下歯槽神経の位置と神経損傷との関連性。システマティックレビューとメタアナリシス

Association of the Inferior Alveolar Nerve Position and Nerve Injury: A Systematic Review and Meta-Analysis.

抄録

背景:

下顎第3大臼歯（LM3）に対する下歯槽神経管（IAC）の頬側および舌側の位置と下歯槽神経（IAN）損傷の割合の関係を比較することを目的とした。

BACKGROUND: We aimed to compare the relationship between the buccal and lingual positions of the inferior alveolar nerve canal (IAC) relative to the lower third molar (LM3) and the rate of the inferior alveolar nerve (IAN) injury.

方法:

以下のデータベースで系統的な検索を行った。PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Journals@Ovid.言語や出版状況の制限は設けない。出版年は2009年から2021年までとした。メタ解析のプロセスはReview Managerソフトウェア（Cochrane Collaboration）を用いて行った。

METHODS: A systematic search was performed in the following databases: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Journals@Ovid. No language or publication status restrictions were set. The publication year was set from 2009 to 2021. The process of meta-analysis was performed by Review Manager software (Cochrane Collaboration).

結果:

合計1063件の論文を最初に検索し，53件の論文の全文を読み，11件の満足できる論文を発見した。IAN損傷の割合とLM3根に対するIACの舌側位置および頬側位置の間に統計的な差があり（OR, 4.96; 95% CI, 2.11 to 11.62; = 0.0002）、高い異質性（= 0.001, I = 65%）を有していた。

RESULTS: A total of 1063 articles were initially searched and full texts of 53 articles were read, and 11 satisfactory articles were found. There was a statistical difference between the rate of IAN injury and the lingual position and buccal position of the IAC relative to the LM3 roots (OR, 4.96; 95% CI, 2.11 to 11.62; = 0.0002), with high heterogeneity ( = 0.001, I = 65%).

結論:

IACがLM3根の頬側に位置する場合と舌側に位置する場合のIAN損傷率に統計的な差異が認められた。第三大臼歯抜歯において、IACがLM3根の舌側に位置する場合、比較的高い確率で損傷することがわかった。

CONCLUSION: A statistical difference was found in the rate of IAN injury between cases where the IAC was positioned buccally and lingually of the LM3 roots. The IAC was at a relatively higher risk of damage in third molar extraction when it was located on the lingual position of the LM3 roots.