Mickenautsch Steffen, Yengopal Veerasamy
Division of Public Oral Health, Faculty of Health Sciences, University of the Witwatersrand - 7 York Rd,, Parktown/Johannesburg 2193, South Africa.
BMC Res Notes. 2011 Mar 11;4:58. doi: 10.1186/1756-0500-4-58.
This article aims to update the existing systematic review evidence elicited by Mickenautsch et al. up to 18 January 2008 (published in the European Journal of Paediatric Dentistry in 2009) and addressing the review question of whether, in the same dentition and same cavity class, glass-ionomer cement (GIC) restored cavities show less recurrent carious lesions on cavity margins than cavities restored with amalgam.
The systematic literature search was extended beyond the original search date and a further hand-search and reference check was done. The quality of accepted trials was assessed, using updated quality criteria, and the risk of bias was investigated in more depth than previously reported. In addition, the focus of quantitative synthesis was shifted to single datasets extracted from the accepted trials.
The database search (up to 10 August 2010) identified 1 new trial, in addition to the 9 included in the original systematic review, and 11 further trials were included after a hand-search and reference check. Of these 21 trials, 11 were excluded and 10 were accepted for data extraction and quality assessment. Thirteen dichotomous datasets of primary outcomes and 4 datasets with secondary outcomes were extracted. Meta-analysis and cumulative meta-analysis were used in combining clinically homogenous datasets. The overall results of the computed datasets suggest that GIC has a higher caries-preventive effect than amalgam for restorations in permanent teeth. No difference was found for restorations in the primary dentition.
This outcome is in agreement with the conclusions of the original systematic review. Although the findings of the trials identified in this update may be considered to be less affected by attrition- and publication bias, their risk of selection- and detection/performance bias is high. Thus, verification of the currently available results requires further high-quality randomised control trials.
本文旨在更新米克瑙奇等人截至2008年1月18日（2009年发表于《欧洲儿童牙科学杂志》）得出的现有系统评价证据，并解决以下评价问题：在同一牙列和同一龋洞分类中，玻璃离子水门汀（GIC）修复的龋洞在洞缘处的继发龋损是否比银汞合金修复的龋洞少。
系统文献检索的时间范围超出了原始检索日期，并进一步进行了手工检索和参考文献核对。采用更新后的质量标准评估纳入试验的质量，并比之前报告更深入地调查偏倚风险。此外，定量合成的重点转移到从纳入试验中提取的单个数据集。
数据库检索（截至2010年8月10日）除了原始系统评价中纳入的9项试验外，还识别出1项新试验，经手工检索和参考文献核对后又纳入了11项试验。在这21项试验中，11项被排除，10项被纳入进行数据提取和质量评估。提取了13个主要结局的二分数据集和4个次要结局的数据集。采用荟萃分析和累积荟萃分析合并临床同质数据集。计算数据集的总体结果表明，对于恒牙修复，GIC比银汞合金具有更高的防龋效果。对于乳牙修复，未发现差异。
这一结果与原始系统评价的结论一致。尽管本次更新中识别出的试验结果可能被认为受失访和发表偏倚的影响较小，但其选择偏倚和检测/实施偏倚的风险较高。因此，目前现有结果的验证需要进一步的高质量随机对照试验。
