de Souza B B, da Silveira M L M, Dantas W R M, A C Almeida R, Germano A R
Department of Oral and Maxillofacial Surgery, Federal University of Rio Grande do Norte, Onofre Lopes University Hospital - EBSERH, Lagoa Nova, Natal, RN, Brazil.
School of Dentistry, University of Pernambuco, Arcoverde, PE, Brazil.
Int J Oral Maxillofac Surg. 2023 Jan;52(1):51-59. doi: 10.1016/j.ijom.2022.07.001. Epub 2022 Aug 5.
The aim of this systematic review and meta-analysis was to assess whether the presence of inferior third molars during sagittal split mandibular ramus osteotomy increases the risk of intraoperative and postoperative complications. The PRISMA protocol was followed in this study, and the review was registered in the PROSPERO database (CRD42020147642). A search was conducted in the MEDLINE (PubMed), Web of Science, Cochrane Central, and Scopus databases on November 1, 2021. Nineteen articles were included, and the variables analysed were unfavourable fractures, infection, neurosensory disturbance, removal of osteosynthesis material, and duration of surgery. Meta-analyses were performed for the variables unfavourable fractures (risk ratio (RR) 0.95, 95% confidence interval (CI) 0.58-1.57, P = 0.84), infection (RR 0.75, 95% CI 0.48-1.18, P = 0.21), and neurosensory disturbance (RR 1.55, 95% CI 0.61-3.91, P = 0.35); no statistically significant difference in the risk of these variables was found between the groups with and without third molars. The third molars did not increase the need to remove fixation material, but increased the surgery time. The presence of the third molar during sagittal split mandibular ramus osteotomy appears not to increase the risk of intraoperative and postoperative complications. The results presented here must be interpreted with caution due to the heterogeneity presented by the observational studies included.
本系统评价和荟萃分析的目的是评估在下颌升支矢状劈开截骨术中下颌第三磨牙的存在是否会增加术中和术后并发症的风险。本研究遵循PRISMA方案，并在PROSPERO数据库（CRD42020147642）中进行了注册。于2021年11月1日在MEDLINE（PubMed）、科学网、Cochrane中心和Scopus数据库中进行了检索。纳入了19篇文章，分析的变量包括不良骨折、感染、神经感觉障碍、取出内固定材料和手术时长。对不良骨折（风险比（RR）0.95，95%置信区间（CI）0.58 - 1.57，P = 0.84）、感染（RR 0.75，95% CI 0.48 - 1.18，P = 0.21）和神经感觉障碍（RR 1.55，95% CI 0.61 - 3.91，P = 0.35）这些变量进行了荟萃分析；在有和没有第三磨牙的组之间，这些变量的风险没有发现统计学上的显著差异。第三磨牙并没有增加取出固定材料的必要性，但增加了手术时间。在下颌升支矢状劈开截骨术中第三磨牙的存在似乎不会增加术中和术后并发症的风险。由于纳入的观察性研究存在异质性，此处呈现的结果必须谨慎解读。
