Feras AlMofreh AlQahtani

Background: Oroantral communication (OAC) and fistulas (OAF) are pathological openings between the maxillary sinus and the oral cavity. Traditional closure methods, such as buccal or palatal flaps, are effective but can cause postoperative discomfort and tissue loss. Platelet‐Rich Fibrin (PRF), has emerged as a minimally invasive alternative, promoting angiogenesis and tissue healing through the sustained release of growth factors. This study aimed to review the current evidence on the effectiveness of Platelet Rich Fibrin in the management of oroantral communications and oroantral fistulas. Methods: A study protocol was developed in accordance with the Preferred Reporting Guideline for Overviews of Reviews (PRIOR) and registered on the International Prospective Register of Systematic Reviews (PROSPERO) under Registration No. CRD 420251027772. Furthermore, the reporting of the present systematic review was performed based on the PRISMA checklist. Results: Our search strategy yielded 220 articles from five electronic databases. Of these, 82 were duplicate studies, leaving 138 unique records, which were screened independently by two authors for eligibility. 120 studies were excluded based on title and abstract screening. The remaining 18 full‐text articles were assessed for eligibility. 15 studies were excluded as they did not meet the inclusion criteria. Finally, a total of three systematic reviews met the criteria for inclusion and were critically reviewed. Conclusions: This systematic review of systematic reviews highlights the consistent effectiveness of platelet‐rich fibrin (PRF) in the closure of oroantral communications and fistulas, with reported success rates between 90% and 100%. PRF enhanced healing, reduced complications, and improved patient comfort, particularly when used as an adjunct to surgical flaps in larger defects. PRF appears to be a reliable and biologically advantageous material; nevertheless higher‐level studies are needed to confirm its comparative effectiveness and guide clinical protocols.

Aim: This study aimed to review the current evidence on the clinical outcomes of coronectomy. Methods: A study protocol was developed in accordance with the Preferred Reporting Guideline for Overviews of Reviews (PRIOR) and registered on the International Prospective Register of Systematic Reviews (PROSPERO) under Registration No. CRD4202450552. Furthermore, the reporting of the present systematic review was performed based on the PRISMA checklist. Results: Our search strategy yielded 577 articles. Of these, 213 were duplicate studies, and 364 were independently reviewed by two authors for eligibility. Of these, 349 were excluded based on the title and Fifteen articles were assessed for eligibility; 7 studies were excluded as they did not meet the inclusion criteria. Finally, a total of 8 systematic reviews met the criteria for inclusion, and they were critically reviewed. Conclusion: This overview of systematic reviews quantified the incidence of key clinical outcomes following coronectomy for mandibular third molars. The pooled data show a low incidence of inferior alveolar nerve injury (0.55%) and relatively low rates of postoperative complications including pain (10.67%), root migration (7.23%), re‐operation (2.95%) and infection (2.49%). Less common events such as residual enamel (0.08%) and lingual nerve injury (0.086%) were infrequently reported.

Background: This study aimed to review the current high‐quality evidence on piezoelectric vs. conventional hand‐piece in third molar surgery: a systematic review of systematic reviews. Methods: A study protocol was developed in accordance with the Preferred Reporting Guideline for Overviews of Reviews (PRIOR) and registered on the International Prospective Register of Systematic Reviews (PROSPERO) under Registration No. CRD42024549962. Furthermore, the reporting of the present systematic review was performed based on the PRISMA checklist. Results: Our search strategy yielded 1720 articles. Of these, 213 were duplicate studies, and 364 studies were screened independently reviewed by two authors for eligibility. Of these, 349 were excluded based on the title and 15 articles were assessed for eligibility, eight studies were excluded as they did not meet the inclusion criteria. Finally, a total of seven systematic reviews met the criteria for inclusion, and they were critically reviewed. Conclusions: Piezoelectric hand‐pieces reduce postoperative pain, swelling, and trismus, with fewer complications like paresthesia and dry socket. Although evidence on analgesic use is mixed, they offer a better overall postoperative experience. Clinicians may favour their use in complex cases where soft tissue preservation is critical. High‐quality RCTs are needed to address current evidence heterogeneity and guide clinical practice.

