Zhu Mengjiao, Li Jialing, Chen Bin, Mei Li, Yao Liang, Tian Jinhui, Li Huang
Department of Oral Sciences, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.
Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.
PLoS One. 2015 Nov 6;10(11):e0140176. doi: 10.1371/journal.pone.0140176. eCollection 2015.
To investigate the effect of calcium sodium phosphosilicate (CSPS) in treating dentin hypersensitivity (DH) and to compare this effect to that of a negative (placebo) control.
Several databases, including Medline, EMBASE, Web of Science, The Cochrane Library, and the Chinese Biomedical Literature Database, were searched to identify relevant articles published through January 2015; grey literature (i.e., academic literature that is not formally published) was also searched. Two authors performed data extraction independently and jointly using data collection forms. The primary outcome was the DH pain response to routine activities or to thermal, tactile, evaporative, or electrical stimuli, and the secondary outcome was the side effects of CSPS use. Each study was evaluated using the Cochrane Collaboration tool for assessing risk bias. Meta-analysis of studies with the same participant demographics, interventions, controls, assessment methods and follow-up periods was performed. The Grading of Recommendations Assessment Development and Evaluation System was used to assess the quality of the evidence and the risk of bias across studies.
Meta-analysis demonstrated that toothpaste containing 5% CSPS was more effective than the negative control at relieving dentin sensitivity, with the level of evidence classified as "moderate". In addition, prophylaxis paste containing 15% calcium sodium phosphosilicate was favored over the negative control at reducing post-periodontal therapy hypersensitivity, with the level of evidence categorized as "low". Only two studies reported side effects of CSPS use.
The majority of studies found that calcium sodium phosphosilicate was more effective than the negative control at alleviating DH. Because strong evidence is scarce, high-quality, well-designed clinical trials are required in the future before definitive recommendations can be made.
探讨磷酸硅钙钠(CSPS)治疗牙本质过敏症(DH)的效果,并将其与阴性(安慰剂)对照的效果进行比较。
检索了多个数据库,包括Medline、EMBASE、科学网、考克兰图书馆和中国生物医学文献数据库,以识别截至2015年1月发表的相关文章;还检索了灰色文献(即未正式发表的学术文献)。两名作者使用数据收集表独立并共同进行数据提取。主要结局是DH对日常活动或热、触觉、蒸发或电刺激的疼痛反应,次要结局是使用CSPS的副作用。每项研究均使用考克兰协作组评估偏倚风险的工具进行评估。对具有相同参与者人口统计学、干预措施、对照、评估方法和随访期的研究进行荟萃分析。使用推荐分级评估、制定和评价系统来评估证据质量和各研究中的偏倚风险。
荟萃分析表明,含5%CSPS的牙膏在缓解牙本质敏感方面比阴性对照更有效,证据级别分类为“中等”。此外,含15%磷酸硅钙钠的预防用牙膏在降低牙周治疗后过敏症方面比阴性对照更具优势,证据级别分类为“低”。仅有两项研究报告了使用CSPS的副作用。
大多数研究发现,磷酸硅钙钠在缓解DH方面比阴性对照更有效。由于缺乏有力证据,未来需要进行高质量、精心设计的临床试验才能做出明确推荐。