青少年和成年人无症状阻生智齿干预措施的疗效评价

Interventions for Treating Asymptomatic Impacted Wisdom Teeth in Adolescents and Adults

目的评价在青少年和成人中拔除与保留无症状阻生智齿的效果。方法计算机检索Cochrane口腔健康组资料库(至2004年8月4日),Cochrane中心临床对照试验资料库(CENTRAL),OvidMEDLINE(1966～2004年8月4日),PubMed(1966～2004年8月4日)和EMBASE(1974～2004年8月4日)。检索无语种限制。同时对主要相关杂志进行手检,并尽力获取正在进行和未发表的研究。纳入比较预防性拔除与保留阻生智齿效果的全部随机对照或临床对照研究。由3位作者分别独立评价所检出文献的相关性、真实性并提取数据,如有不确定性,联系作者以获取关于随机和失访的更多信息。对所有试验均进行了质量评价。结果共纳入3个研究,其中2个已完成的随机对照试验评价了青少年预防性拔除智齿对切牙拥挤的影响,另1个随机对照试验正在进行,但研究者不能提供任何资料,他们准备近期发表文章,如是,其资料将被纳入本评价的更新中。已完成的2个研究结局判断指标不同,不能进行数据合并。结论没有证据支持或反对常规预防性拔除成年人无症状阻生智齿,有一些可靠的证据表明在青少年预防性拔除阻生智齿既不能减少也不能预防切牙拥挤。

Objective To evaluate the effect of prophylactic removal of asymptomatic impacted wisdom teeth in adolescents and adults compared with the retention of these wisdom teeth. Methods We searched the Cochrane Oral Health Group Trials Register （to 4 August, 2004）, the Cochrane Central Register of Controlled Trials （CENTRAL）, PubMed （1966 to 4 August, 2004）, EMBASE （1974 to 4 August, 2004）. There was no restriction to publication of language. Key journals were handsearched. An attempt was made to identify ongoing and unpublished trials. All randomised or controlled clinical trials （KCTs/CCTs） comparing the effect of prophylactic removal of asymptomatic impacted wisdom teeth with no-treatment （retention） were included. Assessment of relevance ,validity and data extraction were conducted in duplicate by three independent reviewers. Where uncertainty existed, authors were contacted for additional information about randomisation and withdrawals. The quality assessments of the trials were carried out. Results Only three trials were identified to fulfill the selection criteria. Two complete RCTs 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 and intended to publish in the near future. Although both complete trials met the inclusion criteria, different outcome measures were prevented us from pooling data. Conclusions No evidence has been found to support or refute routine prophylactic removal of asymptomatic impacted wisdom teeth in adults. There is some reliableevidence that suggests that the prophylactic removal of asymptomatic impacted wisdom teeth in adolescents neither reduces nor prevents late incisor crowding.