Almeida R de A C, Andrade E S de S, Barbalho J C, Vajgel A, Vasconcelos B C do E
Department of Oral and Maxillofacial Surgery, University of Pernambuco - School of Dentistry (UPE/FOP), Tabatinga, Camaragibe, PE, Brazil.
Department of Oral and Maxillofacial Surgery, University of Pernambuco - School of Dentistry (UPE/FOP), Tabatinga, Camaragibe, PE, Brazil.
Int J Oral Maxillofac Surg. 2016 Mar;45(3):359-67. doi: 10.1016/j.ijom.2015.12.016. Epub 2016 Jan 11.
Opinions regarding the treatment of multicystic ameloblastoma are divergent due to its benign nature and the high rate of recurrence if not adequately excised. The aim of the present study was to perform a systematic review of the literature for a qualitative and quantitative assessment of studies addressing primary multicystic ameloblastoma with regard to treatment and recurrence. Searches were conducted of the Ovid Medline and Embase databases for articles published up to January 2014. Based on predefined eligibility criteria, studies were selected in a two-stage screening process conducted by two independent reviewers. Quality assessment of the selected articles was performed using the modified criteria of the Agency for Healthcare Research and Quality. The meta-analysis was performed using Review Manager (RevMan) software. Statistical heterogeneity was investigated by performing a χ(2) test at the 5% significance level (P<0.05) and determining I(2). The relative risk of recurrence was 3.15-fold greater (95% confidence interval 1.98-5.00) when conservative treatment was performed on primary multicystic ameloblastoma in comparison to radical treatment (P<0.00001 for treatment effect; I(2)=0% and P=0.48 for heterogeneity). The findings justify the treatment of primary multicystic ameloblastoma with bone resection.
由于多囊性成釉细胞瘤的良性性质以及若切除不充分则复发率高，关于其治疗的观点存在分歧。本研究的目的是对文献进行系统综述，以对涉及原发性多囊性成釉细胞瘤的治疗和复发的研究进行定性和定量评估。检索了截至2014年1月发表的文章的Ovid Medline和Embase数据库。根据预先确定的纳入标准，在由两名独立评审员进行的两阶段筛选过程中选择研究。使用医疗保健研究与质量局的修改标准对所选文章进行质量评估。使用Review Manager（RevMan）软件进行荟萃分析。通过在5%显著性水平（P<0.05）下进行χ(2)检验并确定I(2)来研究统计异质性。与根治性治疗相比，对原发性多囊性成釉细胞瘤进行保守治疗时，复发的相对风险高3.15倍（95%置信区间1.98 - 5.00）（治疗效果P<0.00001；异质性I(2)=0%且P=0.48）。这些发现证明了采用骨切除术治疗原发性多囊性成釉细胞瘤的合理性。
