Is the extraction of third molars a risk factor for the temporomandibular disorders? A systematic review
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REVIEW
Is the extraction of third molars a risk factor for the temporomandibular disorders? A systematic review Yohana Sandy Souza Damasceno 1 & Daybelis González Espinosa 1,2 & David Normando 1 Received: 12 March 2020 / Accepted: 4 April 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background The aim of this study was to evaluate through a systematic review the extraction of third molars as a risk factor for temporomandibular disorders (TMDs). Types of studies reviewed Randomized and nonrandomized controlled clinical trials where patients underwent third molar extraction and with qualitative evaluation of TMDs before and after extraction were included. Results After applying the inclusion criteria, seven nonrandomized clinical studies were included. QUIPS tool showed that four articles presented a moderate and three a high risk of bias (RoB). Six studies reported that TMDs presented higher level after removal of third molars ranging from OR, 1.81 to 2.15/RR, 2.1. However, one study showed no significant association. GRADE showed heterogeneity in relation to general results, which means that confidence in the estimated effects varied from low to moderate GRADE. The quality of clinical recommendations decreased especially due to the risk of bias in some of the included studies evaluated with the QUIPS tool. Conclusions and practical implications Third molar extraction can be associated with the development of TMD signs and symptoms. Furthermore, TMD can be aggravated according to the third molar location, the degree of impaction and surgical difficulty, age, and gender. This systematic review highlights the need to perform randomized clinical trials with diagnostic criteria and standardized surgical procedures. Keywords Temporomandibular joint disorders . Temporomandibular joint dysfunction syndrome . Temporomandibular joint . Third molar . Risk . Oral surgery
Introduction Surgical treatment for third molar removal is a common clinical practice in dentistry [1–3]. The benefits include the prevention of caries, pericoronaritis, root resorption on the distal surface of
First Author: Yohana Sandy Souza Damasceno All authors read and approved the final manuscript Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00784-020-03277-6) contains supplementary material, which is available to authorized users. * David Normando [email protected] 1
Department of Orthodontics, Dental School, Faculty of Dentistry, Federal University of Pará (UFPA), Augusto Correa St., no 1, Belém, Pará 66075-110, Brazil
2
Facultad de Odontologi, Universidad Católica Redemptoris Mater, Managua, Nicaragua
second molars, and odontogenic cysts [1–4]. However, the prophylactic removal of asymptomatic third molars has been the subject of considerable controversy. There is insufficient evidence to support or refute the prophylactic extraction of asymptomatic impacted third molars, even in adult patients [2–6]. On the other hand, if early removal of third molars coul
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