Field Of Oral Surgery Research Articles

CBCT an inbound necessity in dentistry

CBCT has become increasingly important in treatment planning and diagnosis in implant dentistry, ENT, orthopedics, and interventional radiology (IR), among other things. Perhaps because of the increased access to such technology, CBCT scanners are now finding many uses in dentistry, such as in the fields of oral surgery, endodontics and rthodontics. Integrated CBCT is also an important tool for patient positioning and verification in image-guided radiation therapy

Beyond the Scalpel: Assessing ChatGPT's Potential as an Auxiliary Intelligent Virtual Assistant in Oral Surgery

AI has revolutionized the way we interact with technology. Noteworthy advances in AI algorithms and large language models (LLM) have led to the development of natural generative language (NGL) systems such as ChatGPT. Although these LLM can simulate human conversations and generate content in real time, they face challenges related to the topicality and accuracy of the information they generate. This study aimed to assess whether ChatGPT-4 could provide accurate and reliable answers to general dentists in the field of oral surgery, and thus explore its potential as an intelligent virtual assistant in clinical decision making in oral surgery. Thirty questions related to oral surgery were posed to ChatGPT4, each question repeated 30 times. Subsequently, a total of 900 responses were obtained. Two surgeons graded the answers according to the guidelines of the Spanish Society of Oral Surgery, using a three-point Likert scale (correct, partially correct/incomplete, and incorrect). Disagreements were arbitrated by an experienced oral surgeon, who provided the final grade Accuracy was found to be 71.7%, and consistency of the experts' grading across iterations, ranged from moderate to almost perfect. ChatGPT-4, with its potential capabilities, will inevitably be integrated into dental disciplines, including oral surgery. In the future, it could be considered as an auxiliary intelligent virtual assistant, though it would never replace oral surgery experts. Proper training and verified information by experts will remain vital to the implementation of the technology. More comprehensive research is needed to ensure the safe and successful application of AI in oral surgery.

Comparison of the Efficacy Between Articaine and Lignocaine in Simultaneous Bilateral Orthodontic Maxillary Premolar Extractions: A Split-Mouth Comparative Study.

Introduction Local anesthesia plays a crucial role in ensuring patient comfort during orthodontic extractions. Among the various local anesthetic agents commonly used in the field of oral surgery are articaine and lidocaine, which differ in their duration of action and pain effectiveness (pain control) during surgical procedures. This article aimed to analyze the characteristics of 2% lignocaine with 1:80000 adrenaline and 4% articaine with 1:100000 adrenaline regarding duration of action and pain control in patients undergoing bilateral orthodontic maxillary premolar extractions. Materials and methods A split-mouth comparative study was conducted at Saveetha Dental College and Hospitals,Chennai, for which 50 patients of age less than 30 years and who required bilateral orthodontic premolar extractions were selected. Approximately4% articaine hydrochloride solution was administered on one side, and 2% lignocaine hydrochloride was administered on the contralateral side. Palatal infiltration was not given in the articaine group.The degree of extraction difficulty was similar in both groups, with no discernible variation. In each patient, the duration of anesthesia and pain control were assessed. The IBM Statistical Package for Social Sciences(SPSS version 24.0, IBM SPSS Statistics for Windows, Armonk, NY) was used to perform the student's paired t-test for detecting the difference in outcome parameters between the two groups. Results Upon comparing both groups, it was concluded that the articaine group had a longer mean anesthetic duration of action of 217 minutes, whereas for the lignocaine group, it was 169 minutes, and greater pain reduction was present with the articaine group. The articaine group exhibited less pain (superior pain control) with a mean visual analogue scale (VAS) score of 1.07compared to that of the lignocaine group with a mean VAS score of 1.53 during orthodontic premolar extractions. Both the results were statistically significant (P=0.001). Conclusion This split-mouth comparative study concludes that articaine is a more effective local anesthetic in terms of duration of action andpain reduction than that of lignocaine, and it can be used as a local anesthetic of choice for orthodontic maxillary premolar extractions.

Can natural language processing serve as a consultant in oral surgery?