Purpose: The objective of this study is to systematically evaluate the existing evidence on the prevalence and incidence of pseudoaneurysms following third molar extractions.Methods: The study protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis Protocols, and it was registered with the International Prospective Register of Systematic Reviews under registration number CRD42024578219.Results: Our search strategy yielded 388 articles and all were independently reviewed by two authors for eligibility. Of these, 366 were excluded based on the title and Twenty‐two articles were assessed for eligibility, and 13 studies were excluded as they did not meet the inclusion criteria. Finally, a total of 9 studies met the criteria for inclusion, and they were critically reviewed.Conclusion: Pseudoaneurysms following third molar extractions are rarely encountered; however, oral surgeons should remain vigilant for their potential occurrence. Particular attention should be given if a patient presents with severe intraoral haemorrhage, facial oedema and nasal epistaxis. It is essential for oral surgeons to be familiar with the management protocol as outlined in the proposed algorithm to ensure prompt and effective intervention.

This study aimed to critically reanalyze systematic reviews of patients suffering from condylar resorption (CR) and summarize the current scientific pieces of evidence with a focus on a possible relationship between CR and orthognathic surgery (OS). The work followed the “Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol” guidelines and was registered in the International Prospective Register of Systematic Reviews (registration number: CRD42020168660). The search strategy produced 143 articles. After reading the abstracts, 113 articles were excluded, and the full-text articles in English of the remaining 30 studies were separately examined for eligibility by 2 authors, with 20 of them being excluded because they did not meet the inclusion criteria. Finally, 10 systematic reviews were processed for critical evaluation. Young female patients with a high mandibular plane angle, diminished posterior facial height, posteriorly inclined condylar neck, and a counter-clockwise jaw rotation, are more likely to develop CR after OS. The most common procedure associated with CR in the included systematic reviews was the bimaxillary OS followed by bilateral sagittal split osteotomy. Hence, extreme caution and surgical modification should be used in these high-risk conditions. There is still a need for more evidence on the risks of OS or iatrogenic factors during the fixation of various osteosynthesis devices because it is still inconclusive and requires further justification.

Purpose This study aims to systematically review and identify the changes of occlusion in patients after orthognathic surgery. Methods The protocol was developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and was registered to the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42021253129. Studies included were Original articles only, Additionally, studies were included if the outcome of occlusal force was measured pre- and postoperatively and if occlusal forces resulted from a long follow-up of a minimum of 1 year following orthognathic surgery using adequate measurement tools. Non-English articles, case reports, case series, and non-original articles, including systematic reviews and literature reviews, were excluded. Results The search strategy yielded a total of 978 articles. Of the 978 articles, 285 were duplicates. After reading the titles and abstracts, 649 articles were excluded, and full-text articles of the remaining 47 studies were reviewed independently by two authors for eligibility wherein 33 articles were excluded, because they did not meet the inclusion criteria. Finally, a total of 14 studies were processed for critical review. Conclusion The occlusal force increased after orthognathic surgery, although not to the level of the control group; however, the maximal bite force remained unchanged. Immediately after orthognathic surgery, chewing and swallowing forces increased. Significant reductions in the postoperative occlusal contact pressure areas was also observed.

This study aimed to gather existing evidence regarding the incidence, clinical presentation, and management of pseudoaneurysms (PA) after orthognathic surgery, identify the common blood vessels involved in PA, and propose a treatment algorithm based on current evidence. The protocol for this study was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols and was registered at the International Prospective Register of Systematic Reviews under the registration number CRD42020205479. Although these are rare, oral and maxillofacial surgeons should consider PA as a possible diagnosis, specifically in the maxillary artery of patients with epistaxis, severe facial edema, and swelling following LeFort I osteotomy.