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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.
866 questions in 43 reviews · Oral and maxillofacial surgery
current versionsNo 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.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Absence (previous removal or agenesis) of asymptomatic disease-free impacted wisdom teeth vs Presence (retention) of asymptomatic disease-free impacted wisdom teeth Periodontitis (distal alveolar bone loss, adjacent second molar) · Adults (416 healthy male volunteers aged 24 to 84 years) with asymptomatic disease-free impacted wisdom teeth · Follow-up 3 to over 25 years, Soft tissue impaction Surgical removal versus retention for the management of asymptomatic disease‐free impacted wisdom teeth (2020) · Cochrane | RR 0.11 [0.06, 0.22] | 1 study · 416 participants | Very low |
Bone removal technique (chisel / piezoelectric / ultrasonic) vs Bur (conventional rotary) Permanent altered tongue, chin, or lip sensation · Adults with mandibular third molars requiring removal · >6 months Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | no estimate extracted | NR | No studies |
Absence (previous removal or agenesis) of asymptomatic disease-free impacted wisdom teeth vs Presence (retention) of asymptomatic disease-free impacted wisdom teeth Periodontitis (distal probing depth greater than 4 mm, adjacent second molar) · Adults (416 healthy male volunteers aged 24 to 84 years) with asymptomatic disease-free impacted wisdom teeth · Follow-up 3 to over 25 years, Bony impaction Surgical removal versus retention for the management of asymptomatic disease‐free impacted wisdom teeth (2020) · Cochrane | RR 0.63 [0.37, 1.04] | 1 study · 416 participants | Very low |
Absence (previous removal or agenesis) of asymptomatic disease-free impacted wisdom teeth vs Presence (retention) of asymptomatic disease-free impacted wisdom teeth Caries affecting the (distal) adjacent second molar · Adults (416 healthy male volunteers aged 24 to 84 years) with asymptomatic disease-free impacted wisdom teeth · Follow-up 3 to over 25 years, Bony impaction Surgical removal versus retention for the management of asymptomatic disease‐free impacted wisdom teeth (2020) · Cochrane | RR 0.69 [0.27, 1.82] | 1 study · 416 participants | Very low |
Surgical removal (extraction) of asymptomatic disease-free impacted wisdom teeth vs Retention (conservative management) of asymptomatic disease-free impacted wisdom teeth Costs (days off work/study; direct costs of retention or removal) · Adolescents or adults with asymptomatic disease-free impacted wisdom teeth Surgical removal versus retention for the management of asymptomatic disease‐free impacted wisdom teeth (2020) · Cochrane | Costs: Not measured. The included studies did not measure days off work/study or direct costs associated with retention or removal of wisdom teeth and treatment of associated symptoms or complications. | 0 studies | No studies |
Autologous platelet concentrate (PRP/PRF) in socket vs No blood product (conventional) Adverse effects · Adults with mandibular third molars requiring removal · up to 30 days Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | no estimate extracted | NR | No studies |
Surgical removal (extraction) of asymptomatic disease-free impacted wisdom teeth vs Retention (conservative management) of asymptomatic disease-free impacted wisdom teeth Health-related quality of life · Adolescents or adults with asymptomatic disease-free impacted wisdom teeth Surgical removal versus retention for the management of asymptomatic disease‐free impacted wisdom teeth (2020) · Cochrane | Health-related quality of life: Our primary outcome was not assessed in the included studies. | 0 studies | No studies |
Triangular flap vs Envelope flap Permanent altered tongue, chin, or lip sensation · Adults with mandibular third molars requiring removal · >6 months Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | Peto OR 4.48 [0.07, 286.49] | 1 study · 45 participants | Very low |
Lingual nerve retractor (subperiosteal or Free's) vs No retractor Adverse effects (reactionary bleeding) · Adults with mandibular third molars requiring removal · up to 30 days Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | no estimate extracted | NR | No studies |
Surgical removal (extraction) of asymptomatic disease-free impacted wisdom teeth vs Retention (conservative management) of asymptomatic disease-free impacted wisdom teeth Intercanine width (dimensional changes in the dental arch) · Adolescents or adults with asymptomatic disease-free impacted wisdom teeth · 5 years (66 months) Surgical removal versus retention for the management of asymptomatic disease‐free impacted wisdom teeth (2020) · Cochrane | MD -0.01 [-0.37, 0.35] | 1 study · 77 participants | Low |