ObjectiveIn this comprehensive evaluation, ten experienced oral surgeon experts posed a total of twenty oral surgery-related questions, including dental implant and tooth extractions, to three distinct Natural Language Processing (NLP)-based chatbot platforms: ChatGPT, Microsoft Bing, and Google Bard. The study aimed to assess the effectiveness of these chatbots in responding to specialized medical questions. Materials and methodsTwo primary evaluation metrics were employed: a Likert Scale (LS) for measuring the accuracy and completeness of responses and a Global Quality Scale (GQS) for evaluating the clarity of responses. Statistical analyses, including one-way analysis of variance (ANOVA) and Post Hoc Tukey, were conducted to assess and compare the performance of the chatbots as rated by the experts. ResultsThe results of the study revealed significant differences in the performance of the chatbots. ChatGPT statistically achieved a better mean LS score of 1.4000±0.15986 than Microsoft Bing (1.8750±0.18143) and Google Bards (2.0500±0.12472) (P < 0.001). Additionally, ChatGPT statistically achieved a higher GQS score of 4.4200±0.30111 than Microsoft Bing (3.7550±0.28621) and Google Bards (3.5250±0.22392) (P < 0.001). ConclusionsThese findings showed the substantial advantage of ChatGPT in effectively addressing oral surgery-related questions with superior accuracy, completeness, and clarity. The study highlights the potential of advanced NLP platforms to enhance information retrieval and communication within the field of oral surgery, reinforcing the utility of such technologies in medical and surgical domains.

Laryngeal abscess formation secondary to utilization of nasogastric tube in oral cancer patient: A case report

Introduction: Although laryngeal abscess is a rare disease in this day when antibiotics and vaccines are widely available, it can be fatal in terms of choking risk due to airway narrowing and thus requires an immediate diagnosis and treatment, including airway management. Even in the field of oral surgery, where nasogastric tubes are often used for nutritional management, there have been no reports of laryngeal abscesses. Case Report: One month after right maxillary gingival carcinoma surgery, a 72-year-old man had hoarseness and a fever following nasogastric tube replacement, and blood tests showed a marked increase in inflammatory levels. The patient started chemotherapy with SBT/ABPC (12 g/day). Contrast-enhanced magnetic resonance imaging showed a low-density area with a rim enhancement effect from the left laryngeal surface of the epiglottis to the left supraglottis, which had caused airway narrowing, leading to a diagnosis of laryngeal abscess. Considering the risk of airway obstruction, a tracheostomy was performed under general anesthesia. On day 16, contrast-enhanced computed tomography showed a reduction in the lesion size. On day 36, antibiotic chemotherapy was terminated. At 10 months after surgery, lung metastasis developed without local or cervical recurrence, and chemotherapy was off-label due to his worsening renal function. Therefore, the best supportive care policy was selected. The patient’s general condition gradually deteriorated, and he died 11 months after the surgery. Conclusion: There are very few reports related to nasogastric tubes, so it is necessary to keep the disease concept of laryngeal abscess in mind, especially in the field of oral surgery, where nasogastric tubes are often used for nutritional management.

Extensive Investigation on the Effect of Niobium Insertion on the Physical and Biological Properties of 45S5 Bioactive Glass for Dental Implant

Dental implants have emerged as one of the most consistent and predictable treatments in the oral surgery field. However, the placement of the implant is sometimes associated with bacterial infection leading to its loss. In this work, we intend to solve this problem through the development of a biomaterial for implant coatings based on 45S5 Bioglass® modified with different amounts of niobium pentoxide (Nb2O5). The structural feature of the glasses, assessed by XRD and FTIR, did not change in spite of Nb2O5 incorporation. The Raman spectra reveal the Nb2O5 incorporation related to the appearance of NbO4 and NbO6 structural units. Since the electrical characteristics of these biomaterials influence their osseointegration ability, AC and DC electrical conductivity were studied by impedance spectroscopy, in the frequency range of 102-106 Hz and temperature range of 200-400 K. The cytotoxicity of glasses was evaluated using the osteosarcoma Saos-2 cells line. The in vitro bioactivity studies and the antibacterial tests against Gram-positive and Gram-negative bacteria revealed that the samples loaded with 2 mol% Nb2O5 had the highest bioactivity and greatest antibacterial effect. Overall, the results showed that the modified 45S5 bioactive glasses can be used as an antibacterial coating material for implants, with high bioactivity, being also non-cytotoxic to mammalian cells.

Clinical Findings in Children with Noonan Syndrome-A 17-Year Retrospective Study in an Oral Surgery Center.

