Conservative Department, Faculty of Dentistry, Cairo University, Egypt.
Faculty of Oral and Dental Medicine, Ahram Canadian University, Egypt.
J Dent. 2020 Dec;103:103491. doi: 10.1016/j.jdent.2020.103491. Epub 2020 Sep 30.
Our aim was to systematically assess the efficacy of chlorhexidine (CHX) as a cavity pre-treatment or restoration mix-in on the survival of ART restorations.
We included randomized controlled trials that assessed the effect of cavity pretreatment with CHX or the restoration mix-in of CHX on the survival of ART restorations (test group) versus a similar restorative approach without CHX. Risk of bias was assessed using Cochrane's randomized trial quality assessment Tool (RoB 2.0). Random-effects meta-analysis was conducted, with mean Odds Ratios and 95 % confidence intervals (OR, 95 % CI) as effect estimates. The certainty of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.
Medline, Web of Science, Cochrane Central were searched. Eligible studies were in- or excluded and data extracted for included studies by two reviewers independently.
Four studies with 261 patients (mean age 3.8-14.6 years) and 467 ART restorations were included. All studies showed some concerns about the risk of bias. Three studies involving a total of 167 restorations in the CHX group and 188 restorations in the control group, followed up for one year, were submitted to meta-analysis. There were no significant differences between CHX vs. control (OR = 0.79, 95 % CI [0.26, 2.40], P = 0.68, I = 3%, P = 0.35). The strength of the evidence was estimated as low.
Based on very limited data, CHX pre-treatment or restoration mix-in did not have any significant benefit for survival of ART restorations.
There is a lack of evidence regarding the influence of chlorhexidine on the survival of ART restorations. Our results revealed that there was no significant difference in the survival of ART restorations when CHX was used as a cavity pre-treatment or mix-in.
本研究旨在系统评估洗必泰（CHX）作为窝洞预处理或修复混合剂对 ART 修复体存活率的影响。
我们纳入了评估 CHX 窝洞预处理或修复混合剂对 ART 修复体存活率（试验组）的影响的随机对照试验，与不使用 CHX 的类似修复方法进行比较。使用 Cochrane 随机试验质量评估工具（RoB 2.0）评估偏倚风险。采用随机效应荟萃分析，以均值比值比（OR）和 95%置信区间（OR，95%CI）作为效应估计值。根据推荐评估、制定与评价（GRADE）系统评估证据确定性。
通过 Medline、Web of Science 和 Cochrane Central 进行检索。由两名评审员独立对合格研究进行纳入或排除，并提取纳入研究的数据。
共纳入 4 项研究，涉及 261 名患者（平均年龄 3.8-14.6 岁）和 467 例 ART 修复体。所有研究均存在一定的偏倚风险。其中 3 项研究共纳入 167 例 CHX 组修复体和 188 例对照组修复体，随访 1 年，进行荟萃分析。CHX 组与对照组之间无显著差异（OR=0.79，95%CI[0.26,2.40]，P=0.68，I=3%，P=0.35）。证据强度估计为低。
基于非常有限的数据，CHX 预处理或修复混合剂对 ART 修复体的存活率没有显著益处。
关于洗必泰对 ART 修复体存活率的影响，证据不足。我们的研究结果表明，CHX 作为窝洞预处理或混合剂使用时，ART 修复体的存活率无显著差异。
