Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Av. Prof. Rodolpho Paulo Rocco, 325 - Cidade Universitária, Rio de Janeiro, RJ, CEP: 21941-913, Brazil.
Central Library of the Health Science Center, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Clin Oral Investig. 2020 Sep;24(9):2959-2972. doi: 10.1007/s00784-020-03415-0. Epub 2020 Jul 14.
To assess whether lesion sterilization and tissue repair (LSTR) technique resulted in similar clinical and radiographic success outcomes as compared with pulpectomy in primary teeth.
Randomized clinical trials comparing LSTR with pulpectomy by means of clinical and radiographic parameters were included. Risk of bias was assessed using Cochrane methodology and the certainty of evidence was determined by GRADE.
Six articles were included. Conventional pulpectomy was favored with respect to radiographic success frequency in the systematic review. Four studies were included in meta-analyses. Based on the clinical results at 6 months (RR = 0.99, 95% CI, 0.94-1.04, p = 0.67; I = 0%), 12 months (RR = 0.97, 95% CI, 0.90-1.04, p = 0.34; I = 0%), and 18 months (RR = 0.89, 95% CI, 0.77-1.04, p = 0.14; I = 0%) and radiographic findings at 6 months (RR = 0.91, 95% CI, 0.78-1.06, p = 0.23; I = 9%), 12 months (RR = 0.87, 95% CI, 0.65-1.18, p = 0.38; I = 64%), and 18 months (RR = 0.84, 95% CI, 0.69-1.02, p = 0.08; I = 0%), there was no difference observed regarding success between the two treatments. The quality of evidence ranged from moderate to very low.
No difference between the LSTR and pulpectomy approaches could be confirmed by meta-analyses. The quality of evidence according to the GRADE scheme ranged from moderate to very low.
The present meta-analyses could not demonstrate the superiority of one treatment over the other.
评估在乳恒牙中，相较于牙髓切除术，病变清除和组织修复（LSTR）技术是否具有相似的临床和放射学成功结果。
纳入比较 LSTR 与牙髓切除术的随机临床试验，采用临床和放射学参数。使用 Cochrane 方法评估偏倚风险，并使用 GRADE 确定证据的确定性。
纳入 6 篇文章。系统评价中，常规牙髓切除术在放射学成功率方面更具优势。4 项研究纳入荟萃分析。根据 6 个月（RR=0.99，95%CI，0.94-1.04，p=0.67；I²=0%）、12 个月（RR=0.97，95%CI，0.90-1.04，p=0.34；I²=0%）和 18 个月（RR=0.89，95%CI，0.77-1.04，p=0.14；I²=0%）的临床结果以及 6 个月（RR=0.91，95%CI，0.78-1.06，p=0.23；I²=9%）、12 个月（RR=0.87，95%CI，0.65-1.18，p=0.38；I²=64%）和 18 个月（RR=0.84，95%CI，0.69-1.02，p=0.08；I²=0%）的放射学结果，两种治疗方法的成功率无差异。证据质量从中等至极低不等。
荟萃分析未能证实 LSTR 和牙髓切除术之间存在差异。根据 GRADE 方案，证据质量从中等到极低不等。
本荟萃分析未能证明一种治疗方法优于另一种。