To date, only a limited number of publications have studied the specific oral and maxillofacial findings in patients diagnosed with Noonan syndrome (NS), which is an example of a genetically heterogeneous RASopathy. In this retrospective study, we aimed to ascertain the genotype–phenotype correlations between genetic mutations and certain diagnoses in the field of oral surgery. We collected surgical and genetic data from 42 children (median age, 12 years) who had a confirmed diagnosis of NS and underwent surgery in the Department of Oral Surgery, Medical University of Lodz, over a 17-year period, from 2004 to 2021. In total, 17 patients with mutations of the PTPN11 gene were diagnosed with over-retained deciduous teeth and supernumerary teeth. An amount of 7 patients with mutations of the SOS1 gene were diagnosed with mandibular compound odontomas. Finally, 12 patients with mutations of the LZTR1 gene were diagnosed with bilateral or unilateral central giant cell granulomas in the mandible. Although craniofacial features of many genetic disorders have been previously described in the literature, this study determined the genotype–phenotype correlations in the field of oral surgery.

Efficiency of Nanohydroxyapatite on Repairing Type II Diabetes Dental Implant-Bone Defect.

The purpose of this study was to see how a nanohydroxyapatite (n-HA) composite polyamide 66 (PA66) affected the repair of bone defects in diabetics with titanium implants, as well as to develop experimental materials for the creation of the interface between bone tissue and titanium implants. Rabbit bone marrow mesenchymal stem cells (MSCs) were isolated using n-HA/PA66 composite material, and the effect of coculture with the material on cell proliferation was analyzed after induction of mineralization. Bone defect models of diabetic experimental rabbits and titanium implants were prepared. Normal rabbits with bone defects were used as control (NC group, N = 8). After the diabetic bone defect (DM group, N = 8) and the implantation of n-HA/PA66 composite material (n-HA/PA66 group, N = 8), the differences in body weight, blood glucose, scanning electron microscopy of the implant-bone interface, bone mineral density, new bone trabecular parameters, histomorphology, and biomechanical properties of the implant-bone interface were compared and analyzed. In vitro test results showed that MSC cell growth could be promoted by mineralization induction, the cell growth condition was good after coculture with n-HA/PA66, and the proliferation activity of MSCs was not affected by the material. In vivo test results showed that the body weight of the DM group and n-HA/PA66 group was considerably inferior to that of the NC group, and the blood glucose was dramatically superior to that of the NC group (P < 0.05). However, the body weight of the n-HA/PA66 group was dramatically superior to that of the DM group (P < 0.05). The bone mineral density, bone volume fraction (BV/TV), bone surface area fraction (BS/BV), bone trabecular thickness (Tb.Th), bone trabecular number (Tb.N), bone trabecular area, and biomechanical properties in the DM group were considerably inferior to those in the NC group and n-HA/PA66 group (P < 0.05). The trabecular space (Tb.Sp) in the NC group and n-HA/PA66 group was dramatically superior to that in the NC group (P < 0.05). The bone mineral density, BV/TV, BS/BV, Tb.Th, Tb.N, trabecular area, and biomechanical properties of the n-HA/PA66 group were dramatically superior to those of the NC group (P < 0.05), while Tb.Sp was considerably inferior to that of the NC group (P < 0.05). These findings showed that the n-HA/PA66 material had good biocompatibility and minimal cytotoxicity, and that filling the space between the surrounding bone and the titanium implant can enhance bone repair. This research paved the way for future research into the tissue-engineered bone in the field of oral surgery.

Influence of a novel suturing technique on periodontal health of mandibular second molar following impacted third molar surgery: a split-mouth randomized clinical trial

BackgroundSurgical extraction of the third molar is the most common surgical procedure in the oral surgery field and is associated with several complications. This study aimed to compare the effects of a newly presented suturing technique with the routine suture after surgical removal of the third molar on the postoperative complications.Materials and methodsThis randomized clinical trial was designed as a split-mouth double-blinded investigation. Twenty patients were involved in the current study. After the surgical removal of the third molar, the new suturing technique was used to close the wound on one side of the patient randomly (case side), and the other side was sutured by the routine simple interrupted stitches (control side). Pain, edema, trismus, pocket depth, and the attachment loss of the distal of the second molar were assessed following the surgery. The data were statistically analyzed and compared between the sides.ResultsPain and edema following the surgery in the control side were significantly less than in the case side. The pocket depth and the gingival attachment loss of the distal aspect of the second molar in the case side were significantly less than in the control side. No case of dry socket was observed in the case side.ConclusionIt seems that the newly presented suturing technique is able to keep the wound margins close to each other and may be helpful in reducing the periodontal complication of the second molar following the surgical removal of the impacted third molars.

