Interventions for treating asymptomatic impacted wisdom teeth in adolescents and adults.
Interventions for treating asymptomatic impacted wisdom teeth in adolescents and adults.
复制标题
治疗青少年和成人无症状阻生智齿的干预措施。
DOI：
10.1002/14651858.cd003879.pub2
复制
发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Alphons J. M. Plasschaert
中科院分区：
文献类型：
--
作者：
T. Mettes;M. Nienhuijs;W. V. D. Sanden;E. H. Verdonschot;Alphons J. M. Plasschaert
背景
无症状阻生智齿的预防性拔除定义为在没有局部疾病的情况下（手术）拔除智齿。阻生智齿与病理变化有关，例如牙齿周围牙龈发炎、牙根吸收、牙龈和牙槽骨疾病、邻近牙齿受损、囊肿和肿瘤的发展。还给出了证明预防性切除合理性的其他几个原因。智齿并不总是在口腔中发挥功能性作用。当在老年患者中进行手术切除时，术后并发症、疼痛和不适的风险增加。然而，在大多数发达国家，预防性拔除无问题的智齿，无论是阻生还是完全萌出，长期以来一直被认为是“适当的护理”。谨慎的决策，并坚持特定的指标去除，可以减少60%或更多的外科手术的数量。有人建议，观察监测无症状的智齿可能是一个适当的策略。
目标
比较青少年和成人无症状阻生智齿预防性拔除与保留的效果。
搜索策略
检索了以下电子数据库：科克伦口腔健康组试验注册（2004年8月4日）、科克伦对照试验中心注册（CENTRAL）、MEDLINE（1966年至2004年8月4日）、PubMed（1966年至2004年8月4日）、EMBASE（1974年至2004年8月4日）。对语言没有限制。关键期刊是手工搜索的。试图识别正在进行的和未发表的试验。
选择标准
所有随机或对照临床试验（RCT/CCT）比较预防性拔除无症状阻生智齿与不治疗（保留）的效果。
数据收集和分析
相关性、有效性和数据提取的评估由三名评审员独立进行，一式两份。如果存在不确定性，则联系作者以获取有关随机化和退出的更多信息。对审判进行了质量评估。
主要结果
只有三项试验符合审查选择标准。两项已完成的随机对照试验均评估了预防性拔除对青少年中晚期切牙拥挤的影响。确定了一项正在进行的RCT，但研究人员无法提供任何数据。他们打算在不久的将来发表，收到的资料将列入最新资料。尽管两项已完成的试验均符合综述的入选标准，但关于受试者特征、干预措施和评估的结局，评估了不同的结局指标，这妨碍了数据的汇总。
作者的结论
没有证据支持或反驳常规预防性拔除成人无症状阻生智齿。有一些可靠的证据表明，预防性拔除青少年无症状的阻生智齿既不能减少也不能防止晚期切牙拥挤。
BACKGROUND
The prophylactic removal of asymptomatic impacted wisdom teeth is defined as the (surgical) removal of wisdom teeth in the absence of local disease. Impacted wisdom teeth have been associated with pathological changes, such as inflammation of the gums around the tooth, root resorption, gums- and alveolar bone disease, damage of the adjacent teeth, the development of cysts and tumours. Several other reasons to justify prophylactic removal have also been given. Wisdom teeth do not always fulfil a functional role in the mouth. When surgical removal is carried out in older patients the risk of more postoperative complications, pain and discomfort increases. Nevertheless, in most developed countries the prophylactic removal of trouble-free wisdom teeth, either impacted or fully erupted, has long been considered as 'appropriate care'. Prudent decision-making, with adherence to specified indicators for removal, may reduce the number of surgical procedures by 60% or more. It has been suggested that watchful monitoring of asymptomatic wisdom teeth may be an appropriate strategy.
OBJECTIVES
To evaluate the effect of prophylactic removal of asymptomatic impacted wisdom teeth in adolescents and adults compared with the retention of these wisdom teeth.
SEARCH STRATEGY
The following electronic databases were searched:The Cochrane Oral Health Group Trials Register (4 August 2004), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (1966 to 4 August 2004), PubMed (1966 to 4 August 2004), EMBASE (1974 to 4 August 2004). There was no restriction on language. Key journals were handsearched. An attempt was made to identify ongoing and unpublished trials.
SELECTION CRITERIA
All randomised or controlled clinical trials (RCTs/CCTs) comparing the effect of prophylactic removal of asymptomatic impacted wisdom teeth with no-treatment (retention).
DATA COLLECTION AND ANALYSIS
Assessment of relevance, validity and data extraction were conducted in duplicate and independently by three reviewers. Where uncertainty existed, authors were contacted for additional information about randomisation and withdrawals. A quality assessment of the trials was carried out.
MAIN RESULTS
Only three trials were identified that satisfied the review selection criteria. Two were completed RCTs and both assessed the influence of prophylactic removal on late incisor crowding in adolescents. One ongoing RCT was identified, but the researchers were unable to provide any data. They intend to publish in the near future and information received will be included in updates. Although both completed trials met the inclusion criteria of the review, regarding participants characteristics, interventions and outcomes assessed, different outcomes measures were assessed which prevented pooling of data.
AUTHORS' CONCLUSIONS
No evidence was found to support or refute routine prophylactic removal of asymptomatic impacted wisdom teeth in adults. There is some reliable evidence that suggests that the prophylactic removal of asymptomatic impacted wisdom teeth in adolescents neither reduces nor prevents late incisor crowding.