牙源性角化囊肿和成釉细胞瘤的牙齿处理及其在复发中的预后作用：一项系统回顾和荟萃分析与试验序列分析

IF 4.1 4区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Evidence-Based Dental Practice Pub Date : 2025-02-07 DOI:10.1016/j.jebdp.2025.102121

PIERLUIGI MARIANI DDS , DIANA RUSSO DDS, PhD , MARCO CICCIÙ DDS, PhD , LUIGI LAINO DDS, PhD

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引用次数: 0

摘要

牙源性角化囊瘤（OKC）和成釉细胞瘤（AB）是一种具有侵袭性、生长缓慢、局部侵袭性和高复发率的病理实体。本系统综述采用荟萃分析和试验序贯分析（TSA），目的是评估在OKCs和ABs手术摘除过程中，在复发风险方面拔除受病牙齿的预后作用。材料和方法在PubMed/Medline、Scopus和Web of Science数据库中检索报告拔牙和复发率数据的研究。本系统评价按照Cochrane手册和系统评价和荟萃分析首选报告项目（PRISMA）声明的指南进行。meta分析采用Mantel-Haenszel方法，由于异质性，采用随机效应模型。进行TSA以控制和减少统计分析的I型和II型误差。结果对6项研究进行定性和定量分析。共纳入737例病变（674例OKCs和64例ABs），其中508例累及牙齿。meta分析纳入451名okc；对367例病变进行拔牙治疗，141例保存完好。总风险比为0.17 (95% CI: [0.04, 0.74]；P & lt;0.0001)。结论分析显示，在切除病变核的情况下拔牙可使OKCs的复发风险降低约83%；这似乎与ABs的趋势相同，但还需要更多的证据。

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THE MANAGEMENT OF TEETH IN ODONTOGENIC KERATOCYST AND AMELOBLASTOMA AND ITS PROGNOSTIC ROLE IN RECURRENCE: A SYSTEMATIC REVIEW AND META-ANALYSIS WITH TRIAL SEQUENTIAL ANALYSIS

Introduction

Odontogenic Keratocystic (OKC) and Ameloblastoma (AB) are pathological entities characterized by aggressive behavior, slow growth, local invasiveness, and high recurrence rates. The aim of this systematic review with meta-analysis and trial sequential analysis (TSA) is to assess the prognostic role of extracting involved teeth during the surgical enucleation of OKCs and ABs in terms of recurrence risk.

Materials and Methods

A search was conducted in PubMed/Medline, Scopus, and Web of Science databases for studies reporting data on teeth extraction and recurrence rates. This systematic review was performed according to guidelines in the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Meta-analysis was performed using the Mantel-Haenszel method with a random-effects model due to heterogeneity. The TSA was conducted to control and reduce for type I and II errors of statistical analysis.

Results

Six studies were identified and analyzed qualitatively and quantitatively. A total of 737 lesions (674 OKCs and 64 ABs) were included, of which 508 had involved teeth. The meta-analysis included 451 OKCs; 367 lesions were treated with teeth extraction, and in 141 cases, the teeth were preserved. The overall Risk Ratio was 0.17 (95% CI: [0.04, 0.74]; P < .0001) for OKCs. Quantitative analysis could not be performed for ABs.

Conclusion

The analysis revealed that tooth extraction contextually to the enucleation of the lesion reduces the risk of recurrence by approximately 83% in the OKCs; this appears to have the same trend for ABs, but more evidence is needed.

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来源期刊

Journal of Evidence-Based Dental Practice DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

6.00

自引率

16.70%

发文量

105

审稿时长

28 days

期刊介绍： The Journal of Evidence-Based Dental Practice presents timely original articles, as well as reviews of articles on the results and outcomes of clinical procedures and treatment. The Journal advocates the use or rejection of a procedure based on solid, clinical evidence found in literature. The Journal''s dynamic operating principles are explicitness in process and objectives, publication of the highest-quality reviews and original articles, and an emphasis on objectivity.