A review from mesenchymal stem-cells and their small extracellular vesicles in tissue engineering

This review aims to offer a vision of the clinical reality of cell therapy today in intensive medicine. For this, it has been carried out a description of the properties, functions, and Mesenchymal Stem Cells (MSCS) sources to subsequently address the evidence in preclinical models and studies clinical trials with whole cells and models attributed to small extracellular vesicles (sEVs), nanoparticles made up of microvesicles secreted by cells with an effect on the extracellular matrix, and their impact as an alternative towards cell-free regenerative medicine. MSCs are cells that enhance the regenerative capacity which can be differentiated typically in different lineages committed as bone, cartilage, and adipose tissue. On the other hand, small extracellular vesicles are structures that participate notoriously and crucially in intercellular communication, which has led to a change in the concept of the functions and the role that these vesicles play in living organisms, in the restoration of damaged tissues and the inflammatory response and immunological. We present the mechanisms that are involved in the applications of MSCS as whole cells and their sEVs in cell therapy and cell-free therapy as an alternative in regenerative medicine. Considering the structural loss that occurs after surgical procedures for cystic and tumoral pathology in periodontitis, as well as the maxillary atrophy that determines the rehabilitation with dental implants, it is imperative to find satisfactory solutions. The opportunity provided by the findings in stem cells is a recent introduction in the field of oral surgery, based on the regenerative potential that these cells possess to restore defects at different levels of the oral cavity. This review aims to discover the real applications that stem cells may have in our treatments shortly.

Age Related Immunosenescence Epstein-Barr Virus-positive Mucocutaneous Ulcer of the Palate Mimicking Medication-related Osteonecrosis of the Jaw.

Epstein-Barr virus (EBV) -positive mucocutaneous ulcer (EBVMCU) was first described as a lymphoproliferative disorder in 2010. In recent years, EBVMCU has been reported in the field of oral surgery. On the other hand, medication-related osteonecrosis of the jaw (MRONJ) is an osteomyelitis that occurs in patients receiving antiresorptive agents including bisphosphonates (BP) and/or denosumab developing with bacterial infections such as dental diseases and mucositis. MRONJ caused by EBVMCU in the elderly has not been reported. Here, we report a rare case of MRONJ caused by EBVMCU in the elderly. The patient, an 82-year-old woman, had received BP for more than 2years. An ulcerative lesion was found in the palatal mucosa; biopsy performed from the site confirmed the diagnosis of EBVMCU. At follow-up, the lesion disappeared spontaneously. At the 6-month follow-up, bone formation was observed at the site of the lesion, and the sequestrum was removed. At the 12-month follow-up healing of the EBVMCU region was seen indicating a good prognosis.

In-bone protein digestion followed by LC-MS/MS peptide analysis as a new way towards the routine proteomic characterization ofhuman maxillary and mandibular bone tissue in oral surgery.

Proteomic characterization of alveolar bones in oral surgery represents an analytical challenge due to their insoluble character. The implementation of a straightforward technique could lead to the routine use of proteomics in this field. This work thus developed a simple technique for the characterization of bone tissue for human maxillary and mandibular bones. It is based on the direct in-bone tryptic digestion of proteins in both healthy and pathological human maxillary and mandibular bone samples. The released peptides were then identified by the LC-MS/MS. Using this approach, a total of 1120 proteins were identified in the maxillary bone and 1151 proteins in the mandibular bone. The subsequent partial least squares-discrimination analysis (PLS-DA) of protein data made it possible to reach 100% discrimination between the samples of healthy alveolar bones and those of the bone tissue surrounding the inflammatory focus. These results indicate that the in-bone protein digestion followed by the LC-MS/MS and subsequent statistical analysis can provide a deeper insight into the field of oral surgery at the molecular level. Furthermore, it could also have a diagnostic potential in the differentiation between the proteomic patterns of healthy and pathological alveolar bone tissue. Data are available via ProteomeXchange with the identifier PXD026775.

