Division of Prosthodontics and Restorative Dentistry, Faculty of Dentistry, McGill University, Montreal, QC, Canada.
Department of Reconstructive Dentistry & Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, Berne, Switzerland.
Int Endod J. 2017 Oct;50(10):951-966. doi: 10.1111/iej.12723. Epub 2017 Jan 17.
This systematic review investigated the failure rate of conventional single-unit restorations in root filled posterior permanent teeth. Two reviewers independently applied eligibility criteria, extracted data and assessed the quality of the evidence of each included study according to the Cochrane Collaboration's procedures for randomized control trials (RCTs) and the STROBE criteria for observational studies. The MEDLINE (via Ovid), EMBASE (via Ovid), Cochrane Oral Health Group Trials Register and CENTRAL (via Cochrane Library) databases were searched electronically (January 1993 to week 1, February 2015). This was complemented by an additional hand search of selected journals and the references of relevant studies. Clinical studies published on root filled single-unit restorative treatments with a mean follow-up period of at least 3 years were selected. The outcome measured was clinical or radiological failure. Overall, the four RCTs and the single observational study included were of low and high quality, respectively. Therefore, a meta-analysis was not possible. The pooled mean failure rates were reported according to the type of treatment and remaining coronal tooth structure. The current evidence suggested that the failure rates of the treatments may depend on the amount of remaining tooth structure and type of treatment. Post-retained crowns were associated with the most favourable outcome in teeth with one to two remaining coronal tooth wall(s), whereas post-free crowns were superior when greater tooth structure was available. Restorations in teeth without ferrules had such a high rate of failure that other treatment options should be considered.
本系统评价调查了根管治疗后的后牙用常规单冠修复的失败率。两位评审员独立应用纳入标准，提取数据，并根据 Cochrane 协作组的随机对照试验（RCT）程序和 STROBE 标准对每个纳入研究的证据质量进行评估。电子检索 MEDLINE（通过 Ovid）、EMBASE（通过 Ovid）、Cochrane 口腔健康组试验注册库和 CENTRAL（通过 Cochrane 图书馆）数据库（1993 年 1 月至 2015 年 2 月第 1 周）。此外，还对手头选定的期刊和相关研究的参考文献进行了额外的手工检索。选择了至少随访 3 年的根充后单冠修复治疗的临床研究。测量的结果是临床或影像学失败。总的来说，这四项 RCT 和一项单观察性研究的质量分别为低质量和高质量，因此不可能进行荟萃分析。根据治疗类型和剩余冠部牙齿结构报告了汇总的平均失败率。目前的证据表明，治疗的失败率可能取决于剩余牙体结构的数量和治疗类型。对于剩余一个或两个冠部牙壁的牙齿，保留冠后修复的结果最好，而当有更多牙体结构时，自由保留冠后修复则更优。无卡环的修复体失败率如此之高，应考虑其他治疗选择。
