Paños-Crespo A, Sánchez-Torres A, Gay-Escoda C
School of Medicine and Health Sciences Campus de Bellvitge. University of Barcelona C/ Feixa Llarga s/n; Pavelló Govern, 2ª planta, Despatx 2.9 08907 - L'Hospitalet de Llobregat (Barcelona), Spain
Med Oral Patol Oral Cir Bucal. 2021 Jul 1;26(4):e422-e429. doi: 10.4317/medoral.24262.
Periapical surgery focuses on the treatment of teeth with persistent periapical lesions when orthograde root canal treatment fails. Although MTA® is the gold standard material for retrograde filling, Biodentine® - a tricalcium silicate-based cement - has been proposed in order to resolve several of its limitations. A systematic review has been carried out to compare the physicochemical properties of Biodentine® versus MTA® as root-end filling material in periapical surgery.
An electronic search was conducted by two independent examiners during March 2020 in the Cochrane, PubMed-MEDLINE and Scopus databases. In addition, a manual search was made in specialized journals. Comparative human or in vitro studies that evaluated bond strength, the presence of marginal gap and sealing ability were included. No restriction on publication date was applied. Animal studies, clinical cases, cases series and expert opinions were excluded.
After analyzing 147 initially selected studies, 13 publications were included. Regarding bond strength, the studies seemed to evidence better performance of Biodentine® in both acidic and blood contaminated environments. In relation to the presence of marginal gap and sealing ability, the studies yielded contradictory results. According to some authors, the sealing ability of Biodentine® is greater than that of MTA® during the first 24 hours, though both materials prove equal after one week. Other authors recorded no significant differences.
Considering the limitations and heterogeneity of the studies included, there is not sufficient evidence to confirm the clinical superiority of Biodentine® as a root-end filling material in periapical surgery.
当常规根管治疗失败时，根尖手术主要针对有持续性根尖周病变的牙齿进行治疗。尽管MTA®是倒充填的金标准材料，但为了解决其一些局限性，已有人提出使用Biodentine®——一种基于硅酸三钙的水门汀。本研究进行了一项系统综述，以比较Biodentine®与MTA®作为根尖手术中根尖充填材料的物理化学性质。
2020年3月，两名独立审查员在Cochrane、PubMed-MEDLINE和Scopus数据库中进行了电子检索。此外，还在专业期刊上进行了手工检索。纳入了评估粘结强度、边缘间隙的存在情况和封闭能力的比较性人体或体外研究。对发表日期没有限制。动物研究、临床病例、病例系列和专家意见被排除。
在分析了147项最初筛选的研究后，纳入了13篇出版物。关于粘结强度，研究似乎表明Biodentine®在酸性和血液污染环境中均表现出更好的性能。关于边缘间隙的存在情况和封闭能力，研究得出了相互矛盾的结果。一些作者认为，Biodentine®在最初24小时内的封闭能力大于MTA®，不过两种材料在一周后证明是相同的。其他作者则记录了无显著差异。
考虑到纳入研究的局限性和异质性，没有足够的证据证实Biodentine®作为根尖手术中根尖充填材料的临床优越性。
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