Prevention and Treatment of Complications after Impacted Tooth Extraction: An Overview of Systematic Reviews and Meta-Analyses_Chinese Journal of Evidence-Based Medicine

Authors：

JIAN Yue ^1,2 , WANG Zhu ^1,2 , BAI Chenlu ^1,2 , CHENG Zhen ^1,2 , XU Haili ^1,2 , GU Liping ^1,2 ,  ZENG Xiantao ^1,3,4

1. Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China; 2. School of Stomatology, Hubei University of Medicine, Shiyan 442000, China;3. Oral and Maxillofacial Surgery Research Laboratory, Hubei University of Medicine, Shiyan 442000, China;4. Evidence-Bsed Medicine Center, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China;

Corresponding author：

ZENG Xiantao, Email: zengxiantao1128@163.com

Keywords：

Impacted tooth; Tooth extraction; Complication; Dry socket; Meta-analysis; Systematic review; AMSTAR; GRADE system; Overview

DOI：

10.7507/1672-2531.20130132

Video：

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Objective 　To evaluate the relevant systematic reviews/meta-analyses that focused on the prevention and treatment of complications after impacted tooth extraction.
Methods 　The systematic reviews/meta-analyses on the prevention and treatment of complications after impacted tooth extraction were searched in PubMed, The Cochrane Library, CBM, CNKI and WanFang Data from inception to September 30th, 2012, and a total of 15 professional journals and the references of included studies were also retrieved manually. Two reviewers screened the literature according to the inclusion criteria and extracted the data. Then the AMSTAR was used to evaluate the quality of the included studies, and the GRADE system was used to evaluate the quality of evidence.
Results 　A total of twelve relevant systematic reviews/meta-analyses were included, of which five focused on the prevention and treatment of dry socket, six on the prevention of swelling, seven on the prevention and treatment of pain, six on the prevention of limitation of mouth opening, two on the prevention of infection, three on the prevention of bleeding, and one on the treatment of nerve damage after tooth extraction. Based on AMSTAR, seven studies were minor limitations and five studies were moderate limitations. Based on GRADE system, two was high quality of evidence, twelve were moderate, nine were low, and seven were very low.
Conclusion 　Currently, the systematic reviews/meta-analyses on the prevention and treatment of complications after impacted tooth extraction can provide some references for clinical practice, which should be combined with the real condition by clinical doctors when making an evidence-based decision. However, it also suggests performing more high quality and large sample studies to prove this conclusion.

Citation： JIAN Yue,WANG Zhu,BAI Chenlu,CHENG Zhen,XU Haili,GU Liping,ZENG Xiantao. Prevention and Treatment of Complications after Impacted Tooth Extraction: An Overview of Systematic Reviews and Meta-Analyses. Chinese Journal of Evidence-Based Medicine, 2013, 13(6): 747-753. doi: 10.7507/1672-2531.20130132 Copy

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2.	Clauser B, Barone R, Briccoli L, et al. Complications in surgical removal of mandibular third molars. Minerva Stomatol, 2009, 58(7-8): 359-366.
3.	Colorado-Bonnin M, Valmaseda-Castellón E, Berini-Aytés L, et al. Quality of life following lower third molar removal. Int J Oral Maxillofac Surg, 2006, 35(4): 343-347.
4.	Ruvo AT, Shugars DA, White RP Jr, et al. The impact of delayed clinical healing after third molar surgery on health-related quality-of-life outcomes. J Oral Maxillofac Surg, 2005, 63(7): 929-935.
5.	曾宪涛, 孙竹, 汤红明. Meta分析系列之十: 合格标准的制定. 中国循证心血管医学杂志, 2013, 5(1): 6-9.
6.	吕俊, 李春洁, 王艳, 等. 氯诺昔康控制智牙拔除术后疼痛的系统评价. 中国口腔颌面外科杂志, 2010, 8(6): 487-493.
7.	李冉, 顾晓明. 急性智齿冠周炎即刻拔牙与保守治疗疗效的系统评价. 循证医学, 2006, 6(5): 285-290.
8.	Petersen RB, Labra AC, Araya I, et al. Is Adjuvant Laser Therapy Effective for Preventing Pain, Swelling, and Trismus After Surgical Removal of Impacted Mandibular Third Molars? A Systematic Review and Meta-Analysis. J Oral Maxillofac Surg, 2012, 70(8): 1789-1801.
9.	李薇, 王万芬, 曾宪涛, 等. 中药治疗干槽症效果的Meta分析. 现代中西医结合杂志, 2012, 21(6): 581-584.
10.	Hedström L, Sjögren P. Effect estimates and methodological quality of randomized controlled trials about prevention of alveolar osteitis following tooth extraction: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007, 103(1): 8-15.
11.	Ren YF, Malmstrom HS. Effectiveness of Antibiotic Prophylaxis in Third Molar Surgery: A Meta-Analysis of Randomized Controlled Clinical Trials. J Oral Maxillofac Surg, 2007, 65(10): 1909-1921.
12.	Leung YY, Fung PP, Cheung LK. Treatment Modalities of Neurosensory Deficit After Lower Third Molar Surgery: A Systematic Review. J Oral Maxillofac Surg, 2011, 70(4): 768-778.
13.	Carrasco-Labra A, Brignardello-Petersen R, Yanine N, et al. Secondary Versus Primary Closure Techniques for the Prevention of Postoperative Complications Following Removal of Impacted Mandibular Third Molars: A Systematic Review and Meta- Analysis of Randomized Controlled Trials. J Oral Maxillofac Surg, 2012, 70(8): e441-e457.
14.	Weil K, Hooper L, Afzal Z, et al. Paracetamol for pain relief after surgical removal of lower wisdom teeth. Cochrane Database Syst Rev, 2007, (3): CD004487.
15.	Markiewicz MR, Brady MF, Ding EL, et al. Corticosteroids reduce postoperative morbidity after third molar surgery: A systematic review and meta-analysis. J Oral Maxillofac Surg, 2008, 66(9): 1881-1894.
16.	李薇, 曾宪涛, 龙丹玲, 等. 中药预防第三磨牙拔除术后干槽症效果的Meta分析. 湖北医药学院学报, 2011, 30(4): 402-409.
17.	解龙川, 徐晓明, 曾宪涛. 脱细胞真皮基质预防下颌阻生磨牙拔除术后并发症效果的Meta分析. 湖北医药学院学报, 2012, 31(6): 458-463.
18.	Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR: A Measurement Tool to Assess Systematic Reviews. BMC Medical Research Methodology, 2007, 7(10): 1-10. e7-8.
19.	曾宪涛, 冷卫东, 李胜, 等. 如何正确理解及使用GRADE系统. 中国循证医学杂志, 2011, 11(9): 985-990.
20.	曾宪涛, 田国祥, 牛玉明, 等. GRADE profiler软件的使用简介. 中国循证心血管医学杂志, 2011, 3(5): 390-392.

