处理无症状第三磨牙的循证思考

第三磨牙是最易发生阻生的牙齿，与多种病变形成有关，临床上主要的治疗方法为拔除。虽然国际上对有症状第三磨牙的拔除已达成共识，但就无症状第三磨牙是否应当预防性拔除仍存在争议。循证医学要求医生对患者的诊断和治疗必须基于当前可得到的最佳临床研究证据，以保证患者得到当前最好的治疗效果。本文通过对近年来文献中关于第三磨牙拔除适应证、无症状第三磨牙可能发生的病变以及第三磨牙拔除风险等方面的内容进行综述，以便在处理无症状第三磨牙的决策制定中作出基于证据的合理选择。

Evidence-based decision making in asymptomatic third molars management

Third molars are the most common impacted teeth and associated with a variety of pathologies. The main treatment for third molars is extraction. There have already been well-established indications for removal of symptomatic third molars, however, controversies still exist with regard to the question whether asymptomatic third molars should be removed. Evidence-based medicine asks doctors to apply the most recent and sound evidence into their clinical practice in order to better serve the patients. The purpose of this paper was to provide recent ponderable evidence to help dentists reevaluate the possible pathology of retained asymptomatic third molars and the potential harm caused by prophylactic removal, and then make a rational evidence-based decision.