Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

657 questions · 681 findings · 36 reviews · Oral and maxillofacial surgery

No studies found 188 · 27.6%GRADE not reported 373 · 54.8%Very low 81 · 11.9%Low 27 · 4%Moderate 8 · 1.2%High 4 · 0.6%

2 mm titanium plates vs 2.5 mm bioresorbable plates

Restoration of function (inability to chew hard food) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement

2 mm titanium plates showed no clear difference in restoration of function (inability to chew hard food) compared with 2.5 mm bioresorbable plates; GRADE not reported.

1 finding from 1 review

Pre-radiotherapy extraction of diseased molar teeth vs Conservative treatment (restoration of the teeth and leaving them in place during radiotherapy, with oral health education and disease prevention: oral hygiene, fluoride, diet advice)

Delay in start of radiation treatment · Patients diagnosed with head and neck cancer planned to undergo any type of radiotherapy (external beam, intensity modulated,…

The review found no eligible studies for this question.

1 finding from 1 review

Transbuccal miniplate combined with intraoral approach vs Intraoral approach alone

Post-operative infection (persistent) · Adults with fractures of the mandibular angle

Transbuccal miniplate combined with intraoral approach showed no clear difference in post-operative infection (persistent) compared with intraoral approach alone; GRADE not reported.

1 finding from 1 review

Locking plate vs 2 mm non-locking titanium plates

Post-operative adverse events and complications (paraesthesia, swelling, segmental mobility) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Agarwal 2011: paraesthesia in one participant in the non-locking plate group (resolved by 3 months), none in the locking group; infection rates similar at 6 weeks and 3 months; post-operative swelling in 20% of both…
    1 study
    GRADE not reported

Two miniplates (transbuccal approach) vs One miniplate plus two screws (intraoral approach at external oblique ridge)

Requirement for additional (surgical) interventions (plate removal) · Adults with fractures of the mandibular angle

Two miniplates (transbuccal approach) showed no clear difference in requirement for additional (surgical) interventions (plate removal) compared with one miniplate plus two screws (intraoral approach at external…; GRADE not reported.

1 finding from 1 review

Two miniplates (transbuccal approach) vs One miniplate plus two screws (intraoral approach at external oblique ridge)

Post-operative adverse events and complications (lip numbness; overall) · Adults with fractures of the mandibular angle
1 finding from 1 review
  • Interventions for the management of mandibular fractures 2013 · Cochrane All outcomes
    Angle of mandible only
    Siddiqui 2007: 22/36 (61%) single-miniplate vs 14/26 (54%) two-miniplate had one or more complications; subjective lip numbness 15/36 (41.7%) vs 10/26 (38.5%) (P=0.82), objective 16/36 (44.4%) vs 8/26 (31.7%) (P=0.29).…
    2 studies
    GRADE not reported

2 mm titanium plates vs 2.5 mm bioresorbable plates

Post-operative neurosensory disturbance (mental nerve paraesthesia) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement

2 mm titanium plates led to higher post-operative neurosensory disturbance (mental nerve paraesthesia) compared with 2.5 mm bioresorbable plates; GRADE not reported.

1 finding from 1 review

2 mm titanium plates vs 2.5 mm bioresorbable plates

Requirement for additional (surgical) interventions (plate removal / re-operation) · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Plate removal was statistically more likely in the titanium group (Fisher's exact P<0.05); infection led to plate removal in one titanium participant at 2 months and a further 4/21 (19%) titanium participants (six…
    1 study
    GRADE not reported

Locking plate vs 2 mm non-locking titanium plates

Requirement for additional (surgical) interventions · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Only Collins 2004 provided data: 6/122 participants had minor complications (three in each group); five required surgical removal of the locking plates and one post-operative malocclusion was managed with elastic…
    1 study · 122 participants
    GRADE not reported

Two lag screws vs One lag screw (with arch bars and IMF)

Post-operative adverse events and complications · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Three participants in the two-lag-screws group experienced complications: malocclusion (one) and mental-nerve paraesthesia (two, resolved after 3 months). There were no post-operative complications in the one-lag-screw…
    1 study
    GRADE not reported

3-dimensional (3D) miniplates vs Standard (Champy) plates

Post-operative adverse events and complications · Adults (16 to 68 years) with mandibular fractures excluding condylar involvement
1 finding from 1 review
  • Jain 2010 (3D group): segmental mobility (two), proximity to mental nerve or roots (two), radiologically unsatisfactory reduction (one) and unsatisfactory fixation (four) vs one (standard); only fixation differed…
    2 studies
    GRADE not reported

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) vs paracetamol

Patients not using rescue medication at 6 hours · Patients with pain after surgical removal of lower wisdom teeth (third molars) requiring bone removal or with baseline moderate to severe…

Ibuprofen (single postoperative oral dose; 200 mg to 512 mg) leads to higher patients not using rescue medication at 6 hours compared with paracetamol (acetaminophen) (single postoperative oral dose; 600 mg… (high certainty).

1 finding from 1 review

Pre-radiotherapy extraction of healthy molar teeth vs Conservative treatment (leaving the teeth in place during radiotherapy, with oral health education and disease prevention: oral hygiene, fluoride, diet advice)

Patients' quality of life · Patients diagnosed with head and neck cancer planned to undergo any type of radiotherapy (external beam, intensity modulated,…

The review found no eligible studies for this question.

1 finding from 1 review

Two miniplates (transbuccal approach) vs One miniplate plus two screws (intraoral approach at external oblique ridge)

Restoration of function (malocclusion) · Adults with fractures of the mandibular angle

Two miniplates (transbuccal approach) showed no clear difference in restoration of function (malocclusion) compared with one miniplate plus two screws (intraoral approach at external…; GRADE not reported.

1 finding from 1 review