Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
Clin Oral Investig. 2020 Mar;24(3):1137-1149. doi: 10.1007/s00784-020-03231-6. Epub 2020 Feb 12.
The current dentistry scenario is showing an increase in the availability of cone-beam computed tomography (CBCT) in dental offices. Oral surgeons are using three-dimensional information as an additional tool to assess preoperative data for lower third molar (LTM) removal in moderate and high-risk cases of inferior alveolar nerve (IAN) injury diagnosed through the panoramic radiography (PR). The aim of this study is to identify whether CBCT examination reduces neurosensoric disturbances (ND) following the removal of the LTM when compared to PR.
PubMed, Embase, Web of Science, Science Direct, and Scopus electronic databases were searched for studies published up to February 2019. The gray literature was also searched including papers that eventually met the eligibility criteria. Meta-analysis was performed using the comprehensive meta-analysis software, p < 0.05 considered significant.
Among the search, 6 studies met all eligibility criteria. There was no statistically significant difference between the two groups (PR and CBCT) in all six studies regarding reducing ND (95%. Confidence interval, 0,788-1734; heterogeneity: Q = 10,361; I = 22.788%).
CBCT was not superior to PR in avoiding ND. However, further studies are necessary with standardized parameters for a better comparability between variables in the studies.
To better understand the CBCT clinical applicability in LTM removal to avoid unnecessary extra radiation when compared to PR to the patient and to improve patient's prognosis.
目前，牙科领域的锥形束计算机断层扫描（CBCT）的应用越来越广泛。口腔外科医生将三维信息作为一种额外的工具，用于评估通过全景放射照相术（PR）诊断为下牙槽神经（IAN）损伤的中高危下颌第三磨牙（LTM）拔除的术前数据。本研究旨在确定与 PR 相比，CBCT 检查是否会降低 LTM 拔除后发生的神经感觉障碍（ND）。
在截至 2019 年 2 月的时间范围内，在 PubMed、Embase、Web of Science、Science Direct 和 Scopus 电子数据库中搜索发表的研究。还搜索了灰色文献，包括最终符合入选标准的论文。使用综合荟萃分析软件进行荟萃分析，p<0.05 被认为具有统计学意义。
在搜索中，有 6 项研究符合所有入选标准。在所有 6 项研究中，PR 和 CBCT 两组在降低 ND 方面均无统计学差异（95%置信区间，0，788-1734；异质性：Q=10.361；I=22.788%）。
CBCT 并不能优于 PR 避免 ND。然而，需要进一步研究，以标准化参数来提高研究中变量之间的可比性。
为了更好地了解 CBCT 在 LTM 拔除中的临床应用，与 PR 相比，避免对患者不必要的额外辐射，以改善患者的预后。
