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Evidence found and GRADE certainty

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

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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%

CBT vs alternative treatment

Reduction in pain intensity · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in pain intensity at treatment completion compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

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

Adverse events · Adults (>18 years) having permanent tooth extraction (predominantly mandibular third molars)
1 finding from 1 review
  • Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
    Follow-up: median 7 days
    No adverse events were reported. Six trials (673 participants) reported no adverse events from the use of chlorhexidine gel; one study (Rubio-Palau 2015) reported gastrointestinal discomfort (30, 18%), dizziness (10,…
    7 studies
    GRADE not reported

Neocone vs Alvogyl

Time to initial pain relief (minutes) · Adults (>18 years) with established dry socket following permanent tooth extraction

Neocone led to higher time to initial pain relief (minutes) compared with alvogyl; GRADE not reported.

1 finding from 1 review

Tranexamic acid (AMCA cones) vs Placebo (lactose cones)

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

Tranexamic acid (AMCA cones) showed no clear difference in presence of dry socket compared with placebo (lactose cones); GRADE not reported.

1 finding from 1 review

Primary closure of the extraction socket with a mucoperiosteal flap vs Application of platelet-rich fibrin (PRF) without primary closure

MRONJ (incidence proportion) · People on antiresorptive treatment undergoing tooth extraction (at risk of MRONJ)
1 finding from 1 review
  • Interventions for managing medication‐related osteonecrosis of the jaw 2022 · Cochrane All outcomes
    90 days
    All participants had complete mucosal coverage without any signs of MRONJ at the final control examination 90 days postoperatively (77 randomised; 1 RCT); no case of postoperative MRONJ in either group; effect not…
    1 study · 77 participants
    GRADE not reported

Relaxation vs Occlusal (oral) appliance

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Relaxation showed no clear difference in pain intensity compared with occlusal (oral) appliance; GRADE not reported.

1 finding from 1 review
  • Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
    Treatment completion · Adolescents (12-19 years)
    Not pooled. Wahlund 2015: MD 3.70 (95% CI -1.21 to 8.61), n=57 (relaxation 28, appliance 29); Wahlund 2003: MD not reported, n=83 (relaxation 41, appliance 42). Both studies were in adolescents; the occlusal appliance…
    2 studies · 140 participants
    GRADE not reported

Apernyl (acetylsalicylic acid pellet) vs placebo

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

Apernyl (acetylsalicylic acid pellet) showed no clear difference in presence of dry socket compared with placebo; GRADE not reported.

1 finding from 1 review

Advanced platelet rich fibrin (A-PRF) vs No active treatment (control)

Pain (VAS cm) · Adults (>18 years) with established dry socket following permanent tooth extraction

Advanced platelet rich fibrin (A-PRF) led to lower pain (VAS cm) compared with control (no treatment); GRADE not reported.

1 finding from 1 review

SaliCept (acemannan hydrogel) vs no treatment

Pain (VAS) · Adults (>18 years) with established dry socket following permanent tooth extraction
1 finding from 1 review

CBT vs alternative treatment

Mental distress · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) may leads to lower psychological distress at follow-up compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review
  • Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
    Only 1 study reported adverse events as an outcome (Litt 2010): it found worsening symptoms in 13 people treated with an oral splint (as part of standard treatment) and 4 people treated with CBT.
    1 study · 101 participants
    Very low

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

Complications and side effects · People with cancer treated with intravenous bisphosphonates undergoing dental extractions (at risk of MRONJ)
1 finding from 1 review