Findings

What do systematic reviews say?

153 questions · 212 findings · 18 reviews · Oral and maxillofacial surgery

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No studies found 25 · 11.8%GRADE not reported 151 · 71.2%Very low 20 · 9.4%Low 10 · 4.7%Moderate 2 · 0.9%High 4 · 1.9%

Alvogyl vs SaliCept (acemannan hydrogel)

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

1 finding from 1 review

Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
Alvogyl versus SaliCept (acemannan hydrogel) (Kaya 2011): data not usable (medians presented with error bars). Text reports differences in clinical signs and symptoms between control and all 3 treatment groups…
1 study
GRADE not reported

Neocone vs Alvogyl

Mean time to resolution of pain · Adults (>18 years) with established dry socket following permanent tooth extraction

Neocone led to lower time to complete resolution of pain (days) compared with alvogyl; GRADE not reported.

1 finding from 1 review

Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
Complete resolution of pain
MD -1.62 [-1.86, -1.38]
1 study · 78 participants
GRADE not reported

Alvogyl vs Zinc oxide and eugenol (ZOE)

Mean time to resolution of pain · Adults (>18 years) with established dry socket following permanent tooth extraction

Alvogyl led to lower time to complete resolution of pain (days) compared with zinc oxide eugenol; GRADE not reported.

1 finding from 1 review

Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
Complete resolution of pain
MD -2.17 [-2.37, -1.97]
1 study · 78 participants
GRADE not reported

Zinc oxide and eugenol (ZOE) vs Alvogyl (old formulation)

Success rate (radiographically‐assessed healing of cyst healing based on the Neer/Cole rating system) · Adults (>18 years) with established dry socket following permanent tooth extraction

1 finding from 1 review

Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
Healing: 2 studies (Faizel 2015; Supe 2018) used different healing outcomes and could not be combined; Alvogyl appeared to heal faster than zinc oxide eugenol. Supe 2018: delayed (non-healed after 10 days) 2/25 Alvogyl…
2 studies
GRADE not reported

Alvogyl vs Platelet-rich fibrin (PRF)

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

1 finding from 1 review

Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
Alvogyl versus platelet rich fibrin (Keshini 2020): single study (30 participants); no usable pooled estimate extracted
1 study · 30 participants
GRADE not reported

Metronidazole (intrasocket) vs placebo

Duration of treatment (days) · Adults (>18 years) with established dry socket following permanent tooth extraction

Metronidazole (intrasocket) led to lower duration of treatment (days) compared with placebo; GRADE not reported.

1 finding from 1 review

Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
MD -3.17 [-5.30, -1.04]
1 study · 55 participants
GRADE not reported

Plasma rich in growth factors (PRGF) vs Alvogyl

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

Plasma rich in growth factors (PRGF) showed no clear difference in pain (VAS cm) compared with alvogyl; GRADE not reported.

1 finding from 1 review

Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
Day 7 (also day 3)
MD -0.40 [-1.77, 0.97]
1 study · 44 participants
GRADE not reported

Neocone vs Zinc oxide and eugenol (ZOE)

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

Neocone led to lower time to initial pain relief (minutes) compared with zinc oxide eugenol; GRADE not reported.

1 finding from 1 review

Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
Initial pain relief
MD -7.77 [-8.86, -6.68]
1 study · 78 participants
GRADE not reported

Alvogyl vs no treatment

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

1 finding from 1 review

Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
Alvogyl versus No treatment (Kaya 2011): data not usable (medians presented with error bars). Text reports differences in clinical signs and symptoms between control and all 3 treatment groups significant (P<0.05) at…
1 study
GRADE not reported

Zinc oxide and eugenol (ZOE) vs Alvogyl (old formulation)

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

It is very uncertain whether zinc oxide eugenol changes pain (VAS 0-10) compared with alvogyl (old formulation) (very low certainty).

1 finding from 1 review

Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
Day 7
MD 1.40 [1.04, 1.75]
2 studies · 80 participants
Very low

Neocone vs Zinc oxide and eugenol (ZOE)

Mean time to resolution of pain · Adults (>18 years) with established dry socket following permanent tooth extraction

Neocone led to lower time to complete resolution of pain (days) compared with zinc oxide eugenol; GRADE not reported.