Primary (complete) wound closure vs Secondary (partial) wound closure Postoperative pain (mean) · Adults with mandibular third molars requiring removal · 24 hours Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | MD 0.94 [0.50, 1.38] | 5 studies · 474 participants | Ungraded |
Lingual nerve retractor (subperiosteal or Free's) vs No retractor Alveolar osteitis · Adults with mandibular third molars requiring removal · 1 week Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | no estimate extracted | NR | No studies |
Autologous platelet concentrate (PRP/PRF) in socket vs No blood product (conventional) Permanent altered tongue, chin, or lip sensation · Adults with mandibular third molars requiring removal · >6 months Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | no estimate extracted | NR | No studies |
Lingual nerve retractor (subperiosteal or Free's) vs No retractor Permanent altered tongue, chin, or lip sensation · Adults with mandibular third molars requiring removal · >6 months Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | Peto OR 0.14 [0.00, 6.82] | 1 study · 380 participants | Very low |
Coronectomy vs Complete extraction (odontectomy) Alveolar osteitis · Adults with mandibular third molars requiring removal · 1 week Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | no estimate extracted | NR | No studies |
Lingual nerve retractor (subperiosteal or Free's) vs No retractor Postoperative pain · Adults with mandibular third molars requiring removal · 24 hours Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | no estimate extracted | NR | No studies |
Lingual split with chisel vs Surgical handpiece (bur) Wound infection · Adults with mandibular third molars requiring removal · 1 week, chisel vs bur Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | OR 1.00 [0.31, 3.21] | 1 study · 52 participants | Very low |
Autologous platelet concentrate (PRP/PRF) in socket vs No blood product (conventional) Alveolar osteitis · Adults with mandibular third molars requiring removal · 1 week, PRF vs none Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | OR 0.39 [0.22, 0.67] | 2 studies · 128 participants | Low |
Primary (complete) wound closure vs Secondary (partial) wound closure Maximum mouth opening (mean) · Adults with mandibular third molars requiring removal · 7 days Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | MD -0.29 [-0.90, 0.32] | 4 studies · 274 participants | Ungraded |
Triangular flap vs Envelope flap Temporary altered tongue, chin, or lip sensation · Adults with mandibular third molars requiring removal · ~1 month Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | no estimate extracted | NR | No studies |
Mechanical (high-volume) irrigation vs Manual (low-volume) irrigation Alveolar osteitis · Adults with mandibular third molars requiring removal · 1 week, mechanical vs manual Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | RR 0.33 [0.01, 8.09] | 1 study · 99 participants | Very low |
Triangular flap vs Envelope flap Maximum mouth opening · Adults with mandibular third molars requiring removal · 7 days, short triangular vs envelope Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | SMD -0.67 [-1.04, -0.30] | 2 studies · 158 participants | Ungraded |
Coronectomy vs Complete extraction (odontectomy) Wound infection · Adults with mandibular third molars requiring removal · 1 week Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | no estimate extracted | NR | No studies |
Piezoelectric bone removal vs Conventional rotary handpiece Trismus / maximum mouth opening (mean) · Adults with mandibular third molars requiring removal · 7 days, piezoelectric vs conventional Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | MD 2.68 [0.54, 4.81] | 4 studies · 110 participants | Ungraded |
Autologous platelet concentrate (PRP/PRF) in socket vs No blood product (conventional) Postoperative pain (mean) · Adults with mandibular third molars requiring removal · 24 hours, PRF vs none Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | MD -0.13 [-0.59, 0.34] | 3 studies · 116 participants | Ungraded |
Primary (complete) wound closure vs Secondary (partial) wound closure Alveolar osteitis · Adults with mandibular third molars requiring removal · 1 week Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | RR 0.99 [0.41, 2.40] | 3 studies · 375 participants | Low |
Coronectomy vs Complete extraction (odontectomy) Maximum mouth opening (mean) · Adults with mandibular third molars requiring removal · 7 days Surgical techniques for the removal of mandibular wisdom teeth (2020) · Cochrane | MD -2.94 [-8.20, 2.32] | 1 study · 30 participants | Ungraded |
Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo) Number of minor postoperative bleeding episodes · People with haemophilia (A or B) undergoing minor oral surgery or dental extractions Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… (2019) · Cochrane | This outcome was not reported in either of the trials. | 0 studies | No studies |
Fluoride gel (450 ppm) 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… · 14 to 36 months Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy (2019) · Cochrane | Adverse effects were an outcome of interest in the study conducting this comparison, however no mention was made of the presence or absence of any adverse events | 1 study · 220 participants | Very low |
Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo) Outcome NR · People with Von Willebrand disease undergoing minor oral surgery or dental extractions Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… (2019) · Cochrane | No randomised or quasi-randomised controlled trials in people with Von Willebrand disease met the inclusion criteria; no eligible VWD trials were identified. | 0 studies | No studies |
Hyperbaric oxygen therapy (HBO) following extractions vs Perioperative antibiotic prophylaxis (penicillin G) following extractions Incidence of ORN · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the… · 6 months Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy (2019) · Cochrane | RR 0.18 [0.43, 0.76] | 1 study · 74 participants | Very low |
Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo) Major bleeding, requiring transfusion of packed red blood cells · People with haemophilia (A or B) undergoing minor oral surgery or dental extractions Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… (2019) · Cochrane | Only reported in the Walsh (EACA) trial: in none of the 31 included participants was blood transfusion required. | 1 study · 31 participants | Ungraded |
Combined HBO and perioperative antibiotics prior to dental implant therapy vs Antibiotics alone prior to dental implant therapy Adverse effects (including quality of life) · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the… · 1 year Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy (2019) · Cochrane | This comparison was only made in 1 study which reported no serious adverse events associated with HBO therapy. Quality of life measures (oral status, functioning, satisfaction) showed emotional functioning and pain… | 1 study · 26 participants | Very low |
Hyperbaric oxygen therapy (HBO) following extractions vs Perioperative antibiotic prophylaxis (penicillin G) following extractions Adverse effects · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the… · 6 months Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy (2019) · Cochrane | Adverse effects were an outcome of interest in the study conducting this comparison, however no mention was made of the presence or absence of any adverse events | 1 study · 74 participants | Very low |
Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo) Change in haemoglobin level from baseline · People with haemophilia (A or B) undergoing minor oral surgery or dental extractions Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… (2019) · Cochrane | Mean fall in haemoglobin. Forbes (TXA): 1.4 g/100 mL (placebo) vs 0.3 g/100 mL (TXA). Walsh (EACA): 6.3% (placebo, both centres) vs 3.9% and 3.7% (EACA, centres 1 and 2); differences not significant. Reported in… | 2 studies · 59 participants | Ungraded |
Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo) Bleeding duration · People with haemophilia (A or B) undergoing minor oral surgery or dental extractions Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… (2019) · Cochrane | This outcome was not reported in either of the trials. | 0 studies | No studies |
Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo) Need for and dose of clotting factor concentrates · People with haemophilia (A or B) undergoing minor oral surgery or dental extractions Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… (2019) · Cochrane | Reported in both trials in different ways. Forbes (TXA): mean units of replacement therapy per root extracted 617 IU (range 0 to 15,800) in 11 placebo participants versus 30 IU and 65 IU per root in 2 TXA participants… | 2 studies · 59 participants | Ungraded |
Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo) Any postoperative complication except bleeding (such as wound infection) · People with haemophilia (A or B) undergoing minor oral surgery or dental extractions Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… (2019) · Cochrane | This outcome was not reported in either of the trials. | 0 studies | No studies |
Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo) Number of postoperative bleeding episodes requiring intervention · People with haemophilia (A or B) undergoing minor oral surgery or dental extractions · Up to 10 days postoperative Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… (2019) · Cochrane | RD -0.57 [-0.76, -0.37] | 2 studies · 59 participants | Moderate |
Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo) Amount of postoperative blood loss (mL) · People with haemophilia (A or B) undergoing minor oral surgery or dental extractions Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… (2019) · Cochrane | Only reported in the Forbes (TXA) trial: over five-day follow-up, mean blood loss per participant 84.1 mL (range 4 to 323) in the placebo group (n=14) versus 61.2 mL (range 1 to 749) in the TXA group (n=14), P = 0.02. | 1 study · 28 participants | Ungraded |
PRP (platelet-rich plasma) in cellulose foam placed in extraction socket vs No treatment/placebo (cellulose foam only) placed in extraction socket Incidence of ORN · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the… · 5-year follow-up Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy (2019) · Cochrane | OR 3.32 [0.58, 19.09] | 1 study · 44 participants | Very low |
Fluoride gel (450 ppm) vs High-content fluoride toothpaste (1350 ppm) Incidence of ORN · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the… · 14 to 36 months Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy (2019) · Cochrane | This comparison was only made in 1 study, which showed no difference between the 2 interventions: no patients in either group developed ORN (12- to 36-month follow-up) (0/99 in the fluoride gel group and 0/91 in the… | 1 study · 220 participants | Very low |
PRP (platelet-rich plasma) in cellulose foam placed in extraction socket vs No treatment/placebo (cellulose foam only) placed in extraction socket Adverse effects (wound pain) · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the… · 2 weeks to 12 months Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy (2019) · Cochrane | This comparison was only made in 1 study: mean pain scores at 2 weeks, 2, 6, 9, and 12 months showed no 'significant' differences between the 2 groups (self-reported Likert scale 1 to 10; difference at 2 weeks P =… | 1 study · 44 participants | Very low |
Combined HBO and perioperative antibiotics prior to dental implant therapy vs Antibiotics alone prior to dental implant therapy Incidence of ORN · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the… · 1 year Interventions for preventing osteoradionecrosis of the jaws in adults receiving head and neck radiotherapy (2019) · Cochrane | RR 3.00 [0.14, 65.16] | 1 study · 26 participants | Very low |
Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo) Number of immediate (less than 24 hours) and delayed (24 hours to 10 days) postoperative bleeding episodes requiring intervention · People with haemophilia (A or B) undergoing minor oral surgery or dental extractions · Immediate (<24 h) and delayed (24 h to 10 days) Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… (2019) · Cochrane | This outcome was not reported in either of the trials. | 0 studies | No studies |
Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo) Side effects or other adverse events · People with haemophilia (A or B) undergoing minor oral surgery or dental extractions · Up to 10 days postoperative Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… (2019) · Cochrane | RD 0.034 [-0.32, 0.38] | 2 studies · 59 participants | Low |
Bilateral extraction of compromised mandibular first permanent molars vs Age- and gender-matched non-extraction controls Lower incisor inclination (lingual tipping and retrusion) · 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: lower incisor lingual tipping (1.NB mean 23.2 vs 28.4 degrees, P = 0.004) and retrusion (P = 0.03) after bilateral lower FPM loss. Table 3: Category III, Class C. | 1 study | Ungraded |
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) 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 [-0.04, 0.04] | 2 studies · 125 participants | Ungraded |
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 thromboembolic complications · 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 extracted | 0 studies | No studies |
Any surgical or non-surgical technique or material used for the treatment of post-extraction bleeding vs Another active intervention, placebo, or no treatment Bleeding, as measured by: amount of blood loss; complete cessation of bleeding as assessed clinically by the investigator; time required for the control of bleeding · 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 bleeding | 0 studies | No studies |