Loh Alex, O'Hoy Polly, Tran Xuan, Charles Rachael, Hughes Andrew, Kubo Kotaro, Messer Louise Brearley
School of Dental Science, University of Melbourne, Melbourne, Australia.
Pediatr Dent. 2004 Sep-Oct;26(5):401-9.
Formocresol and ferric sulfate were evaluated as pulpotomy medicaments using evidence-based dentistry principles. Formocresol has been challenged as a potential carcinogen and mutagen, leading to consideration of ferric sulfate.
The PICOT statement was: (P) In human carious primary molars with reversible coronal pulpitis, (I) does a pulpotomy performed with ferric sulfate, (C) compared with formocresol, (O) result in dinical/radiographic success, (T) in time periods up to exfoliation? Relevant papers (N=894) were identified from databases and inclusion criteria were applied; 94 papers remained (randomized clinical trials [RCTs]=7; clinical trials [CTs]=28; case-control studies=14; opinions, cohort, and cross-sectional studies=4; reviews=22; irretrievable papers=19). Three RCTs and 10 CTs (total teeth: formocresol=753; ferric sulfate=90) were meta-analyzed; 1 RCT and 1 CT were tested for homogeneity (odds ratios; 95% confidence intervals); 3 RCTs and 10 CTs were examined by student's t test.
Clinical data indicated ferric sulfate was significantly more successful than formocresol (OR=1.95; CI=1.01-3.80). Radiographic data indicated no difference between medicaments (OR=0.90; CI=0.58-1.39). Medicaments did not differ with t-tests of clinical (P>.10) and radiographic (P>.50) data.
This evidence-based assessment concluded that, in human carious primary molars with reversible coronal pulpitis, pulpotomies performed with either formocresol or ferric sulfate are likely to have similar clinical/radiographic success.
运用循证牙科原则，对甲醛甲酚和硫酸铁作为活髓切断术药物进行评估。甲醛甲酚因被质疑为潜在致癌物和诱变剂，促使人们对硫酸铁进行研究。
PICOT声明为：（P）在患有可逆性冠髓炎的人类龋源性乳磨牙中，（I）与甲醛甲酚相比，（C）使用硫酸铁进行活髓切断术，（O）在直至乳牙脱落的时间段内，（T）是否能取得临床/影像学成功？从数据库中检索出相关论文（N = 894篇）并应用纳入标准；最终保留94篇论文（随机临床试验[RCTs] = 7篇；临床试验[CTs] = 28篇；病例对照研究 = 14篇；观点、队列和横断面研究 = 4篇；综述 = 22篇；无法获取的论文 = 19篇）。对3篇RCT和10篇CT（牙齿总数：甲醛甲酚 = 753颗；硫酸铁 = 90颗）进行荟萃分析；对1篇RCT和1篇CT进行同质性检验（优势比；95%置信区间）；通过学生t检验对3篇RCT和10篇CT进行分析。
临床数据表明硫酸铁的成功率显著高于甲醛甲酚（OR = 1.95；CI = 1.01 - 3.80）。影像学数据表明两种药物之间无差异（OR = 0.90；CI = 0.58 - 1.39）。通过临床（P >.10）和影像学（P >.50）数据的t检验，两种药物无差异。
基于循证的评估得出结论，在患有可逆性冠髓炎的人类龋源性乳磨牙中，使用甲醛甲酚或硫酸铁进行活髓切断术在临床/影像学上可能具有相似的成功率。
