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下三手术中的冠状管切除术:系统性审查和元分析
Fei Wu Kang1, Xin Rui Yuan2, Gong Cheng Li3
1Professor, Department of Oral and Maxillofacial Surgery, Stomatology Hospital Affiliated to Tongji University, Shanghai, China.
概括
冠状管切除术显著降低了下膜神经损伤 (IANI) 和语言神经损伤 (LNI) 的风险,而不是取出受影响的下第三牙. 虽然它降低了干腔风险,但冠状动脉切除术具有更高的重新干预率和特定失败率.
科学领域:
- 口腔和牙面部外科手术
- 牙科研究 牙科研究
- 手术并发症 手术并发症
背景情况:
- 受影响的下第三通常需要手术干预.
- 下膜神经损伤 (IANI) 是与第三骨提取相关的重大并发症.
- 冠状管切除术是一种不那么侵入性的方法,被认为是完全摘除的替代方案.
研究的目的:
- 系统地审查和进行比较冠状切除术和拔除受冲击的下第三的元分析.
- 评估下膜神经损伤 (IANI) 和两种手术技术之间的其他并发症的发生率.
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 在5个数据库中进行了全面的文献搜索,用于比较冠状动脉切除和提取的研究.
- 包括34项研究 (24个队列,10个病例控制) 涉及7,115颗智慧牙.
主要成果:
- 冠状管切除术显著降低了IANI (RR:0.1),LNI (RR:0.2) 和干 (RR:0.4) 的风险.
- 在冠状动脉切除和摘取之间没有观察到术后感染率的显著差异.
- 冠状管切除显示了更高的手术重新干预 (3.63%) 的风险,根暴露 (2.66%) 和失败率为2.79%.
结论:
- 冠状动脉切除术是减少神经损伤和干位风险的有利选择,当切除高风险下第三时.
- 较高的二次手术干预率和特定失败率与冠状动脉切除术有关.
- 引导骨再生可以减轻残留的根迁移,减少对二次手术的需要.
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