渗透和密封治疗非腔化近中病变：系统评价和荟萃分析。
Infiltration and sealing for managing non-cavitated proximal lesions: a systematic review and meta-analysis.
机构信息
Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.
Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.
出版信息
BMC Oral Health. 2021 Jan 7;21(1):13. doi: 10.1186/s12903-020-01364-4.
BACKGROUND
Infiltration and sealing are micro-invasive treatments for arresting proximal non-cavitated caries lesions; however, their efficacies under different conditions remain unknown. This systematic review and meta-analysis aimed to evaluate the caries-arresting effectiveness of infiltration and sealing and to further analyse their efficacies across different dentition types and caries risk levels.
METHODS
Six electronic databases were searched for published literature, and references were manually searched. Split-mouth randomised controlled trials (RCTs) to compare the effectiveness between infiltration/sealing and non-invasive treatments in proximal lesions were included. The primary outcome was obtained from radiographical readings.
RESULTS
In total, 1033 citations were identified, and 17 RCTs (22 articles) were included. Infiltration and sealing reduced the odds of lesion progression (infiltration vs. non-invasive: OR = 0.21, 95% CI 0.15-0.30; sealing vs. placebo: OR = 0.27, 95% CI 0.18-0.42). For both the primary and permanent dentitions, infiltration and sealing were more effective than non-invasive treatments (primary dentition: OR = 0.30, 95% CI 0.20-0.45; permanent dentition: OR = 0.20, 95% CI 0.14-0.28). The overall effects of infiltration and sealing were significantly different from the control effects based on different caries risk levels (OR = 0.20, 95% CI 0.14-0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01-8.27), there were significant differences between micro-invasive and non-invasive treatments (low risk: OR = 0.24, 95% CI 0.08-0.72; low to moderate risk: OR = 0.38, 95% CI 0.18-0.81; moderate to high risk: OR = 0.17, 95% CI 0.10-0.29; and high risk: OR = 0.14, 95% CI 0.07-0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01-8.27), infiltration was superior (low risk: OR = 0.24, 95% CI 0.08-0.72; low to moderate risk: OR = 0.38, 95% CI 0.18-0.81; moderate to high risk: OR = 0.20, 95% CI 0.10-0.39; and high risk: OR = 0.14, 95% CI 0.05-0.37).
CONCLUSION
Infiltration and sealing were more efficacious than non-invasive treatments for halting non-cavitated proximal lesions.
背景
渗透和密封是用于阻止近中面非龋性病变的微创治疗方法；然而，它们在不同条件下的疗效尚不清楚。本系统评价和荟萃分析旨在评估渗透和密封在阻止龋病方面的疗效，并进一步分析它们在不同牙位类型和龋病风险水平下的疗效。
方法
在六个电子数据库中检索发表的文献，并手动检索参考文献。纳入了比较渗透/密封与非侵入性治疗近中面病变效果的随机对照试验（RCT）。主要结局从放射学读数中获得。
结果
共识别出 1033 条引文，纳入了 17 项 RCT（22 篇文章）。渗透和密封降低了病变进展的几率（渗透与非侵入性治疗相比：OR=0.21，95%CI 0.15-0.30；密封与安慰剂相比：OR=0.27，95%CI 0.18-0.42）。对于恒牙和乳牙，渗透和密封均优于非侵入性治疗（恒牙：OR=0.30，95%CI 0.20-0.45；乳牙：OR=0.20，95%CI 0.14-0.28）。渗透和密封的总体效果与基于不同龋病风险水平的对照组效果有显著差异（OR=0.20，95%CI 0.14-0.28）。除中危龋病（中危龋病：OR=0.32，95%CI 0.01-8.27）外，微创治疗与非微创治疗之间存在显著差异（低危龋病：OR=0.24，95%CI 0.08-0.72；低危至中危龋病：OR=0.38，95%CI 0.18-0.81；中危至高危龋病：OR=0.17，95%CI 0.10-0.29；高危龋病：OR=0.14，95%CI 0.07-0.28）。除中危龋病（中危龋病：OR=0.32，95%CI 0.01-8.27）外，渗透优于非微创治疗（低危龋病：OR=0.24，95%CI 0.08-0.72；低危至中危龋病：OR=0.38，95%CI 0.18-0.81；中危至高危龋病：OR=0.20，95%CI 0.10-0.39；高危龋病：OR=0.14，95%CI 0.05-0.37）。
结论
渗透和密封在阻止近中面非龋性病变方面比非侵入性治疗更有效。
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