Faculty of Dentistry, SEGi University, Kota Damansara, Malaysia.
Acta Odontol Scand. 2021 Oct;79(7):514-522. doi: 10.1080/00016357.2021.1901984. Epub 2021 Mar 25.
To perform a systematic review of the characteristics of ectopic mandibular third molar (EMTM) in terms of its clinical presentation, radiographic findings, associated lesions, management and post-operative complications.
We searched the Pubmed, Medline, Embase and EBSCO databases for full-text, peer-reviewed journal publications from January 1965 to August 2020. Data extraction was done using preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines.
Our search yielded 45 case reports involving 48 EMTM teeth. The mean age of the patients was 46.3 years with an age range of 22-80 years. Thirty-two cases were seen in women as compared to 13 cases in men. The majority of the cases (42) were unilateral, with only three bilateral cases. Among the 48 EMTM teeth, 21 were seen in the condylar region followed by 13 in the ramus, seven in the sigmoid notch, three in the angle and two each in the coronoid process and the lower border of the mandible. Twenty-five EMTM teeth had histopathologically confirmed dentigerous cysts, eight teeth had chronic infection/inflammation/granulation tissue, two had radicular cysts, two had infected cysts, two teeth had normal follicular spaces, and associated lesions were not mentioned for nine teeth. The most common symptoms were swelling (33 teeth) and pain (29 teeth), and six teeth were asymptomatic. Surgical removal through intraoral approach was carried out for 27 teeth, while an extra-oral approach was adopted in 15 teeth, a spontaneous regression of the pericoronal radiolucency was noticed in one tooth, four teeth were not treated and choice of treatment was not mentioned for one tooth. Mild transient paraesthesia was frequently observed; however, serious post-surgical complications were not reported.
The present review found that EMTM can present with complex clinicopathological characteristics, with a majority of the cases being asymptomatic in the beginning and turning out to be symptomatic with lesions at later stages, requiring surgical intervention.
系统评价异位下颌第三磨牙（EMTM）的临床特征、影像学表现、相关病变、处理和术后并发症。
我们检索了 1965 年 1 月至 2020 年 8 月期间的 Pubmed、Medline、Embase 和 EBSCO 数据库中的全文同行评议期刊出版物。使用系统评价和荟萃分析的首选报告项目（PRISMA）指南进行数据提取。
我们的搜索共产生了 45 例涉及 48 颗 EMTM 牙齿的病例报告。患者的平均年龄为 46.3 岁，年龄范围为 22-80 岁。32 例见于女性，13 例见于男性。大多数病例（42 例）为单侧，仅有 3 例为双侧。在 48 颗 EMTM 牙齿中，21 颗位于髁突区，13 颗位于升支，7 颗位于乙状切迹，3 颗位于下颌角，2 颗分别位于喙突和下颌下缘。25 颗 EMTM 牙齿经组织病理学证实为含牙囊肿，8 颗牙齿为慢性感染/炎症/肉芽组织，2 颗为根囊肿，2 颗为感染性囊肿，2 颗牙齿为正常滤泡空间，9 颗牙齿未提及相关病变。最常见的症状是肿胀（33 颗牙）和疼痛（29 颗牙），6 颗牙无症状。通过口腔内途径进行手术切除的有 27 颗牙，而通过口腔外途径的有 15 颗牙，一颗牙的牙囊透光区出现自发消退，四颗牙未治疗，一颗牙的治疗选择未提及。轻度短暂的感觉异常经常观察到，但未报告严重的术后并发症。
本综述发现，EMTM 可表现出复杂的临床病理特征，大多数病例在开始时无症状，后来出现病变，需要手术干预。
