A comparison of piezoelectric surgery and conventional techniques in the enucleation of cysts and tumors in the jaws: a systematic review and meta-analysis.
L Suárez-Pérez, M Peralta-Mamani, R-T Velázquez-Cayón
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引用次数: 0
Abstract
Background: Despite the comprehensive classifications provided by the WHO, the most common lesions include radicular cysts, dentigerous cysts, odontogenic keratocysts, ameloblastomas, and odontomas. The piezoelectric technique has shown effectiveness in removing intraosseous pathologies by relying on ultrasonic microvibrations, which help preserve soft and vascular tissues. Precision in manipulating intraosseous pathology can impact the prognosis and improve the surgical procedure by controlling hemorrhage and promoting microscopic benefits. While previous research has compared the advantages of piezoelectric surgery and rotational methods, a systematic review is needed to consolidate the available information on this specific clinical issue.
Material and methods: A search strategy was developed with de PRISMA statement. PubMed, Web of Science, Scopus, and Embase electronic databases were searched. The bibliographic search was conducted in December 2023. The methodological quality of the studies followed the Joanna Briggs Institute (JBI) critical evaluation tool for randomized clinical trials.
Results: The final sample comprised 5 clinical trials, involving 231 cysts and 120 tumors in the experimental group. The mean age of participants was 30.6 years, with 196 men and 141 women included in the study. However, conventional surgery is faster than piezosurgery, both techniques exhibited similarities in epithelial perforation, soft tissue damage, edema, postoperative infections, and occurrences of paresthesia. Regarding recurrence, no statistically significant difference was observed between the two techniques (p-value=0.339; 95% confidence interval, -0.093-0.270).
Conclusions: The surgical removal of benign odontogenic cysts and tumors in the jaws using piezosurgery yielded slight intraoperative and postoperative advantages compared to conventional rotary surgery, except for the duration of surgical procedures. It shows reduced intraoperative hemorrhage and postoperative pain but similar outcomes in other variables. The results should be interpreted with caution, more studies are needed to obtain a more robust result.
背景：尽管世界卫生组织提供了全面的分类，但最常见的病变包括根状囊肿、牙性囊肿、牙源性角化囊肿、成釉细胞瘤和牙瘤。压电技术已经证明，依靠超声微振动来去除骨内病变是有效的，这有助于保存软组织和血管组织。精确地操作骨内病理可以通过控制出血和促进显微效益来影响预后和改善手术过程。虽然以前的研究比较了压电手术和旋转方法的优点，但需要系统的回顾来巩固这一特定临床问题的可用信息。材料与方法：采用de PRISMA语句建立检索策略。检索PubMed、Web of Science、Scopus和Embase电子数据库。文献检索于2023年12月进行。研究的方法学质量遵循乔安娜布里格斯研究所（JBI）随机临床试验的关键评估工具。结果：最终样本包括5个临床试验，实验组包括231个囊肿和120个肿瘤。参与者的平均年龄为30.6岁，其中包括196名男性和141名女性。然而，传统手术比压电手术更快，两种技术在上皮穿孔、软组织损伤、水肿、术后感染和感觉异常的发生方面表现出相似之处。复发率方面，两种方法比较差异无统计学意义(p值=0.339；95%置信区间，-0.093-0.270)。结论：与传统的旋转手术相比，使用压电外科手术切除颌骨良性牙源性囊肿和肿瘤在术中和术后具有轻微的优势，除了手术时间。它显示术中出血和术后疼痛减少，但其他变量的结果相似。结果应谨慎解释，需要更多的研究来获得更可靠的结果。
期刊介绍：
1. Oral Medicine and Pathology:
Clinicopathological as well as medical or surgical management aspects of
diseases affecting oral mucosa, salivary glands, maxillary bones, as well as
orofacial neurological disorders, and systemic conditions with an impact on
the oral cavity.
2. Oral Surgery:
Surgical management aspects of diseases affecting oral mucosa, salivary glands,
maxillary bones, teeth, implants, oral surgical procedures. Surgical management
of diseases affecting head and neck areas.
3. Medically compromised patients in Dentistry:
Articles discussing medical problems in Odontology will also be included, with
a special focus on the clinico-odontological management of medically compromised patients, and considerations regarding high-risk or disabled patients.
4. Implantology
5. Periodontology
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