Sponchiado Junior Emílio Carlos, Vieira Walbert de Andrade, Normando Ana Gabriela Costa, Pereira Juliana Vianna, Ferraz Caio Cezar Randi, Almeida José Flávio A, Marciano Marina Angélica, Gomes Brenda P F A, de-Jesus-Soares Adriana
Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
Division of Endodontics, Dental School, Federal University of Amazonas, Manaus, Amazonas, Brazil.
Eur J Dent. 2021 May;15(2):347-359. doi: 10.1055/s-0041-1724157. Epub 2021 Mar 23.
This review aims to evaluate whether root canal obturation with calcium silicate-based (CSB) sealers reduces the risk and intensity of endodontic postoperative pain when compared to epoxy resin-based (ERB) sealers. The review was registered at PROSPERO (CRD42020169255). Two independent reviewers conducted an electronic search in PubMed, Scopus, EMBASE, Web of Science, Cochrane Library and LILACS until November 2020 and included only randomized clinical trials with adult health participants undergoing root canal treatment. After selection, the JBI Critical Appraisal tool was used to assess the risk of bias. A fixed-effect meta-analysis was performed to summarize the results of pain risk and pain intensity at time intervals of 24 and 48 hours. Finally, the certainty of evidence was assessed using the GRADE approach. The search resulted in 1,206 records, of which five studies ( = 421 patients) met the eligibility criteria and presented moderate to low risk of bias. There was no significant difference between groups in the risk of pain in the first 24 hours (relative risk or RR = 0.83, 95% confidence interval or CI: 0.60, 1.16, =) or 48 hours (RR = 0.56, 95% CI: 0.26, 1.21, =). Silicate-based sealers led to lower pain intensity only at 48 hours (mean and standard deviation = 0.37, 95% CI: 0.69, 0.05). All analyses revealed low heterogeneity ( < 25%). The evidence presented moderate level of certainty. Currently available evidence has shown that there is no difference between CSB and ERB sealers in the risk or intensity of postoperative pain.
本综述旨在评估与环氧树脂基（ERB）封闭剂相比，使用硅酸钙基（CSB）封闭剂进行根管充填是否能降低根管治疗术后疼痛的风险和强度。该综述已在国际前瞻性注册系统（PROSPERO）注册（注册号：CRD42020169255）。两名独立评审员于2020年11月前在PubMed、Scopus、EMBASE、Web of Science、Cochrane图书馆和拉丁美洲及加勒比地区卫生科学数据库（LILACS）中进行了电子检索，仅纳入了成年健康参与者接受根管治疗的随机临床试验。筛选后，使用澳大利亚 Joanna Briggs 循证卫生保健中心（JBI）的批判性评价工具评估偏倚风险。采用固定效应荟萃分析来总结24小时和48小时时间间隔的疼痛风险和疼痛强度结果。最后，使用GRADE方法评估证据的确定性。检索结果共获得1206条记录，其中五项研究（n = 421例患者）符合纳入标准，且偏倚风险为中度至低度。两组在术后24小时（相对风险或RR = 0.83，95%置信区间或CI：0.60，1.16，P =）或48小时（RR = 0.56，95%CI：0.26，1.21，P =）的疼痛风险方面无显著差异。仅在48小时时，硅酸钙基封闭剂导致的疼痛强度较低（均值和标准差 = 0.37，95%CI：0.69，0.05）。所有分析均显示异质性较低（I² < 25%）。证据显示确定性为中等水平。目前可得的证据表明，在术后疼痛风险或强度方面，CSB封闭剂和ERB封闭剂之间没有差异。
