非龋性颈病变中，不含 HEMA 的黏结系统比含 HEMA 的黏结系统的临床性能更好吗？系统评价和荟萃分析。

Do HEMA-free adhesive systems have better clinical performance than HEMA-containing systems in noncarious cervical lesions? A systematic review and meta-analysis.

机构信息

Post-Graduation Program in Dentistry, Faculty of Dentistry, Federal University of Pará, Rua Augusto Corrêa, 1, Guamá, CEP 66075-110 Belém, PA, Brazil.

出版信息

J Dent. 2018 Jul;74:1-14. doi: 10.1016/j.jdent.2018.04.005. Epub 2018 Apr 9.

DOI:10.1016/j.jdent.2018.04.005

PMID:29649505

Abstract

OBJECTIVES

To determine through a systematic review whether HEMA-free adhesive systems have better clinical performance than HEMA-containing systems in noncarious cervical lesion (NCCL) restorations.

SOURCES

We systematically searched PubMed, The Cochrane Library, Scopus, Web of Science, and Open Grey databases using MeSH terms, synonyms, and keywords, with no language or date restriction. The reference lists of included articles were manually searched.

STUDY SELECTION

Randomized controlled clinical trials comparing the effectiveness of HEMA-free and HEMA-containing adhesive systems in NCCL restorations were included. The risk of bias in the included studies was assessed and classified through the Cochrane Collaboration's common scheme for bias. Quantitative data were subgrouped according to the main clinical parameters evaluated, and heterogeneity was tested using I index.

DATA

A total of 2889 potentially relevant studies were identified. After title and abstract examination, 51 studies remained. Finally, 22 studies were included in the systematic review, totaling to 997 participants. Thus, 13 studies were classified as "low" risk of bias and nine as "unclear". These 22 studies were also included in the meta-analysis, and no significant statistical difference was found between the clinical performances of HEMA-free and HEMA-containing adhesive systems for all parameters analyzed: retention risk difference (RD) 0.03 [-0.01, 0.07] (p = 0.13); marginal discoloration RD 0.02 [-0.01, 0.04] (p = 0.19); marginal adaptation RD -0.01 [-0.04, 0.01] (p = 0.34); caries RD 0.00 [-0.01, 0.01] (p = 0.92); or postoperative sensitivity RD -0.00 [-0.02, 0.01] (p = 0.72) and for overall effect RD 0.00 [-0.01, 0.01] (p = 0.65).

CONCLUSIONS

HEMA-free and HEMA-containing adhesive systems showed a similar clinical performance in NCCL restorations.

CLINICAL SIGNIFICANCE

Only the presence of HEMA does not indicate better clinical performance of adhesive systems.

摘要

目的

通过系统评价来确定在非龋性颈（牙合）面缺损（NCCL）修复中，不含 HEMA 的黏结系统是否比含 HEMA 的黏结系统具有更好的临床性能。

资料来源

我们使用 MeSH 术语、同义词和关键词系统地检索了 PubMed、The Cochrane Library、Scopus、Web of Science 和 Open Grey 数据库，未对语言和日期进行限制。还手动检索了纳入文章的参考文献列表。

研究选择

纳入了比较 NCCL 修复中不含 HEMA 和含 HEMA 的黏结系统有效性的随机对照临床试验。通过 Cochrane 协作组的常见偏倚方案评估并分类纳入研究的偏倚风险。根据主要临床参数评估，对定量数据进行了亚组分析，并使用 I 指数检验异质性。

数据

共识别出 2889 篇潜在相关研究。经过标题和摘要检查，保留了 51 项研究。最终，共有 22 项研究纳入了系统评价，共有 997 名参与者。因此，13 项研究被归类为“低”偏倚风险，9 项研究为“不清楚”。这 22 项研究也纳入了荟萃分析，在分析的所有参数中，均未发现不含 HEMA 和含 HEMA 的黏结系统的临床性能存在统计学差异：保留风险差异（RD）0.03[-0.01，0.07]（p=0.13）；边缘变色 RD 0.02[-0.01，0.04]（p=0.19）；边缘适应性 RD-0.01[-0.04，0.01]（p=0.34）；龋齿 RD 0.00[-0.01，0.01]（p=0.92）；或术后敏感性 RD-0.00[-0.02，0.01]（p=0.72）和总体效果 RD 0.00[-0.01，0.01]（p=0.65）。