Bezerra Isis Morais, Brito Arella Cristina Muniz, de Sousa Simone Alves, Santiago Bianca Marques, Cavalcanti Yuri Wanderley, de Almeida Leopoldina de Fátima Dantas
Federal University of Paraíba, Brazil.
Department of Clinical and Social Dentistry, Federal University of Paraíba, Brazil.
Heliyon. 2020 May 21;6(5):e03969. doi: 10.1016/j.heliyon.2020.e03969. eCollection 2020 May.
Restoring noncarious cervical lesions are challenging to clinical practice. This study aimed to compare the clinical performance/longevity of glass ionomer cements (GIC) and composite resins (CR) used for noncarious cervical lesions (NCCL) through a systematic review and meta-analysis (MA).
Randomized and controlled clinical trials and nonrandomized clinical trials, which compared the clinical performance/longevity of CR and GIC (conventional and/or resin-modified) in the treatment of NCCL, were included.
The methodological quality and risk of bias were evaluated using the Cochrane Collaboration tool. Seven MAs were performed considering (1) the clinical performance of the parameters in common: retention, marginal discoloration, marginal adaptation, secondary caries, color, anatomic form, surface texture and (2) a follow-up time of 12, 24 and 36 months. The prevalence of successful restorations and the total number of restorations per clinical parameter/follow-up time were used to calculate the relative risk (95% CI).
After screening of the studies, 13 studies were used for quantitative synthesis. The risk difference (CI 95%, α, I) between GIC and CR for anatomic form was 0.00 (-0.02, 0.02; p = 0.83; 0%); for color was -0.02 (-0.08, 0.04; p = 0.48; 80%); for surface texture was -0.02 (-0.06, 0.02; p = 0.31; 63%); for secondary caries was -0.00 (-0.01, 0.01; p = 0.87; 0%); for marginal discoloration was 0.01 (-0.01, 0.03; p = 0.23; 3%); for marginal adaptation was 0.01 (-0.01, 0.04; p = 0.34; 32%) and for retention was 0.07 (0.02, 0.12; p = 0.003; 76%).
GIC showed a clinical performance significantly higher than CR in regard to retention, whereas for the other parameters, GIC was similar to CR.
NCCLs is increasingly prevalent among the population and this type of lesion causing defects in the tooth that affect not only aesthetics but also everyday habits, such as drinking, eating and teeth brushing, due to the sensitivity these lesions cause.
修复非龋性颈部病变对临床实践而言具有挑战性。本研究旨在通过系统评价和荟萃分析比较用于非龋性颈部病变(NCCL)的玻璃离子水门汀(GIC)和复合树脂(CR)的临床性能/使用寿命。
纳入了比较CR和GIC(传统型和/或树脂改性型)治疗NCCL的临床性能/使用寿命的随机对照临床试验和非随机临床试验。
使用Cochrane协作工具评估方法学质量和偏倚风险。进行了七项荟萃分析,考虑因素包括:(1)常见参数的临床性能:固位、边缘变色、边缘适合性、继发龋、颜色、解剖形态、表面质地;(2)随访时间为12、24和36个月。使用成功修复的患病率以及每个临床参数/随访时间的修复总数来计算相对风险(95%可信区间)。
在对研究进行筛选后进行定量综合分析。GIC和CR在解剖形态方面的风险差异(95%可信区间,α,I)为0.00(-0.02,0.02;p = 0.83;0%);颜色方面为-0.02(-0.08,0.04;p = 0.48;80%);表面质地方面为-0.02(-0.06,0.02;p = 0.31;63%);继发龋方面为-0.00(-0.01,0.01;p = 0.87;0%);边缘变色方面为0.01(-0.01,0.03;p = 0.23;3%);边缘适合性方面为0.01(-0.01,0.04;p = 0.34;32%);固位方面为0.07(0.02,0.12;p = 0.003;76%)。
在固位方面,GIC的临床性能显著高于CR,而在其他参数方面,GIC与CR相似。
NCCL在人群中越来越普遍,这种类型的病变会导致牙齿缺损,不仅影响美观,还会影响日常习惯,如饮水、进食和刷牙,因为这些病变会引起敏感。