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哪种终印模技术和材料最适合全口义齿和可摘局部义齿?

Which final impression technique and material is best for complete and removable partial dentures?

作者信息

Al-Ansari Asim

机构信息

College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

出版信息

Evid Based Dent. 2019 Sep;20(3):70-71. doi: 10.1038/s41432-019-0039-0.

DOI:10.1038/s41432-019-0039-0
PMID:31562402
Abstract

Data sources Cochrane Oral Health's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform databasesStudy selection Randomised controlled trials (RCTs) comparing different final-impression techniques and materials for treating people with complete dentures (CD) and removable partial dentures (RPD) were included.Data extraction and synthesis Two reviewers independently extracted data and assessed risk of bias. Results were expressed as risk ratios (RR) for dichotomous outcomes, and as mean differences (MD) or standardised mean differences (SMD) for continuous outcomes, with 95% confidence intervals (CI). Meta-analysis used a random-effects model.Results Nine studies were included, eight involving CD. Six of the CD studies were at high risk of bias, two at low risk. For complete dentures there was low-quality evidence that silicone was a better final-impression material for oral health-related quality of life than alginate. There was also very low-quality evidence of no clear differences between the single-stage impression alginate and the two stage- two step elastomer groups in participant-reported quality of life using OHIP-EDENT. The RCT involving RPD altered-cast technique versus one-piece cast technique found low quality evidence of no difference between groups, for general satisfaction at one-year follow-up.Conclusions There is no clear evidence that one technique or material has a substantial advantage over another for making complete dentures and removable partial dentures. Available evidence for the relative benefits of different denture fabrication techniques and final-impression materials is limited and is of low or very low quality. More high-quality RCTs are required.

摘要

数据来源

考科蓝口腔健康试验注册库、考科蓝对照试验中央注册库(CENTRAL)、医学期刊数据库、荷兰医学文摘数据库、美国国立卫生研究院试验注册库(ClinicalTrials.gov)以及世界卫生组织国际临床试验注册平台数据库

研究选择

纳入比较不同最终印模技术和材料用于治疗全口义齿(CD)和可摘局部义齿(RPD)患者的随机对照试验(RCT)。

数据提取与合成

两名 reviewers 独立提取数据并评估偏倚风险。结果以二分类结局的风险比(RR)表示,以连续结局的均值差(MD)或标准化均值差(SMD)表示,并带有 95%置信区间(CI)。Meta 分析采用随机效应模型。

结果

纳入 9 项研究,8 项涉及全口义齿。其中 6 项全口义齿研究存在高偏倚风险,2 项为低风险。对于全口义齿,有低质量证据表明,与藻酸盐相比,硅酮是一种在与口腔健康相关的生活质量方面更好的最终印模材料。也有极低质量证据表明,使用 OHIP - EDENT 在参与者报告的生活质量方面,单阶段印模藻酸盐组和两阶段两步弹性体组之间没有明显差异。涉及可摘局部义齿改良铸造技术与一体式铸造技术的 RCT 发现,在一年随访时总体满意度方面,两组之间无差异的证据质量较低。

结论

没有明确证据表明在制作全口义齿和可摘局部义齿时,一种技术或材料比另一种具有实质性优势。关于不同义齿制作技术和最终印模材料相对益处的现有证据有限,且质量低或极低。需要更多高质量的 RCT。

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