1 finding from 1 review

Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
Complete resolution of pain
MD -3.79 [-4.04, -3.54]
1 study · 78 participants
GRADE not reported

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

Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
48 hours
MD -0.20 [-1.87, 1.47]
1 study · 35 participants
GRADE not reported

Alvogyl vs Zinc oxide and eugenol (ZOE)

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

Alvogyl led to lower time to initial pain relief (minutes) compared with zinc oxide eugenol; GRADE not reported.

1 finding from 1 review

Local interventions for the management of alveolar osteitis (dry socket) 2022 · Cochrane All outcomes
Initial pain relief
MD -17.64 [-18.76, -16.52]
1 study · 78 participants
GRADE not reported

High-volume irrigation (~175 mL) vs Low-volume irrigation (~25 mL)

Wound infection · Adults with mandibular third molars requiring removal

It is very uncertain whether high-volume irrigation (~175 mL) changes wound infection compared with low-volume irrigation (~25 mL) (very low certainty).

1 finding from 1 review

Surgical techniques for the removal of mandibular wisdom teeth 2020 · Cochrane All outcomes
1 week · high vs low volume
RR 0.17 [0.02, 1.37]
1 study · 211 participants
Very low

High-volume irrigation (~175 mL) vs Low-volume irrigation (~25 mL)

Presence of dry socket · Adults with mandibular third molars requiring removal

It is very uncertain whether high-volume irrigation (~175 mL) changes alveolar osteitis compared with low-volume irrigation (~25 mL) (very low certainty).

1 finding from 1 review

Surgical techniques for the removal of mandibular wisdom teeth 2020 · Cochrane All outcomes
1 week · high vs low volume
RR 0.52 [0.27, 1.02]
1 study · 211 participants
Very low

Mechanical (high-volume) irrigation vs Manual (low-volume) irrigation

Wound infection · Adults with mandibular third molars requiring removal

It is very uncertain whether mechanical (high-volume) irrigation changes wound infection compared with manual (low-volume) irrigation (very low certainty).

1 finding from 1 review

Surgical techniques for the removal of mandibular wisdom teeth 2020 · Cochrane All outcomes
1 week · mechanical vs manual
RR 0.50 [0.05, 5.43]
1 study · 99 participants
Very low

Mechanical (high-volume) irrigation vs Manual (low-volume) irrigation

Presence of dry socket · Adults with mandibular third molars requiring removal

It is very uncertain whether mechanical (high-volume) irrigation changes alveolar osteitis compared with manual (low-volume) irrigation (very low certainty).

1 finding from 1 review

Surgical techniques for the removal of mandibular wisdom teeth 2020 · Cochrane All outcomes
1 week · mechanical vs manual
RR 0.33 [0.01, 8.09]
1 study · 99 participants
Very low

Intraoperative Rapid IMF vs Eyelet wire ties

Intraoperative complications · Adults with mandibular fractures excluding condyles (following open reduction)

Intraoperative Rapid IMF showed no clear difference in intraoperative complications compared with eyelet wire ties; GRADE not reported.

1 finding from 1 review

Interventions for the management of mandibular fractures 2013 · Cochrane All outcomes
RR 2.6 [1.0, 7.0]
Studies not reported
GRADE not reported

Orthodontic treatment with appliances inducing stable, permanent orthodontic tooth movement (splints worn 8 to 12 weeks and surgical interventions excluded) vs Control: no treatment, placebo, or reassurance

Development of TMD (onset/incidence of signs and symptoms) · People without TMD at baseline undergoing orthodontic treatment (TMD clinically absent at baseline); no age restriction provided follow-up…

The review found no eligible studies for this question.

1 finding from 1 review

Orthodontics for treating temporomandibular joint (TMJ) disorders 2010 · Cochrane All outcomes
Follow-up period extended into adulthood
no estimate extracted
0 studies
No studies found

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Presence of dry socket · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

Systemic antibiotic prophylaxis (any regimen; topical therapy… may leads to lower dry socket compared with placebo (low certainty).

1 finding from 1 review

Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
1st to 7th day
RR 0.66 [0.45, 0.97]
13 studies · 1882 participants
Low