Do antibiotics prevent infection after third molar surgery? A network meta-analysis.

The aim of this systematic review was to determine whether antibiotics, compared to placebo, can prevent infection or dry socket after third molar surgery. A systematic review and network meta-analysis (NMA) was performed following registration of the protocol (CRD42021276266). Four databases and the grey literature were searched, and papers were selected based on the PICOS question. RoB 2 and GRADE were used to evaluate the risk of bias and certainty of the evidence, respectively. The NMA was performed using Stata. Of 58 randomized clinical trials identified, 34 were included in the NMA. Patients treated with amoxicillin (relative risk (RR) 0.56, 95% confidence interval (CI) 0.38-0.84; low quality of evidence) and those treated with metronidazole (RR 0.51, 95% CI 0.31-0.84; low quality of evidence) showed a lower risk of infection and dry socket when compared to patients given a placebo. Postoperative amoxicillin (750 mg) and amoxicillin plus clavulanate (500 mg + 125 mg, or 2000 mg + 125 mg), and preoperative metronidazole (800 mg) are useful to prevent infection or dry socket when compared to placebo. The low rate of infection after third molar surgery, the correct concept of antibiotic prophylaxis, and antibiotic resistance must be taken into account when choosing to treat healthy patients undergoing third molar surgery with antibiotics.

Estratégias para melhorar conhecimentos, atitudes e práticas quanto às medidas de controle e prevenção da COVID-19: uma revisão sistemática / Strategies to improve knowledge, attitude, and practice in COVID-19 prevention and control measures: a systematic review

Objetivos: Identificar estratégias para melhorar conhecimentos, atitudes e práticas (CAP) sobre medidas de prevenção e controle da COVID-19 no mundo.Métodos: Foi realizada uma revisão sistemática de evidência quantitativa e qualitativa com busca nas bases de dados PubMed, LILACS e Scopus. A qualidade do relato e da metodologia dos estudos incluídos foi avaliada por meio da ferramenta do Joanna Briggs Institute.Resultados: De 2.196 registros identificados na busca, 12 estudos foram incluídos. A maioria avaliou estratégias educacionais (n=10), principalmente treinamentos baseados em simulação (n=6) para profissionais de saúde (n=9). Independente da estratégia ou público, todos os estudos identificaram melhorias em conhecimento (n=7), prática (n=7) e atitude (n=4). Entretanto, todos os estudos apresentaram pelo menos uma limitação de qualidade.Conclusões: Estratégias efetivas foram identificadas para melhorar CAP na prevenção e controle da COVID-19, especialmente para profissionais de saúde com treinamento baseado em simulação (baixa qualidade). (AU)

Objectives: To identify strategies to improve knowledge, attitude, and practice (KAP) about prevention and control measures of COVID-19 in the world.Method: A systematic review of quantitative and qualitative evidence was conducted, searching PubMed, LILACS and Scopus databases. Reporting and methodological quality of the included studies was assessed using the Joanna Briggs Institute tool.Results: Of 2,196 records identified in the search, 12 studies were included. Most studies evaluated educational strategies (n=10), mainly training based on simulation (n=6) for health professionals (n=9). Regardless of strategy or audience, all studies identified improvements in knowledge (n=7), practice (n=7), and attitude (n=4). However, all studies presented at least one quality limitation.Conclusions: Effective strategies have been identified to improve CAP in the prevention and control of COVID-19, especially aimed at healthcare professionals with simulation-based training (low quality). (AU)

Complications after different methods for fixation of mandibular angle fractures: network meta-analysis of randomized controlled trials.

The aim of this review was to compare mandibular angle fracture fixation methods that were evaluated through randomized clinical trials considering postoperative complications. Additionally, different treatment methods were ranked based on their performance. A systematic review was performed based on the Cochrane and PRISMA guidelines. The quality of evidence and network meta-analysis were conducted using the GRADE tool and R software, respectively. Four databases were searched, and the papers were selected based on the PICOS strategy. A total of 3584 papers were found. After screening 15 papers were included. One plate placed on lateral border (tension zone) presented lower risk than one plate placed on superior border (tension zone) for infection [risk ratio (RR): 0.48, 95% confidence interval (CI): 0.33 to 0.71] and plate removal necessity (RR: 0.44, 95% CI: 0.28 to 0.69), with moderate quality of evidence. There were no significant differences among the mandibular angle fracture treatments for malocclusion and paraesthesia outcomes. In conclusion, one plate placed on the lateral border in the tension zone is the best choice regarding postoperative infection and plate removal necessity when fixing mandibular angle fractures. None of the tested fixation methods were associated with a significant risk of malocclusion and paraesthesia events.

Intramuscular injection of dexamethasone for the control of pain, swelling, and trismus after third molar surgery: a systematic review and meta-analysis.

This systematic review aimed to answer the following PICO question: Does the intramuscular injection of dexamethasone result in less pain, swelling, and trismus after mandibular third molar removal when compared to other routes of administration or a control group (saline solution injection or no treatment)? An electronic search was conducted in Virtual Health Library, PubMed, and Web of Science, through March 2018. Eligibility criteria included clinical trials. The search strategy resulted in 331 studies. Following the selection process, 15 articles were included in the systematic review; eight of these were included in the meta-analysis. Most of the studies had an unclear risk of bias (Cochrane Handbook assessment). Pain (mean difference (MD) -1.58, 95% confidence interval (CI) -1.99 to -1.16) and oedema (MD -1.76, 95% CI -2.38 to -1.14) were lower in the intramuscular dexamethasone group when compared to the control group. When compared to the submucosal route, the intramuscular route was more effective only for pain on the third postoperative day (MD -0.79, 95% CI -1.38 to -0.20). The results suggest that the intramuscular injection of dexamethasone may be an alternative route of administration, since it is effective at reducing pain and oedema when compared to non-steroidal treatment and has similar results to the submucosal route.

Fracture resistance of teeth restored with the bonded amalgam technique.

This study evaluated the fracture resistance of maxillary premolars with MOD Class II cavity preparations restored with silver amalgam (G1), Scotchbond Multi Purpose Plus and silver amalgam (G2) and Panavia F and silver amalgam (G3). After the restorations were made, the specimens were stored at 37 degrees C for 24 hours at 100% humidity and submitted to the compression test. Statistical analysis of the data (ANOVA and Tukey Test) revealed no significant differences among the three groups that were studied.

[Monoarthritis of the knee as an isolated manifestation of paracoccidioidomycosis]. / Monoartrite de joelho como manifestação isolada de paracoccidioidomicose.

Osteoarthritis in paracoccidioidomycosis has been rarely reported. The present case describes a 36-"year"-old woman, with chronic monoarthritis in the knee lasting 4 years. The diagnosis was achieved only after synovial biopsy, by anatomopathological examination showing granulomatous reaction with a large number of the characteristic "pilot wheel"Paracoccidioides brasiliensis yeast cells. Specific therapy, initially with ketoconazole and followed by cotrimoxazole led to complete functional recovery of the compromised joint. No other affected site was detected by various propaedeutic methods, including computed axial tomography of the thorax and abdomen. The authors emphasize the rarity of the case and discuss its possible pathophysiology.