Effect of educational intervention on the appropriate use of oral antimicrobials in oral and maxillofacial surgery: a retrospective secondary data analysis

BackgroundIn Japan, oral third-generation cephalosporins with broad-spectrum activity are commonly prescribed in the practices of dentistry and oral surgery. However, there are few reports on the appropriate use of antibiotics in the field of oral surgery. This study aimed to evaluate the appropriateness of antibiotic use before and after an educational intervention in the Department of Oral and Maxillofacial Surgery, Kobe University Hospital.MethodsThe use of oral antibiotics was investigated among inpatients and outpatients before and after an educational intervention conducted by the antimicrobial stewardship team. Additionally, the frequency of surgical site infection after the surgical removal of an impacted third mandibular molar under general anesthesia and the prevalence of adverse effects of the prescribed antibiotics were comparatively evaluated between 2013 and 2018.ResultsAfter the educational intervention, a remarkable reduction was noted in the prescription of oral third-generation cephalosporins, but increased use of penicillins was noted among outpatients. There was reduced use of macrolides and quinolones in outpatients. Although a similar trend was seen for inpatients, the use of quinolones increased in this population. Despite the change in the pattern of antibiotic prescription, inpatients who underwent mandibular third molar extraction between 2013 and 2018 did not show a significant increase in the prevalence of surgical site infections (6.2% vs. 1.8%, p = .336) and adverse effects of drugs (2.1% vs. 0%, p = .466).ConclusionsThis study suggests that the judicious use of oral antibiotics is possible through conscious and habitual practice of appropriate antibiotic use. However, further investigation is required to develop measures for appropriate use of oral antibiotics.

The Platelet Concentrates Therapy: From the Biased Past to the Anticipated Future.

The ultimate goal of research on platelet concentrates (PCs) is to develop a more predictable PC therapy. Because platelet-rich plasma (PRP), a representative PC, was identified as a possible therapeutic agent for bone augmentation in the field of oral surgery, PRP and its derivative, platelet-rich fibrin (PRF), have been increasingly applied in a regenerative medicine. However, a rise in the rate of recurrence (e.g., in tendon and ligament injuries) and adverse (or nonsignificant) clinical outcomes associated with PC therapy have raised fundamental questions regarding the validity of the therapy. Thus, rigorous evidence obtained from large, high-quality randomized controlled trials must be presented to the concerned regulatory authorities of individual countries or regions. For the approval of the regulatory authorities, clinicians and research investigators should understand the real nature of PCs and PC therapy (i.e., adjuvant therapy), standardize protocols of preparation (e.g., choice of centrifuges and tubes) and clinical application (e.g., evaluation of recipient conditions), design bias-minimized randomized clinical trials, and recognize superfluous brand competitions that delay sound progress. In this review, we retrospect the recent past of PC research, reconfirm our ultimate goals, and discuss what will need to be done in future.

Direct tryptic cleavage in bone tissue followed by LC-MS/MS as a first step towards routine characterization of proteins embedded in alveolar bones

While methods like radiology or histology are routinely used in oral surgery, a simple and effective method for characterization of alveolar bones at the molecular level is missing. This is primarily due to the fact that proteomic analysis of hard tissue represents a serious analytical challenge. In this study, we developed a simple technique for the proteomic characterization of bone tissue in the field of oral surgery. After a prewashing step with different solvents, specific digestion with trypsin was performed directly in porcine alveolar bone tissues without the prior reduction and alkylation of disulfide bonds. The released peptides were then analyzed using liquid chromatography-tandem mass spectrometry. When 2-propanol was used in the pre-incubation step, this approach identified 487 proteins in the maxillary (upper jaw) bone and 443 proteins in the mandibular (lower jaw) bone, 40 of each being specifically ascribed to bone tissue. This suggests that routine use of our technique can provide deeper insights into the field of oral surgery at the molecular level. Furthermore, it could also have diagnostic potential in differentiating between the proteomic patterns of healthy and pathological alveolar bone tissue. The mass spectrometry proteomics data are available via ProteomeXchange with identifier PXD018836.

A split-mouth study comparing piezo electric surgery and traditional rotary burs on impacted third molars in young patients: an intraoperative and postoperative evaluation.

