Cardoso Miguel, Coelho Ana, Lima Rui, Amaro Inês, Paula Anabela, Marto Carlos Miguel, Sousa José, Spagnuolo Gianrico, Marques Ferreira Manuel, Carrilho Eunice
Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal.
Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3000-354 Coimbra, Portugal.
J Clin Med. 2020 Oct 23;9(11):3407. doi: 10.3390/jcm9113407.
Dental caries is a disease of dental hard tissues, considered the most common non-communicable disease worldwide. Conventional treatments for caries removal are often associated with pain and fear, so different therapeutic approaches have been developed towards more conservative and pleasant treatments. This systematic review aimed to assess the efficacy and patient's acceptance of alternative methods for caries removal compared to conventional methods. The Cochrane Library, Embase, Medline/Pubmed, Web of Science, and Clinical Trials databases were searched. Clinical trials of primary dental caries treated with alternative methods were included. The last search was performed on 5 August 2020. The Population, Intervention, Comparison, and Outcome (PICO) strategy was followed. Thirty-seven clinical trials were included, reporting caries removal using alternative (chemomechanical-Brix 3000, Carie-care, Carisolv and Papacarie, laser-Er:YAG (Erbium-doped Yttrium Aluminium Garnet) and Er,Cr:YSGG (Erbium, Chromium-doped Yttrium, Scandium, Gallium and Garnet), and a system combining air and sono-abrasion-Vector System) and conventional methods. Alternative methods tended to prolong treatment time and lessen anesthesia need. All treatments were effective in reducing cariogenic flora, and the restoration's performance did not differ significantly. Chemomechanical solutions seemed to be the best option towards minimally invasive treatments, with good control during application and action and good treatment experiences for patients. Papacarie was demonstrated to be an effective method for caries removal with less pain, and superior acceptance by patients when compared to conventional treatments.
龋齿是一种牙体硬组织疾病，被认为是全球最常见的非传染性疾病。传统的龋齿去除治疗方法常常伴随着疼痛和恐惧，因此人们开发了不同的治疗方法，以实现更保守、更舒适的治疗。本系统评价旨在评估与传统方法相比，替代龋齿去除方法的疗效和患者接受度。检索了Cochrane图书馆、Embase、Medline/Pubmed、Web of Science和临床试验数据库。纳入了采用替代方法治疗原发性龋齿的临床试验。最后一次检索于2020年8月5日进行。遵循了人群、干预措施、对照和结局（PICO）策略。纳入了37项临床试验，报告了使用替代方法（化学机械法——Brix 3000、Carie-care、Carisolv和Papacarie，激光——掺铒钇铝石榴石（Er:YAG）和掺铒铬钇钪镓石榴石（Er,Cr:YSGG），以及一种结合空气和超声喷砂的系统——Vector System）和传统方法去除龋齿的情况。替代方法往往会延长治疗时间并减少麻醉需求。所有治疗方法在减少致龋菌群方面均有效，修复体的性能没有显著差异。化学机械溶液似乎是微创治疗的最佳选择，在应用和作用过程中控制良好，患者的治疗体验也很好。Papacarie被证明是一种有效的龋齿去除方法，疼痛较轻，与传统治疗相比，患者接受度更高。
