Major approaches to minimally traumatic surgery in dentistry: a systematic review

It is estimated that in minimally traumatic dental surgery, synthesis studies with meta-analysis and decision analysis represent almost 29% of all studies. Most of the selected studies were carried out in the USA, Netherlands, and UK. These three countries and 15 journals accounted for nearly 50% of all publications. The remaining works were published in another 61 journals and originated from 32 other countries, including Brazil. Objective: This study aimed to demonstrate, through literature review and case reports, the evolution and consequent importance of improving minimally traumatic surgery techniques in dentistry. It was hypothesized that there were statistically significant results about advances in the attempt to minimize trauma. Methods: The research was carried out from July 2021 to October 2021 and developed based on Google Scholar, Scopus, PubMed, Scielo, and Cochrane Library. The inclusion and exclusion criteria were systematic review studies, meta-analysis, controlled and randomized cases, non-randomized clinical cases, and opinion articles, which addressed the term minimally traumatic surgery in dentistry. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results: Since the most primordial extraction techniques were created and developed, several attempts have been made to minimize the professional's effort, reduce surgical time and alleviate bleeding and inflammatory processes, edema, pain, and ecchymosis that can affect the patients, in the trans and postoperative periods. Thus, the maximum preservation of the integrity of the soft tissues (papillae and free and inserted gingival band) adjacent to the prosthetic spaces should be sought; preservation of the alveolar bone ridge level. Based on the histological concept in which living tissues are formed by cells joined by thin elastic tissue and with nerve fibrils, capillaries, lymphatic and blood vessels. The disruption of these cells by surgical trauma provides the release of enzymes that delay healing. For this reason, surgical trauma should be minimized. Conclusion: There are many attempts to minimize the professional effort, reduce surgical time and alleviate bleeding and inflammatory processes, edema, pain, and ecchymosis that can affect patients. Thus, the maximum preservation of the integrity of the soft tissues adjacent to the prosthetic spaces and the preservation of the level of the ridge of the alveolar bone to achieve a minimization of surgical trauma must be sought.