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Which treatments are best for oro-antral fistulae?
Evidence-Based Dentistry Pub Date : 2019-06-28 , DOI: 10.1038/s41432-019-0023-8
Carlos Fernando de Almeida Barros Mourão 1
Affiliation  

Data sources Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Oral Health's Trials Register, the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organisation International Clinical Trials Registry Platform. There were no restrictions on language or date of publication selected.Study selection Randomised controlled trials (RCTs) of interventions for the management of oro-antral fistulae or communications as a result of dental procedures only were considered. Crossover trials and quasi-randomised studies were excluded. Data extraction and synthesis Two reviewers independently elected studies, extracted data and assessed risk of bias. The main outcome of closure of the oro-antral fistulae or communications was dichotomous and expressed as a risk ratio (RR) 95% confidence intervals (CI). The GRADE approach was used to assess the overall quality of the evidence.Results Only one study with unclear risk of bias was included. This involved 20 patients and compared two surgical interventions: pedicled buccal fat pad flap and buccal flap. There was successful closure of all oro-antral communications in both groups, so no difference was reported between the interventions one month after surgery (RR 1.00, 95% Cl 0.83 to 1.20). The quality of the evidence was very low (GRADE). Conclusions As all the interventions in the one small study were effective there is insufficient evidence to assess any difference. Further research including large well-conducted and reported RCTs on treating oro-antral communications and fistulae caused by dental procedures is needed to inform clinical practice.

中文翻译:

哪种方法最适合口腔-肛瘘?

数据来源Medline,Embase,Cochrane对照试验中央注册系统(CENTRAL),Cochrane口腔健康试验注册系统,美国国立卫生研究院临床试验注册机构(ClinicalTrials.gov)和世界卫生组织国际临床试验注册平台。选择语言或出版日期没有限制。研究选择仅考虑通过牙科手术治疗口-肛瘘或交流的干预措施的随机对照试验(RCT)。交叉试验和半随机研究被排除在外。数据提取和综合两名审稿人独立选择研究,提取数据并评估偏倚风险。封闭口-口瘘或沟通的主要结果是二分法,并表示为风险比(RR)95%置信区间(CI)。使用GRADE方法评估证据的整体质量。结果仅包括一项偏倚风险不清楚的研究。这项研究涉及20例患者,并比较了两种手术干预:带蒂颊脂垫皮瓣和颊瓣。两组均成功关闭了所有口-口通讯,因此术后一个月的干预措施之间无差异(RR 1.00,95%Cl 0.83至1.20)。证据质量非常低(GRADE)。结论由于一项小型研究中的所有干预措施均有效,因此没有足够的证据评估任何差异。
更新日期:2019-06-28
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