The association of third molars with mandibular angle fractures: a meta-analysis.
The association of third molars with mandibular angle fractures: a meta-analysis.
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发表时间：
2004
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通讯作者：
B. Hanson;P. Cummings;F. Rivara;M. John
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作者：
B. Hanson;P. Cummings;F. Rivara;M. John
目的评估下颌角骨折在有下第三磨牙和没有下第三磨牙人群中的相对危险性。方法通过在MEDLINE和EMBASE中进行文献检索以确定合适的观察性研究，获得病例对照荟萃分析的数据。要纳入，研究必须提供下颌骨骨折患者的数据，纳入关于下第三磨牙存在的交叉分类信息，并表明骨折是否为同侧下颌骨角骨折。结果6项研究，涉及3002例下颌骨骨折患者，符合纳入标准。比较有第三磨牙和没有第三磨牙的患者，角度骨折的粗略相对风险估计在1.2到12.7之间。有证据表明6项研究存在异质性（p = 0.001），但当排除2项方法不严谨的研究时，同质性检验不再具有统计学意义（p = 0.22）。其余4项研究的估计相对危险度为2.4 （95% CI 1.9 ~ 3.0）。结论下第三磨牙的存在可能使下颌骨角骨折的风险增加一倍。这可能会对是否拔除臼齿的临床决定产生影响。
OBJECTIVE To estimate the relative risk of mandibular angle fractures among people with a lower third molar compared with those without a lower third molar. METHODS Data for a case-control meta-analysis were obtained by performing a literature search in MEDLINE and EMBASE to identify suitable observational studies. To be included, studies had to present data on patients with mandibular fractures, incorporate cross-classified information about the presence of a lower third molar and indicate whether the fracture was a mandibular angle fracture on the ipsilateral side. RESULTS Six studies, involving 3,002 patients with mandibular fractures, met the inclusion criteria. Crude relative risk estimates for an angle fracture, comparing patients with a third molar with those without, ranged from 1.2 to 12.7. There was evidence of heterogeneity across the 6 studies (p = 0.001), but when 2 studies with less methodologic rigour were excluded, a test of homogeneity was no longer statistically significant (p = 0.22). The estimated relative risk across the remaining 4 studies was 2.4 (95% CI 1.9 to 3.0). CONCLUSIONS The presence of a lower third molar may double the risk of an angle fracture of the mandible. This could have a bearing on any clinical decision on whether to extract the molar.