Dodson Thomas B, Susarla Srinivas M
Harvard School of Dental Medicine and Centre for Applied Clinical Investigation Surgery, Massachusetts General Hospital, Boston, USA.
BMJ Clin Evid. 2010 Apr 8;2010:1302.
The incidence of impacted wisdom teeth is high, with some 72% of Swedish people aged 20 to 30 years having at least one impacted third molar. Impacted wisdom teeth occur because of a lack of space, obstruction, or abnormal position, and can cause inflammatory dental disease manifested by pain and swelling of infected teeth and may destroy adjacent teeth and bone.
We conducted a systematic review and aimed to answer the following clinical questions: Should asymptomatic and disease-free impacted wisdom teeth be removed prophylactically? What are the effects of different surgical methods of removing impacted wisdom teeth? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We performed a GRADE evaluation of the quality of evidence for interventions.
We found 25 systematic reviews, RCTs, or observational studies that met our inclusion criteria.
In this systematic review we present information relating to the effectiveness and safety of the following interventions: prophylactic extraction, active surveillance, and different surgical methods of removing impacted wisdom teeth.
阻生智齿的发生率很高,约72%的20至30岁瑞典人至少有一颗阻生第三磨牙。阻生智齿的出现是由于空间不足、阻塞或位置异常,可导致炎症性牙病,表现为患牙疼痛和肿胀,还可能破坏相邻牙齿和骨质。
我们进行了一项系统评价,旨在回答以下临床问题:无症状且无疾病的阻生智齿是否应预防性拔除?拔除阻生智齿的不同手术方法有何效果?我们检索了:截至2009年7月的Medline、Embase、Cochrane图书馆及其他重要数据库(Clinical Evidence综述会定期更新,请查看我们的网站获取本综述的最新版本)。我们纳入了来自美国食品药品监督管理局(FDA)和英国药品及医疗保健产品监管局(MHRA)等相关组织的危害警示。我们对干预措施的证据质量进行了GRADE评估。
我们发现25项系统评价、随机对照试验或观察性研究符合我们的纳入标准。
在本系统评价中,我们提供了以下干预措施的有效性和安全性相关信息:预防性拔除、主动监测以及拔除阻生智齿的不同手术方法。