RESUMO
The aim of this systematic review was to investigate whether the presence of third molars (3Ms) during sagittal split osteotomy of the mandible increases the risk of complications. Searches were conducted using MEDLINE via PubMed, LILACS, Cochrane Central, Scopus, DOSS, and SIGLE via OpenGrey up to December 2020. Fifteen articles were included for evaluation and 14 in the meta-analysis, with a total of 3909 patients and 7651 sagittal split osteotomies (670 complications). Inferior alveolar nerve (IAN) exposure in the proximal segment was the most frequent complication (n = 409), followed by bad splits (n = 151). Meta-analysis revealed no significant increase in the incidence of 3M-related IAN exposure (P = 0.45), post-surgical infections (P = 0.15), osteosynthesis material removal (P = 0.37), or bad splits (P = 0.23). The presence of 3Ms was associated with a reduced risk of nerve disorder (P = 0.05) and favoured bad splits in the lingual plate (P = 0.005). The quality of evidence was very low, mainly due to non-randomized study designs, high risk of bias, inconsistency, and imprecision. This systematic review suggests that the removal of 3Ms before sagittal mandibular osteotomy does not reduce the incidence of complications. Thus, we recommend future better-designed studies with rigorous methodologies and adjustments for confounding factors.
Assuntos
Dente Serotino , Osteotomia Sagital do Ramo Mandibular , Humanos , Mandíbula/cirurgia , Nervo Mandibular , Osteotomia Mandibular , Dente Serotino/cirurgia , Osteotomia Sagital do Ramo Mandibular/efeitos adversos , Osteotomia Sagital do Ramo Mandibular/métodos , Fatores de RiscoRESUMO
The invasion of new regions by exotic pests has been more than ever a critical issue that warrants coordinated international actions to manage established populations and prevent further spreading. Invasive insects can undermine the ecological equilibrium of both natural and agricultural ecosystems. Moreover, increasing temperatures due to climatic change exacerbate this problem by allowing pests to further reach regions previously considered unsuitable. The tomato pinworm Tuta absoluta (Meyrick) (Lepidoptera) is an exotic pest native to Peru that has spread beyond Neotropical America. In Europe, its occurrence was reported in Spain in 2006, and thereafter, it has spread throughout the Mediterranean Basin and further into Africa and part of Asia. While T. absoluta can cause losses to tomato production all over the globe, the differences in each invaded region (e.g., climate, vegetation) may affect its population dynamics and, consequently, management protocols. Therefore, the main intent of this forum paper is to explore how European growers and researchers are dealing with T. absoluta in the Mediterranean area. As for many other invasive pests, the best approach has been the adoption of integrated pest management (IPM). Specifically, the integration of biological control agents (e.g., mirid predators and egg parasitoids), microbial insecticides (i.e., Bacillus thuringiensis), selective chemical insecticides, and sex pheromone-based control has proven adequate, especially in tomato greenhouses. Nonetheless, some of the challenges ahead include the development of resistant tomato cultivars, the management of wild vegetation and companion plants to optimize the conservation of natural enemies and their effectiveness at the crop level, the management of insecticide resistance, and the improvement of sex pheromone-based tactics.