Division of Restorative Dentistry, Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, KY, United States.
Division of Restorative Dentistry, Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, KY, United States.
J Dent. 2016 Nov;54:25-32. doi: 10.1016/j.jdent.2016.09.009. Epub 2016 Sep 21.
A systematic review was performed to compare the long-term survival of deep dentine caries-affected permanent teeth treated with partial-caries-removal (PCR) versus similar teeth treated with stepwise-caries-removal techniques (SWT).
Clinical studies investigating long-term PCR and SWT outcomes in unrestored permanent teeth with deep dentine caries were evaluated. Failures were defined as loss of pulp vitality or restorative failures following treatment.
PubMed, Web of Science, Dentistry and Oral Sciences Source, and Central databases were systematically searched.
From 136 potentially relevant articles, 9 publications utilizing data from 5 studies (2 RCTs, and 3 observational case-series) reporting outcomes for 426 permanent teeth over two to ten years were analyzed. Regarding restorative failures, >88% success at two years for both techniques was reported. For loss of pulp vitality, observational studies reported >96% vitality at two years for each technique, while one RCT reported significantly higher vitality (p<0.05) at three years for PCR (96%) compared to SWT (83%). Risk of bias was high in all studies.
Successful vitality and restorative outcomes for both PCR and SWT have been demonstrated at two years and beyond in permanent teeth with deep dentine caries. Partial-caries-removal may result in fewer pulpal complications over a three year period than SWT, although claims of a therapeutic advantage are based on very few, limited-quality studies.
Partial-caries-removal and SWT are deep caries management techniques that reduce pulp exposure risk. Permanent teeth with deep dentine caries treated with either technique have a high likelihood for survival beyond two years.
系统评价比较了部分去腐（PCR）和逐步去腐技术（SWT）治疗深龋恒牙的长期生存率。
评估了未修复深龋恒牙长期 PCR 和 SWT 结果的临床研究。失败定义为治疗后牙髓活力丧失或修复失败。
系统检索了 PubMed、Web of Science、Dentistry and Oral Sciences Source 和中央数据库。
从 136 篇潜在相关文章中，有 9 篇文章利用来自 5 项研究的数据（2 项 RCT 和 3 项观察性病例系列研究），分析了 426 颗恒牙 2 至 10 年的结果。关于修复失败，两种技术的两年成功率均>88%。对于牙髓活力丧失，观察性研究报告两种技术的两年活力均>96%，而一项 RCT 报告 PCR（96%）的活力明显高于 SWT（83%），差异有统计学意义（p<0.05）。所有研究的偏倚风险均较高。
在深龋恒牙中，PCR 和 SWT 在两年及以后均能获得成功的活力和修复结果。与 SWT 相比，PCR 可能在三年内导致更少的牙髓并发症，尽管治疗优势的说法基于少数、质量有限的研究。
部分去腐和 SWT 是降低牙髓暴露风险的深龋管理技术。用这两种技术治疗的深龋恒牙，两年后存活的可能性很高。
