Dalle Carbonare M, Zavattini A, Duncan M, Williams M, Moody A
Department of Oral and Maxillofacial Surgery, Eastbourne District General Hospital, King's Dr., Eastbourne, BN21 2UD, East Sussex, United Kingdom.
Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Mindelsohn Way Edgbaston, Birmingham, B15 2TH, West Midlands, United Kingdom.
Br J Oral Maxillofac Surg. 2017 Nov;55(9):892-898. doi: 10.1016/j.bjoms.2017.09.006. Epub 2017 Oct 20.
The aim of this systematic review was to evaluate the incidence of damage to the inferior alveolar (IAN) and dental nerves in successful coronectomies, and to compare the results with coronectomies that failed. To the best of our knowledge no such analyses have been reported. Between January 1990 and October 2016 we surveyed published papers to find those that examined clinical outcomes after coronectomy. Fourteen met the criteria for final inclusion. Of 2087 coronectomies, 152 failed (7%). Successful procedures were associated with a low overall incidence of injury to the IAN (0.5%) and lingual nerve (0.05%). The incidence of injury to the IAN in failed coronectomies was 2.6%. The incidence of permanent paraesthesia was 0.05% in successful coronectomies and 1.3% in those that failed. No permanent injury to the lingual nerve was reported. Mobility (36%, 55/152) and migration or exposure (33%, 50/152) of roots were the most common underlying causes of failure. Coronectomy seems to be safe, but it depends on the patient and the technique used. To ensure adequate assessment of postoperative complications, we strongly recommend systematic evaluation of the reduction in sensitivity of the lower lip, chin, or tongue, and a standard follow up.
本系统评价的目的是评估成功的冠切除术中下牙槽神经（IAN）和牙神经损伤的发生率，并将结果与失败的冠切除术进行比较。据我们所知，尚未有此类分析的报道。1990年1月至2016年10月期间，我们查阅了已发表的论文，以找到那些研究冠切除术后临床结果的文献。14篇符合最终纳入标准。在2087例冠切除术中，152例失败（7%）。成功的手术与IAN损伤（0.5%）和舌神经损伤（0.05%）的总体低发生率相关。失败的冠切除术中IAN损伤的发生率为2.6%。成功的冠切除术中永久性感觉异常的发生率为0.05%，失败的为1.3%。未报告舌神经的永久性损伤。牙根移位（36%，55/152）和牙根迁移或暴露（33%，50/152）是最常见的失败原因。冠切除术似乎是安全的，但这取决于患者和所使用的技术。为确保对术后并发症进行充分评估，我们强烈建议对下唇、下巴或舌头的感觉减退进行系统评估，并进行标准随访。