Piezoelectric surgery has been used in many different medical fields, for instance it is used in the field of oral surgery, as a valuable alternative to traditional rotary burs. Its first use dates to 1975 by Horton even if the first effective device for use in dentistry, has been developed by Vercellotti after the year 2000. The hypothesis of this study is that piezosurgery technology is more suitable in terms of specific intra-operative and postoperative evaluations compared to the rotary technology in ostectomy for the avulsion of the third molar germ. The null hypothesis presented is the lack of significant differences between the two technologies after and during surgery. Intraoperative and postoperative aspects are evaluated for a comparison between traditional rotary instruments and piezosurgery during germectomies in young patients through a blind randomized study (split-mouth). The surgical technique to employ for each hemi-arch was randomly selected from a computer algorithm. Different criteria were considered during the surgical procedure, in order to compare the two techniques. The piezoelectric technique demanded more time than traditional rotary method, and the difference was statistically significant both for the time of the entire procedure and the time only required for the ostectomy itself. Postoperative evaluations such as maximum mouth opening, facial swelling and postoperative pain showed no statistical difference. Even if the adopted clinical trial did not highlight any statistical difference the following review of literature showed an encouraging reduction in postoperative discomfort given by the piezosurgery as opposed to the traditional rotary bur surgery. The time taken to complete the operation, however, was longer with piezosurgery compared to traditional burs.

Trust Based Fuzzy Linguistic Recommender Systems as Reinforcement for Personalized Education in the Field of Oral Surgery and Implantology

The rapid advances in Web technologies are promoting the development of new pedagogic models based on virtual teaching. In this framework, personalized services are necessary. Recommender systems can be used in an academic environment to assist users in their teaching-learning processes. In this paper, we present a trust based recommender system, adopting a fuzzy linguistic modeling, that provides personalized activities to students in order to reinforce their education, and applied it in the field of oral surgery and implantology. We don’t take into account users with similar ratings history but users in which each user can trust and we provide a method to aggregate the trust information. This system can be used in order to aid professors to provide students with a personalized monitoring of their studies with less effort. The results obtained in the experiments proved to be satisfactory.

Current knowledge and future perspectives of barrier membranes: A biomaterials perspective

Periodontal regenerations and bone augmentations are common procedures practiced on a daily basis worldwide. This had led to the introduction of a wide number of barrier membranes, all aiming at regenerating a sufficient amount of bone while being safe, cost effective and easy to handle. Membranes have different characteristics that may influence their clinical properties and the result obtained. The article aims at presenting an overview of the different barrier membranes commonly used in the oral surgery field, while shedding light on the new advances in the third generation membranes.

"Laser Dentistry"-The Need of the Hour: A Cross-sectional Study.

ABSTRACTAim:The increase in the technological development in dentistry has led to a better and efficient treatment being rendered to the patient. One such development is the application of laser in the field of dentistry. The introduction of laser has provided various advantages to the dentist. Therefore, a study was conducted to assess awareness among the dentists in Coimbatore district about the application of laser.Materials and Methods:A cross-sectional study was conducted among the dentists in Coimbatore district. A questionnaire consisting of three parts was used to assess the knowledge, attitude, and practice of laser dentistry.Results:The results were tabulated, and the percentages were statistically analyzed. The knowledge of laser usage and application of laser was present for almost 55% of the dentist. The attitude of dentist toward the advantage of laser was less. The practice of laser dentistry was poor among dentists, and only 10% were effectively practicing laser dentistry.Conclusion:The advantages of laser in daily dental practice are more advantageous than the disadvantages such as cost of equipment and material handling. Therefore, there is a great need for creating awareness of laser dentistry. Cost-effective equipment is the need of the hour to promote laser dentistry.

Diagnosis and indications for the extraction of third molars - The SECIB clinical practice guideline.

The removal of third molars (3Ms) is the most frequent surgical procedure in the field of Oral Surgery. As a result, the Spanish Society of Oral Surgery (SECIB) aims to create a Clinical Practice Guideline (CPG) that offers evidence-based recommendations for optimal clinical practice. Specifically, the CPG will focus on providing guidance regarding the indications and criteria for clinical and radiological diagnosis of patients with 3Ms. This CPG was developed by the SECIB, following the methodological guidelines described in the methodological manual for the "Development of Clinical Practice Guidelines in the National Health System". Several PICO questions related to the diagnosis and indications for the extraction of 3Ms were formulated. The leading experts carried out the evaluation of the evidence and the formulation of specific recommendations. A total of 17 PICO questions were evaluated, addressing the indications, prognosis, diagnosis, and cost-benefit relationship of 3M extraction. The present Clinical Practice Guideline provides evidence-based recommendations on the diagnosis and indications for 3M extraction. These evidence-based recommendations can assist healthcare professionals and the general population in making informed decisions regarding the management of 3Ms.