1. Flick WG. The third molar controversy: framing the controversy as a public health policy issue. Oral Maxillofac Surg, 1999, 57(4): 438-445.
2. Clauser B, Barone R, Briccoli L, et al. Complications in surgical removal of mandibular third molars. Minerva Stomatol, 2009, 58(7-8): 359-366.
3. Colorado-Bonnin M, Valmaseda-Castellón E, Berini-Aytés L, et al. Quality of life following lower third molar removal. Int J Oral Maxillofac Surg, 2006, 35(4): 343-347.
4. Ruvo AT, Shugars DA, White RP Jr, et al. The impact of delayed clinical healing after third molar surgery on health-related quality-of-life outcomes. J Oral Maxillofac Surg, 2005, 63(7): 929-935.
5. 曾宪涛, 孙竹, 汤红明. Meta分析系列之十: 合格标准的制定. 中国循证心血管医学杂志, 2013, 5(1): 6-9.
6. 吕俊, 李春洁, 王艳, 等. 氯诺昔康控制智牙拔除术后疼痛的系统评价. 中国口腔颌面外科杂志, 2010, 8(6): 487-493.
7. 李冉, 顾晓明. 急性智齿冠周炎即刻拔牙与保守治疗疗效的系统评价. 循证医学, 2006, 6(5): 285-290.
8. Petersen RB, Labra AC, Araya I, et al. Is Adjuvant Laser Therapy Effective for Preventing Pain, Swelling, and Trismus After Surgical Removal of Impacted Mandibular Third Molars? A Systematic Review and Meta-Analysis. J Oral Maxillofac Surg, 2012, 70(8): 1789-1801.
9. 李薇, 王万芬, 曾宪涛, 等. 中药治疗干槽症效果的Meta分析. 现代中西医结合杂志, 2012, 21(6): 581-584.
10. Hedström L, Sjögren P. Effect estimates and methodological quality of randomized controlled trials about prevention of alveolar osteitis following tooth extraction: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007, 103(1): 8-15.
11. Ren YF, Malmstrom HS. Effectiveness of Antibiotic Prophylaxis in Third Molar Surgery: A Meta-Analysis of Randomized Controlled Clinical Trials. J Oral Maxillofac Surg, 2007, 65(10): 1909-1921.
12. Leung YY, Fung PP, Cheung LK. Treatment Modalities of Neurosensory Deficit After Lower Third Molar Surgery: A Systematic Review. J Oral Maxillofac Surg, 2011, 70(4): 768-778.
13. Carrasco-Labra A, Brignardello-Petersen R, Yanine N, et al. Secondary Versus Primary Closure Techniques for the Prevention of Postoperative Complications Following Removal of Impacted Mandibular Third Molars: A Systematic Review and Meta- Analysis of Randomized Controlled Trials. J Oral Maxillofac Surg, 2012, 70(8): e441-e457.
14. Weil K, Hooper L, Afzal Z, et al. Paracetamol for pain relief after surgical removal of lower wisdom teeth. Cochrane Database Syst Rev, 2007, (3): CD004487.
15. Markiewicz MR, Brady MF, Ding EL, et al. Corticosteroids reduce postoperative morbidity after third molar surgery: A systematic review and meta-analysis. J Oral Maxillofac Surg, 2008, 66(9): 1881-1894.
16. 李薇, 曾宪涛, 龙丹玲, 等. 中药预防第三磨牙拔除术后干槽症效果的Meta分析. 湖北医药学院学报, 2011, 30(4): 402-409.
17. 解龙川, 徐晓明, 曾宪涛. 脱细胞真皮基质预防下颌阻生磨牙拔除术后并发症效果的Meta分析. 湖北医药学院学报, 2012, 31(6): 458-463.
18. Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR: A Measurement Tool to Assess Systematic Reviews. BMC Medical Research Methodology, 2007, 7(10): 1-10. e7-8.
19. 曾宪涛, 冷卫东, 李胜, 等. 如何正确理解及使用GRADE系统. 中国循证医学杂志, 2011, 11(9): 985-990.
20. 曾宪涛, 田国祥, 牛玉明, 等. GRADE profiler软件的使用简介. 中国循证心血管医学杂志, 2011, 3(5): 390-392.

Chinese Journal of Evidence-Based Medicine

Prevention and Treatment of Complications after Impacted Tooth Extraction: An Overview of Systematic Reviews and Meta-Analyses

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