Warwick Medical School, University of Warwick, Coventry, West Midlands, United Kingdom.
Warwick Medical School, University of Warwick, Coventry, West Midlands, United Kingdom.
J Evid Based Dent Pract. 2017 Sep;17(3):205-215. doi: 10.1016/j.jebdp.2017.01.001. Epub 2017 Jan 28.
A systematic review of literature was conducted to compare the success and survivability of primary root canal interventions.
The Preferred Reporting Items for Systematic Reviews and Meta Analyses protocol was adopted in this study to systematically assess and report systematic reviews related to success or survival or failure rates of primary root canal interventions. MEDLINE and Cochrane Oral Health Library were both searched by using specific search terms to identify relevant literature, until June 2016. The search was augmented by handsearching. Then, the quality of the included systematic reviews was assessed by using the Revised Assessment of Multiple Systematic Reviews (RAMSTAR) protocol.
Only 9 systematic reviews were identified. The RAMSTAR scores of the included reviews ranged from 43/44 to 29/44. Nevertheless, the later reviews did not provide sufficient evidence or statistically significant evidence to support any of the interventions used during primary root canal treatment. In addition, a number of key steps during primary root canal treatment, such as types of dental files, root canal instrumentation techniques, orthograde obturation materials, and techniques, were not assessed by systematic reviews.
The current status of evidence related to the success and survivability of primary root canal interventions is lacking. This puts dentists under marked degrees of uncertainty. Consequently, patients are potentially exposed to health care risks. It is then essential to develop tailored methods and tools for decision-making under uncertainty to aid both dentists and patients engaged in primary root canal treatment.
系统回顾文献，比较一次根管治疗的成功率和存活率。
本研究采用系统评价和荟萃分析首选报告项目（Preferred Reporting Items for Systematic Reviews and Meta Analyses protocol），系统评估和报告与一次根管治疗成功率或存活率或失败率相关的系统评价。使用特定的检索词，对 MEDLINE 和 Cochrane 口腔健康图书馆进行检索，以确定相关文献，检索时间截至 2016 年 6 月。通过手工检索对检索进行补充。然后，使用修订的多系统评价评估（Revised Assessment of Multiple Systematic Reviews，RAMSTAR）方案评估纳入的系统评价的质量。
仅确定了 9 项系统评价。纳入的综述的 RAMSTAR 评分范围为 43/44 至 29/44。然而，后来的综述并没有提供足够的证据或统计学上显著的证据来支持一次根管治疗中使用的任何干预措施。此外，许多关键步骤在一次根管治疗过程中，如牙锉的类型、根管预备技术、正牙填充材料和技术，并没有被系统评价评估。
目前缺乏与一次根管治疗成功率和存活率相关的证据，这使牙医处于明显的不确定状态。因此，患者可能面临健康风险。因此，制定有针对性的决策方法和工具，以帮助牙医和参与一次根管治疗的患者应对不确定性至关重要。
