Manta K, et al. J Dent Anesth Pain Med. 2023 Jun;23(3):135-141. https://doi.org/10.17245/jdapm.2023.23.3.135

Background and Objectives: The role of surgical extraction of the third molar in patients’ sleep quality remains unclear, although it is one of the most common oral surgical procedures. The aim of this study is to assess the changes in patient-reported sleep health outcomes after third molar surgery and to investigate any associations between sleep parameters and post-extraction pain. Materials and Methods: Young adults without known comorbidities who were in need of mandibular third molar surgical extraction were included. All participants completed a sleep diary, the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) questionnaires, which were used to assess sleep habits, daytime sleepiness, sleep quality and insomnia severity one week before and after extraction. In addition, a visual analog scale was completed postoperatively to assess the perception of pain. Results: Out of 75 patients who completed the study protocol, 32 (42.7%) were males and 43 (57.3%) were females, with a mean age of 24.01 (±3.43) years. Postoperatively, statistically significant higher scores were observed for PSQI [4.85 (±2.32) before vs. 5.39 (±2.75) after, p = 0.041], AIS [5.56 (±3.23) before vs. 6.91 (±4.06) after, p < 0.001] and average weekly number of nocturnal awakenings [2.01 (±3.72) before vs. 4.19 (±5.20) after, p < 0.001] but not for ESS, average weekly sleep duration and average weekly sleep onset latency. Pain perception was increased in patients who slept worse on almost all seven postoperative days, although this did not reach statistical significance. Conclusions: Third molar surgery impacts sleep quality and insomnia severity in the first week after extraction, while there is no effect on daytime sleepiness. The worsening of subjective sleep symptoms after extraction may be associated with an increased perception of pain.

Aims and Objectives: This cross‐sectional study aims to compare the accuracy, precision and clarity of responses to dental implant questions from three artificial intelligence (AI) models: ChatGPT (OpenAI, GPT‐4), Gemini (Google) and MedGebra. Materials and Methods: 56 questions from an EAO patient guide were used and responses from each AI system were evaluated independently by two oral surgery specialists using a four‐point Likert scale for correctness, precision and clarity. Results: ChatGPT consistently scored highest especially in clarity with perfect marks from both evaluators. Gemini ranked lower in accuracy and precision but exhibited similar clarity. MedGebra received the lowest ratings on all criteria. Though consistency generally remained excellent, the inter‐rater reliability study revealed some variance in agreement levels between two examiners. Conclusion: ChatGPT and Gemini provided more accurate and informative responses on dental implants questions compared to MedGebra. According to the findings of the present study AI chatbots have potential for enhancing patient education on dental implants but professional oversight is crucial for ensuring accuracy and reliability. The study highlights the promising and potential benefits of large language models (LLMs) in dental patient education.

Purpose: Clopidogrel is a P2Y12 purinergic receptor inhibitor and a widely prescribed antiplatelet drug for the prevention of atherosclerotic events. Accumulated evidence suggests that purinergic receptors regulate important functions in bone healing and homeostasis. The purpose of the present ...

Purpose: This 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. Methods: Literature 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. Results: Thirty-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. Conclusion: Minimizing 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.

Key Clinical Message: Dental fusion should be included in differential diagnosis when panoramic radiograph reveals changes in tooth shape or size. The use of specialized dental photographic techniques can augment the dentists' knowledge and awareness of such conditions. Dental fusion of impacted teeth may show up as a change in tooth shape and size on the first radiographic examination. This report presents an impacted maxillary third molar fused with a peg‐like distomolar in a 20‐year‐old male. The patient presented with symptoms of localized periodontitis distal to the second molar, and radiographic examination revealed abnormal dental structure of the third molar. Surgical extraction of the impacted molar was the treatment of choice. The final diagnosis of fusion was based on data from ex vivo CBCT, photographs of the extracted tooth, and extracted tooth's sections using polarizing filters. Two‐dimensional radiographs may conceal special dental anatomies. Visualization of such cases using CBCT and dental photography serves to educate dentists and reduce postoperative complications. Knowledge and awareness of possible dental abnormalities are of utmost importance for successful treatment planning.