Evidence map›Paper›PMID 40844636›Full record

SynthesisOral and maxillofacial surgery2025

Interventions to minimize periodontal defect distal to second molar after mandibular third molar surgery: an overview of systematic reviews.

Ioulianos Apessos, Christodoulos Dovas, Spyridon Mantalenakis, Theodoros Lillis, Georgios Antonoglou

Abstract readSystematic Review
In one paragraph

Synthesis in Oral and maxillofacial surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ioulianos ApessosDepartment of Dentoalveolar Surgery, Implantology and Oral Radiology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece. julianapessos@hotmail.com.ORCID http://orcid.org/0000-0002-4085-6378
Christodoulos DovasDepartment of Dentoalveolar Surgery, Implantology and Oral Radiology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece.
Spyridon MantalenakisDepartment of Dentoalveolar Surgery, Implantology and Oral Radiology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece.
Theodoros LillisDepartment of Dentoalveolar Surgery, Implantology and Oral Radiology, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece.ORCID http://orcid.org/0000-0002-9029-8714
Georgios AntonoglouPeriodontology Unit, Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.ORCID http://orcid.org/0000-0002-8254-5471

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis overview summarized different interventions that were performed for minimizing periodontal defects distal to the mandibular second molar and improve hard and soft tissue healing after third molar surgery.

methodsLiterature search was conducted in the following 9 databases: Medline (via Pubmed), ScienceDirect, Scopus, Virtual Health Library, Wiley Online Library, Web of Science, ProQuest Dissertations and Theses Global and Google Scholar. Systematic reviews with or without meta-analysis investigating the effect of different interventions on soft and hard tissue healing after third molar surgery were considered. Methodological quality of included reviews was assessed with AMSTAR-2 tool. The degree of overlapping of index publications in the eligible reviews was presented and calculated with the GROOVE tool.

resultsThirty-three reviews were included, collectively encompassing 191 distinct primary studies that evaluated flap design, extraction socket management, and postsurgical care. Quantitative data retrieved from the methodologically rigorous MAs revealed that the application of autologous platelet concentrates (APCs) is the best choice to improve soft tissue healing [MD = 1.01; 95% CI (0.77, 1.24), 7 days follow-up] and bone mineral density [SMD = 2.34; 95% CI (0.18,4.51), 4 months follow-up] and alleviate pain [SMD= -0.86; 95% CI (-1.26, -0.46), 3 days follow-up], trismus [SMD= -0.26; 95% CI (-0.48, -0.03), 7 days follow-up], alveolar osteitis [RR = 0.43; 95% CI (0.28, 0.65)] and swelling [MD= -1.66; 95% CI (-2.43, -0.90), 3 days follow-up]. Ridge preservation is the most effective intervention in improving pocket probing depth [MD= -1.42; 95% CI (-2.01, -0.83), 6-72 months follow-up], clinical attachment level [MD = 1.98; 95% CI (1.44, 2.52), 4.5-72months follow-up] and alveolar bone height [MD = 1.21; 95% CI (0.21, 2.21), 6-12 months follow-up] distal to mandibular second molar.

conclusionMinimizing tissue trauma is key in surgical extractions. Our overview found that triangular flaps reduce PPD, while envelope flaps lower postoperative pain. APCs improved healing and reduced adverse events, and HyA mainly alleviated pain. All regenerative techniques enhanced periodontal outcomes, though high heterogeneity and variable study quality urge cautious interpretation.

Indexed as

Molar, ThirdPeriodontal DiseasesPostoperative ComplicationsTooth ExtractionTooth, ImpactedHumansMandibleSurgical FlapsSystematic Reviews as TopicTooth SocketWound HealingMolar, third/surgeryOral surgical proceduresPeriodontal diseasesSystematic reviews (as topic)

Identifiers

PMID40844636
PMCPMC12373545

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.