Summary of findings 4. Wound irrigation techniques (A compared to B) for the removal of mandibular wisdom teeth.
| Irrigation techniques (A compared to B) following the removal of mandibular wisdom teeth | ||||||
| Population: adults with mandibular third molars requiring removal Setting: oral surgery Intervention: irrigation technique A Comparison: irrigation technique B | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Irrigation technique B | Irrigation technique A | |||||
| Manual irrigation (low volume) | Mechanical irrigation (high volume) | |||||
|
Alveolar osteitis (up to 1‐week follow‐up) |
10 per 10001 | 3 per 1000 (0 to 81) | RR 0.33 (0.01 to 8.09) | 99 (1 study) | ⊕⊝⊝⊝ verylow2 | Single split‐mouth study. Insufficient evidence to claim either is better |
|
Wound infection (up to 1‐week follow‐up) |
20 per 10001 | 10 per 1000 (10 to 109) | RR 0.5 (0.05 to 5.43) | 99 (1 study) | ⊕⊝⊝⊝ verylow2 | Insufficient evidence to claim either is better |
|
Permanent altered tongue, chin, or lip sensation (more than 6 months) |
Not reported | |||||
|
Adverse effects (up to 30 days) |
Not reported | |||||
| Mechanical irrigation (low volume versus high volume) | ||||||
|
Low volume (approximately 25 mL) |
High volume (approximately 175 mL) |
|||||
|
Alveolar osteitis (up to 1‐week follow‐up) |
10 per 10001 | 5 per 1000 (3 to 10) | RR 0.52 (0.27 to 1.02) | 211 (1 study) | ⊕⊝⊝⊝ very low2 | Insufficient evidence to claim either is better |
|
Wound infection (up to 1‐week follow‐up) |
28 per 10001 | 5 per 1000 (1 to 38) | RR 0.17 (0.02 to 1.37) | 211 (1 study) | ⊕⊝⊝⊝ very low2 | Insufficient evidence to claim either is better |
|
Permanent altered tongue, chin, or lip sensation (more than 6 months) |
Not reported | |||||
|
Adverse effects (up to 30 days) |
Not reported | |||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio | ||||||
|
GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect. | ||||||
1Asssumed risk from the single study. 2Certainty of evidence downgraded three times due to single study at either high or unclear risk of bias and imprecision.