The present systematic review was performed to investigate if there is evidence justifying the prophylactic extraction of third molars, one of the most frequent procedures in oral surgery. A series of searches was carried out for randomized, clinical trials and systematic reviews in seven databases (MEDLINE, BBO, LILACS, Web of Science, EMBASE, BIREME and Cochrane Library), with no restrictions regarding year or language. A supplemental manual search of the references of retrieved articles was also performed. The search strategy resulted in 260 papers. Both the data extracted and the quality of each paper were evaluated independently by two reviewers. After selection based on the preestablished eligibility criteria, four papers qualified for the final analysis. A medium degree of quality and methodological consistency was found in three studies, and low quality was found in one study. No studies showed a high degree of consistency. The most significant flaw was an inadequate sample size. The results of the present review indicate a lack of scientific evidence to justify the indication of the prophylactic extraction of third molars.
Objective: To determine the prevalence of nickel allergy in a sample of orthodontic patients and longitudinally compare the clinical periodontal status of these individuals with that of a group of nonallergic patients.
Materials and Methods:The initial sample consisted of 96 patients selected randomly from a databank of patients who sought orthodontic care at a teaching institution. Following the selection and beginning of treatment, periodontal status was assessed over a 12-month period (one evaluation every 3 months-T 1 , T 2, T 3, T 4 ) using the Loe index. The evaluations were performed blindly by a single, calibrated examiner and were followed by prophylaxis and orientation regarding oral hygiene. The prevalence of nickel allergy was determined by the patch test 9 months after the beginning of treatment and occurred in 16 individuals (17.2%). Two groups were then established: the allergic group (AG, n ϭ 16) and the age-paired nonallergic control group (NAG, n ϭ 16). Data were analyzed using the Mann-Whitney U-test and Friedman's analysis of variance (ANOVA) tests (P Յ .05). Results: Significant differences were present between groups at the T 3 and T 4 evaluations for the LOE index (P ϭ .045 and .009), with allergic individuals showing higher mean values than nonallergic individuals (hyperplasia, change in color, and bleeding). No significant differences were found in the intragroup evaluations between the four evaluations (P Ͼ .05).
Conclusions:The results suggest a cumulative effect from nickel throughout orthodontic treatment associated with clinically significant periodontal abnormalities in allergic individuals over time. (Angle Orthod. 2009;79:922-927.)
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