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下颌第三磨牙冠切除术的再次干预率、时机及指征:系统评价的系统综述

Re-Intervention Rate, Timing, and Indications Following Coronectomy of the Mandibular Third Molar: A Systematic Review of Systematic Reviews.

作者信息

Di Spirito Federica, Caggiano Mario, Acerra Alfonso, Rizki Iman, Leonetti Grazia, Allegretti Gianluca, Amato Massimo

机构信息

Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, Italy.

出版信息

J Clin Med. 2025 May 30;14(11):3877. doi: 10.3390/jcm14113877.

Abstract

: Coronectomy is an alternative to complete third molar extraction to reduce the risk of inferior alveolar nerve injury. This systematic review of systematic reviews evaluates re-intervention rate, timing, and indications after mandibular third molar coronectomy. : A systematic search following PRISMA guidelines was conducted across Scopus, MEDLINE/PubMed, BioMed Central, Web of Science, Cochrane Library and PROSPERO. Studies reporting re-intervention rates after at least six months from coronectomy were included. Data extraction focused on re-intervention timing, indications, and complications. : Six systematic reviews, including 5896 subjects and 7913 successful coronectomies (not requiring immediate tooth extractions), were analyzed. The overall re-intervention rate was 4.45%, with timing ranging from six months to ten years (mean: 10.4 months). Root exposure (16.76%) was the primary cause, followed by infection (4.55%) and pain (2.84%). Root migration (12.20%) was common, while inferior alveolar nerve injury remained rare (0.76%). : Coronectomy is a viable alternative in high-risk cases, with a low re-intervention rate. Root migration and exposure require long-term follow-up. Standardized imaging protocols and refined re-intervention criteria are needed.

摘要

冠切除术是完全拔除第三磨牙的一种替代方法,可降低下牙槽神经损伤的风险。这项对系统评价的系统评价评估了下颌第三磨牙冠切除术后的再次干预率、时机和指征。

按照PRISMA指南在Scopus、MEDLINE/PubMed、BioMed Central、Web of Science、Cochrane图书馆和PROSPERO中进行了系统检索。纳入了报告冠切除术后至少六个月再次干预率的研究。数据提取集中在再次干预的时机、指征和并发症上。

分析了六项系统评价,包括5896名受试者和7913例成功的冠切除术(不需要立即拔牙)。总体再次干预率为4.45%,时间范围从六个月到十年(平均:10.4个月)。牙根暴露(16.76%)是主要原因,其次是感染(4.55%)和疼痛(2.84%)。牙根移位(12.20%)很常见,而下牙槽神经损伤仍然很少见(0.76%)。

在高风险病例中,冠切除术是一种可行的替代方法,再次干预率较低。牙根移位和暴露需要长期随访。需要标准化的成像方案和完善的再次干预标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eebb/12155643/b969b9c65aae/jcm-14-03877-g001.jpg

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