Cyanoacrylate versus suture as flap closure methods in mandibular third molar surgery: a split-mouth randomized controlled clinical study.

BACKGROUND: Sutures have been the standard flap closure method of choice following mandibular third molar surgery but can lead to some complications. Tissue adhesives, including cyanoacrylate, have emerged as alternative flap closure method in this surgery to overcome such drawbacks. However, limited clinical trials can be found. Therefore, the aim of this clinical study was to compare two methods of flap closure in mandibular third molar surgery, cyanoacrylate and 4/0 silk sutures, by assessing post-operative outcome measures (pain, swelling, trismus, and healing) and patient-reported outcome measures (PROMs). MATERIAL AND METHODS: A randomized split-mouth clinical trial was designed, in which mandibular third molar (M3M) extractions were performed, where the control side flap was closed with 4/0 silk sutures and the test side flap with cyanoacrylate. Swelling, pain, trismus, healing, and PROMs were recorded post-operatively. These variables were analyzed by means of the nonparametric Mann-Whitney U test, using SPSS statistical software version 28.0.0 (IBM® SPSS®, Chicago, IL, USA). For all results, a 95% confidence interval was recorded (significance level p < 0.05, two-tailed). RESULTS: A total of 17 patients were recruited and 34 mandibular third molar extractions were performed. No statistically significant differences were found in terms of swelling, pain, trismus, healing, and PROMs between both groups (p<0.05). CONCLUSIONS: No statistically significant differences were found between flap closure with 4/0 silk sutures and cyanoacrylate, in terms of surgical post-operative outcomes and PROMs. However, further studies with larger sample sizes are required to be able to affirm it with greater certainty.

Valoración de las diferentesopciones de tratamientoen el manejo clínico delSíndrome de Boca Ardiente(SBA) / ASSESSMENT OF THE DIFFERENT TREATMENT OPTIONS IN THE CLINICAL MANAGEMENT OF BURNING MOUTH SYNDROME (BMS)

Introducción: El Síndrome de Boca Ardiente (SBA), cuya definición y fisiopatología continúan siendo un tema de debate actual, tampoco cuenta con unas pautas universalmente aceptadas para su tratamiento. Por ello, el objetivo del presente trabajo es presentar una valoración de los distintos tratamientos para el manejo clínico de los pacientes con SBA en base a la evidencia científica disponible, para que se valore su aplicación en cada caso concreto. Material y métodos: Se realizó una búsqueda en las bases de datos de PubMed (MEDLINE) y The Cochrane Library (Wiley) sobre los distintos tratamientos del SBA. Con los datos obtenidos respecto a la efectividad de cada modalidad terapéutica y los efectos adversos que produce, se han elaborado tres diferentes líneas de tratamiento. Resultados: En la primera línea de tratamiento encontramos los chicles, la LLLT (terapia con láser de baja potencia, en inglés), el protector lingual, la psicoterapia, clonazepam tópico, ALA (ácido alfa-lipoico, en inglés) y la Catauma. Conclusión: Hacen falta más investigaciones que brinden una orientación suficiente a los clínicos sobre las modalidades terapéuticas efectivas y que permitan establecer una correcta estrategia en el manejo del SBA (AU)

Introduction: The definition and pathophysiology of Burning Mouth Syndrome (BMS) remain a subject of ongoing debate, and there are no universally accepted guidelines for its treatment. Therefore, the objective of this paper is to present an assessment of the different treatments for the clinical management of patients with BMS on the basis of the available scientific evidence, so that their application in each specific case can be assessed. Material and methods: A search was carried out in the PubMed (MEDLINE) and The Cochrane Library (Wiley) databases on the different treatments for BMS. With the data obtained regarding the effectiveness of each therapeutic modality and the adverse effects it produces, three different lines of treatment have been developed. Results: The first line of treatment includes chewing gum, LLLT (low level laser therapy), tongue guard, psychotherapy, topical clonazepam, ALA (alpha lipoic acid) and Catauma. Conclusion: Further research is required to provide sufficient guidance to clinicians on effective therapeutic modalities and to establish a correct strategy in the management of BMS (AU)