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创伤性前牙乳牙损伤后后遗症的患病率:系统评价和荟萃分析。

Prevalence of sequelae after traumatic dental injuries to anterior primary teeth: A systematic review and meta-analysis.

机构信息

Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.

Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

Dent Traumatol. 2022 Aug;38(4):286-298. doi: 10.1111/edt.12744. Epub 2022 Mar 11.

Abstract

BACKGROUND/AIM: Clinical and radiographic sequelae are common following traumatic dental injuries to primary teeth. The aim of this systematic review was to assess the prevalence of such sequelae.

MATERIALS AND METHODS

Searches were conducted in the PubMed, Scopus, Embase, Web of Science, and BBO/LILACS databases as well as the gray literature. The outcome of interest was the prevalence of the most common sequelae following traumatic dental injuries to anterior primary teeth. Observational studies that evaluated such sequelae were included. Data were extracted, and methodological quality was appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. The number of sequelae per tooth and the total number of teeth evaluated in each study were considered to calculate pooled prevalence rates with 95% confidence intervals (CI). The quality of the evidence was determined using the GRADE approach.

RESULTS

Twenty-five articles were included in this systematic review and meta-analysis. The prevalence of each complication in descending order was as follows: 39.7% crown discoloration (95% CI: 29.52-50.32), 24.3% pulp necrosis with infection (95% CI: 17.34-32.06), 16.2% periapical radiolucency (95% CI: 8.88-25.49), 15.9% premature tooth loss (95% CI: 9.93-23.15), 14.8% pulp canal obliteration (95% CI: 8.46-22.73), 11.9% pathological root resorption (95% CI: 7.68-16.98), 7.1% abscess/fistula (95% CI: 4.4-10.6), and 1.8% ankylosis (95% CI: 0.82-3.17). The certainty of the evidence was very low.

CONCLUSIONS

Crown discoloration was the most common sequela in injured primary teeth, but this should be interpreted with caution due to the very low certainty of the evidence. Considerable variation was found in the prevalence of each sequela.

摘要

背景/目的:外伤性乳牙损伤后常出现临床和影像学后遗症。本系统评价的目的是评估这些后遗症的发生率。

材料和方法

在 PubMed、Scopus、Embase、Web of Science 和 BBO/LILACS 数据库以及灰色文献中进行了检索。感兴趣的结果是外伤性前乳牙损伤后最常见的后遗症发生率。纳入评估这些后遗症的观察性研究。提取数据,并使用 Joanna Briggs 研究所用于报告流行率数据的批判性评估清单评估方法学质量。考虑到每颗牙齿的后遗症数量和每颗牙齿的评估数量,计算了汇总流行率和 95%置信区间(CI)。使用 GRADE 方法确定证据质量。

结果

本系统评价和荟萃分析纳入了 25 篇文章。按并发症发生率降序排列,如下:39.7%的冠变色(95%CI:29.52-50.32),24.3%的牙髓坏死伴感染(95%CI:17.34-32.06),16.2%的根尖周透光区(95%CI:8.88-25.49),15.9%的过早牙齿缺失(95%CI:9.93-23.15),14.8%的牙髓腔封闭(95%CI:8.46-22.73),11.9%的病理性根吸收(95%CI:7.68-16.98),7.1%的脓肿/瘘管(95%CI:4.4-10.6),1.8%的骨粘连(95%CI:0.82-3.17)。证据的确定性非常低。

结论

冠变色是受伤乳牙中最常见的后遗症,但由于证据的确定性非常低,因此应谨慎解释。每个后遗症的发生率存在相当大的差异。

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