7%) in the resorbable group presented with wound dehiscence. One patient in each group with dehisced wounds became infected; all non-infected wounds closed…1 study · 60 participantsUngraded
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Postoperative chronic or lasting pain (wound discomfort) at 4 to 6 months (VAS 0 to 10) · Adults (>16 years old) undergoing orthognathic surgery · 4 to 6 months
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
MD -0.77 [-1.58, 0.04]1 study · 60 participantsVery low
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Facial appearance and profile · Adults (>16 years old) undergoing orthognathic surgery · Up to 3 years postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
No data available for this outcome.0 studiesNo studies
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Immediate postoperative swelling (assessed by photography or digital morphometry) · Adults (>16 years old) undergoing orthognathic surgery · Up to 3 years postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
Though Cheung 2004 reported the presence of postoperative swelling, it was only noted in conjunction with infection and pus discharge; assessment of this outcome did not include the use of photography or digital…1 study · 60 participantsUngraded
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Quality of life · Adults (>16 years old) undergoing orthognathic surgery · Up to 3 years postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
None of the included studies reported this outcome.0 studiesNo studies
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Degree of function postoperatively (mastication, swallowing, speech) · Adults (>16 years old) undergoing orthognathic surgery · Up to 3 years postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
No data available for this outcome.0 studiesNo studies
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Adverse effects (composite: plate exposure, wound infection, sinus tract, wound dehiscence, plate removal) · Adults (>16 years old) undergoing orthognathic surgery · Up to 24 months postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
SoF row. Adverse effects; 60 participants (1 RCT); Quality of the evidence (GRADE): VERY LOW. Exposure of the plate: both titanium and resorbable groups experienced 2 plate exposures which occurred between the third…1 study · 60 participantsVery low
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Superficial and deep wound infection (adverse effect) · Adults (>16 years old) undergoing orthognathic surgery · Up to 3 years postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
The trialists did not differentiate between superficial and deep wound infection. Three (10%) of the patients in each group developed infections accounting for six plates: 3/196 (1.53%) in the titanium group and 3/165…1 study · 60 participantsUngraded
Resorbable (bioresorbable) plates or screws for fixation vs Titanium plates or screws for fixation
Satisfactory radiographic appearance (cephalometric radiographs) · Adults (>16 years old) undergoing orthognathic surgery · Up to 3 years postoperatively
Resorbable versus titanium plates for orthognathic surgery (2017) · Cochrane
No data available for this outcome.0 studiesNo studies
Perioperative infraorbital nerve block vs Infiltration of the incision (peri-incisional infiltration)
Duration of postoperative analgesia · Children up to 13 years of age, undergoing cleft lip repair surgery
Infraorbital nerve block for postoperative pain following cleft lip repair in children (2016) · Cochrane
This outcome was not reported.0 studiesNo studies