Search

Background: The removal of third molars (3Ms) is the most frequent surgical procedure in the field of Oral Surgery. As a result, the Spanish Society of Oral Surgery (SECIB) aims to create a Clinical Practice Guideline (CPG) that offers evidence-based recommendations for optimal clinical practice. Specifically, the CPG will focus on providing guidance regarding the indications and criteria for clinical and radiological diagnosis of patients with 3Ms. Material and Methods: This CPG was developed by the SECIB, following the methodological guidelines described in the methodological manual for the “Development of Clinical Practice Guidelines in the National Health System”. Several PICO questions related to the diagnosis and indications for the extraction of 3Ms were formulated. The leading experts carried out the evaluation of the evidence and the formulation of specific recommendations. Results: A total of 17 PICO questions were evaluated, addressing the indications, prognosis, diagnosis, and costbenefit relationship of 3M extraction. Conclusions: The present Clinical Practice Guideline provides evidence-based recommendations on the diagnosis and indications for 3M extraction. These evidence-based recommendations can assist healthcare professionals and the general population in making informed decisions regarding the management of 3Ms. [ABSTRACT FROM AUTHOR]

Background: Apicomarginal lesions affect the root apex and root surface concurrently and reduce the success rate in periapical surgery. The purpose of this systematic review was to analyze the published literature on the surgical treatment of apicomarginal lesions in periapical surgery. Material and Methods: A systematic review was conducted on PRISMA statement. Three data bases (PubMed-Medline, Scopus, and Embase) were searched up to March 2023. The inclusion criteria for this systematic review encompass studies pertaining to apicomarginal lesions and their surgical treatment, both preclinical and clinical in nature (including randomized trials, prospective, and retrospective observational trials), without any language or time limitations. Exclusion criteria encompass studies with duplicated population data, no description of the surgical treatment or regenerative material. Different tools for the assessment of bias were applied for each study design Results: A total of 155 articles were searched and 10 were included. Studies on teeth with apicomarginal lesions undergoing periapical surgery showed a high success rate when regenerative techniques were used, resulting in reduced probing depth, increased bone formation on the root surface, increased root cementum formation, and reduced healing by junctional epithelium. Guided tissue regeneration, platelet-rich plasma or fibrin, and enamel matrix derivatives have emerged as alternative treatments offering favorable outcomes. Conclusions: The use of regenerative materials in periapical surgery could improve the prognosis of apicomarginal lesions. Future research in this field should aim to standardize classification and healing criteria to enhance comparability across studies and provide more conclusive evidence for optimal treatment approaches. [ABSTRACT FROM AUTHOR]

Background: The number of patients treated with coagulation disorders, and more specifically with anticoagulant therapy, has increased worldwide in recent years due to increased life expectancy in developed countries. The protocols for managing this type of patient in oral surgery has varied over recent years, especially after the appearance of new direct-acting oral anticoagulants (DOACs). The assessment of risk of bleeding in this type of patient when undergoing a surgical procedure continues to be a controversial issue for patients, dentists and general practitioners. The objective of this document is to offer recommendations, based on evidence, for decision making for patients with coagulopathies who require dental surgical intervention. Material and Methods: Based on the indications of the "Preparation of Clinical Practice guidelines in the National Health System. Methodological manual", we gathered a group of experts who agreed on 15 PICO questions based on managing patients with coagulation disorders in dental surgical procedures, such as fitting of implants or dental extractions. Results: The 15 PICO questions were answered based on the available evidence, being limited in most cases due to the lack of a control group. Two of the PICO questions were answered by the experts with a grade C recommendation, while the rest were answered with grade D. Conclusions: The results of this review highlight the need to undertake well designed clinical trials with control groups and with a representative sample size. [ABSTRACT FROM AUTHOR]