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脱敏剂对非手术牙周治疗后牙本质敏感的影响:系统评价和荟萃分析。

Effect of desensitizing agents on dentin hypersensitivity after non-surgical periodontal therapy: A systematic review and meta-analysis.

机构信息

School of Dentistry, Federal University of Para (UFPA), Belém-PA, Brazil.

Araraquara School of Dentistry, Paulista State University (UNESP), Araraquara, SP, Brazil.

出版信息

J Dent. 2020 Dec;103:103498. doi: 10.1016/j.jdent.2020.103498. Epub 2020 Oct 15.

Abstract

OBJECTIVE

To investigate the effectiveness of desensitizing agents (DA) on dentin hypersensitivity (DH) after non-surgical periodontal treatment (NSPT) through a systematic review and meta-analysis.

DATA

The PICO strategy was used to include randomized clinical trials in human subjects with DH (P) after NSPT treated with DA (I) compared to those treated with placebo or control (C) to identify DH relief (O). The Cochrane guidelines and GRADE was used to classify the risk of bias and the quality of the evidence, respectively.

SOURCES

PubMed, Web of Science, Scopus, Lilacs, Cochrane Library databases, and OpenGrey were searched on the 20 of May 2020.

STUDY SELECTION

Nine studies were included in the quantitative synthesis. Five meta-analyses were performed. Three meta-analyzes assessed the effectiveness of DA compared to a placebo or control in relation to pain assessment stimuli and two meta-analyzes assessed the mechanism of action of DA. For the mechanical stimulus in overall analysis, the control group presented a higher mean of pain reduction (SMD 1.03 [0.73, 1.32], p < 0.001) with very low certainty of evidence. For water (SMD -0.78 [-1.22, -0.35], p = 0.0009) and evaporative in overall analysis (SMD -1.21 [-1.79, -0.64], p < 0.001) stimuli, the DA decreased DH pain with very low and low certainty of evidence, respectively.

CONCLUSION

Due to the limited quality of evidence, there is no definitive conclusion on the effectiveness of DA on DH after NSPT. Thus, further clinical studies with a low risk of bias and high-quality evidence are encouraged to reinforce the certainty of evidence on that issue.

CLINICAL SIGNIFICANCE

The use of desensitizing agents show promise for relief of dentin hypersensitivity after non-surgical periodontal therapy.

摘要

目的

通过系统评价和荟萃分析,研究脱敏剂(DA)在非手术牙周治疗(NSPT)后对牙本质敏感症(DH)的疗效。

资料来源

使用 PICO 策略纳入了接受 NSPT 治疗后患有 DH(P)的人类受试者的随机临床试验,并用 DA(I)治疗,与安慰剂或对照(C)治疗相比,以确定 DH 缓解(O)。分别使用 Cochrane 指南和 GRADE 对偏倚风险和证据质量进行分类。

检索日期

2020 年 5 月 20 日在 PubMed、Web of Science、Scopus、Lilacs、Cochrane 图书馆数据库和 OpenGrey 进行了检索。

研究选择

纳入了 9 项研究进行定量综合分析。进行了 5 项荟萃分析。3 项荟萃分析评估了 DA 与安慰剂或对照在疼痛评估刺激方面的疗效,2 项荟萃分析评估了 DA 的作用机制。在整体分析中,对于机械刺激,对照组疼痛减轻的平均幅度更高(SMD 1.03 [0.73, 1.32],p < 0.001),证据确定性非常低。在整体分析中,对于水(SMD -0.78 [-1.22, -0.35],p = 0.0009)和蒸发刺激(SMD -1.21 [-1.79, -0.64],p < 0.001),DA 降低 DH 疼痛的证据确定性分别为非常低和低。

结论

由于证据质量有限,对于 NSPT 后 DA 对 DH 的疗效尚无明确结论。因此,鼓励进行低偏倚风险和高质量证据的进一步临床研究,以增强该问题证据的确定性。

临床意义

脱敏剂的使用为非手术牙周治疗后牙本质敏感症的缓解带来了希望。

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