恒前牙髓坏死的风险和相关并发症:系统回顾和荟萃分析

IF 2.3 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
Nitesh Tewari, Eva Lauridsen, Mohammad Atif, Sukeshana Srivastav, Georgios Tsilingaridis, Partha Haldar, Lars Andersson
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引用次数: 0

摘要

本系统综述旨在评估与侧方塌陷恒前牙牙髓坏死的发生和相关并发症有关的证据。它旨在解决与成熟根尖牙牙髓拔除建议相关的模糊问题。根据循证医学的最佳实践制定了先验方案,并在 PROSPERO 上进行了注册。2023 年 7 月 10 日,在 PubMed、LILACS、Web of Science、EMBASE、Scopus 和 Cochrane 中进行了全面的电子检索,对语言和发表年份没有任何限制。先筛选标题和摘要,然后再筛选全文。随后,使用自行设计的表格进行数据提取,评估偏倚风险(ROB),进行荟萃分析,并使用 GRADE 方法评估证据质量。定性综合对1985年至2020年期间在医院环境中进行的13项研究进行了分析。研究的最短观察期和总观察期、样本大小以及样本人群的特征均存在差异。研究发现,牙髓坏死的总患病率为57%(95% CI:42%,72%)。未成熟牙的发病率为 12%(95% CI:8%,18%,I2 = 0%),成熟牙的发病率为 58%(95% CI:42%,73%,I2 = 86%)。EIRR 的合计患病率为 11% (95% CI: 4, 27%, I2 = 95%),根尖成熟的牙齿患病风险更高(RR: 1.26, 95% CI: 1.12, 1.42, I2 = 0%)。九项研究的 ROB 为中度或高度,15 项结果中有 14 项的证据 GRADE 为极低。侧向塌陷的牙齿,尤其是先端成熟的牙齿,牙髓坏死的几率更大。然而,在大多数病例中,牙髓坏死的几率仍然低于 60%,而 EIRR 的发生率低于 20%。因此,在解释对有侧向松动的成熟牙齿进行牙髓干预的绝对建议时必须略微谨慎。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Risk of pulp necrosis and related complications in the permanent anterior teeth with lateral luxation: A systematic review and meta-analysis

Risk of pulp necrosis and related complications in the permanent anterior teeth with lateral luxation: A systematic review and meta-analysis

This systematic review aimed to evaluate the evidence related to the occurrence of pulp necrosis and related complications in permanent anterior teeth with lateral luxation. It was envisaged to address the ambiguity related to the recommendation for pulp extirpation in teeth with mature root apex. An a priori protocol was formulated as per the best practices of evidence-based medicine and registered in PROSPERO. A comprehensive search was performed electronically in PubMed, LILACS, Web of Science, EMBASE, Scopus, and Cochrane on July 10,2023 without any restriction of language or year of publication. The screening of titles and abstracts and later the full-text articles were performed. Later, the data extraction was performed by using a self-designed sheet, risk of bias (ROB) assessment was done, meta-analysis was performed, and the GRADE approach was used to assess the quality of evidence. The qualitative synthesis was performed on 13 studies done from 1985 to 2020 in hospital settings. There was variability in the minimum and total observation periods, sample sizes, and characteristics of the sample population. The overall pooled prevalence of pulp necrosis was found to be 57% (95% CI: 42, 72%). It was 12% (95% CI: 8%, 18%, I2 = 0%) in immature teeth, and 58% (95% CI: 42, 73%, I2 = 86%) in mature teeth. The pooled prevalence of EIRR was found to be 11% (95% CI: 4, 27%, I2 = 95%) with greater risk in teeth with mature root apex (RR: 1.26, 95% CI: 1.12, 1.42, I2 = 0%). The ROB was moderate or high in nine studies and the GRADE of evidence was very low in 14 of 15 outcomes. There are greater chances of pulp necrosis in teeth with lateral luxation, especially with mature apex. However, it can still be less than 60% in most cases with the prevalence of EIRR less than 20%. Hence, an absolute recommendation for endodontic intervention in mature teeth with lateral luxation must be interpreted with slight caution.

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来源期刊
Dental Traumatology
Dental Traumatology 医学-牙科与口腔外科
CiteScore
6.40
自引率
32.00%
发文量
85
审稿时长
6-12 weeks
期刊介绍: Dental Traumatology is an international journal that aims to convey scientific and clinical progress in all areas related to adult and pediatric dental traumatology. This includes the following topics: - Epidemiology, Social Aspects, Education, Diagnostics - Esthetics / Prosthetics/ Restorative - Evidence Based Traumatology & Study Design - Oral & Maxillofacial Surgery/Transplant/Implant - Pediatrics and Orthodontics - Prevention and Sports Dentistry - Endodontics and Periodontal Aspects The journal"s aim is to promote communication among clinicians, educators, researchers, and others interested in the field of dental traumatology.
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