School of Dentistry, Department of Periodontology, Fluminense Federal University, Rua Mario dos Santos Braga, 30, Centro, Niterói, Rio de Janeiro, CEP 24020-140, Brazil.
School of Dentistry, Department of Integrated Clinic, Fluminense Federal University, Rua Mario dos Santos Braga, 30, Centro, Niterói, Rio de Janeiro, CEP 24020-140, Brazil.
Clin Oral Investig. 2018 Mar;22(2):617-631. doi: 10.1007/s00784-017-2330-9. Epub 2018 Jan 12.
The aim of this review is to conduct a systematic review and meta-analysis comparing the effectiveness of in-home or in-office treatments for dentin hypersensitivity.
An electronic search without restriction on dates or languages was performed in four electronic databases until March 2017. In addition, hand-searches in regular journals and in the gray literature were also conducted. To develop the search strategy, clinical questions were formulated using the PICOS method. Eligibility criteria included randomized clinical trials (RCTs) that compared the effectiveness of different agents for the treatment of dentin hypersensitivity through chemical occlusion, physical occlusion, nerve desensitization, or photobiomodulation (low-level light therapy). This systematic review was registered in PROSPERO under number CRD42016039394.
Twenty-five RCTs (16 parallel; 9 split-mouth), published from 1992 to 2016, were included. The results of the meta-analysis showed that in-office subgroups treated with chemical or physical occlusion of dentin tubules and nerve desensitization had a statistically significant difference from placebo, with P < 0.00001, P < 0.00001, and P = 0.02, respectively. For in-home treatments, the results of the meta-analysis showed that only those subgroups treated with chemical occlusion of dentin tubules and nerve desensitization exhibited a statistically significant difference from placebo, with P < 0.00001 and P = 0.03, respectively.
The results of pairwise meta-analysis suggest that among in-office treatments, dentinal tubule occlusion (whether chemical or physical) and nerve desensitization provide the best outcomes for treatment of dentin hypersensitivity. For in-home treatments, only chemical occlusion of dentin tubules and nerve desensitization showed a greater treatment efficacy than placebo and the difference was statistically significant.
本综述的目的是对比较家庭或诊室治疗牙本质敏感症的有效性的研究进行系统评价和荟萃分析。
我们在四个电子数据库中进行了无时间和语言限制的电子检索,检索时间截至 2017 年 3 月。此外,我们还对手册和灰色文献进行了手工检索。为了制定检索策略,我们使用 PICOS 方法制定了临床问题。纳入标准包括比较不同药物通过化学封闭、物理封闭、神经脱敏或光生物调节(低水平光疗)治疗牙本质敏感症的效果的随机临床试验(RCT)。本系统评价已在 PROSPERO 中注册,注册号为 CRD42016039394。
共纳入 25 项 RCT(16 项平行设计,9 项交叉设计),发表时间为 1992 年至 2016 年。荟萃分析结果显示,诊室治疗组中,使用化学或物理封闭牙本质小管和神经脱敏的亚组与安慰剂相比,差异有统计学意义(P<0.00001、P<0.00001 和 P=0.02)。家庭治疗组中,仅使用化学封闭牙本质小管和神经脱敏的亚组与安慰剂相比,差异有统计学意义(P<0.00001 和 P=0.03)。
成对荟萃分析结果表明,在诊室治疗中,牙本质小管封闭(无论是化学的还是物理的)和神经脱敏为治疗牙本质敏感症提供了最佳的效果。对于家庭治疗,只有化学封闭牙本质小管和神经脱敏的治疗效果优于安慰剂,差异具有统计学意义。