乳牙II类洞修复的牙齿颜色材料：系统评价与Meta分析

Tooth-coloured materials for class II restorations in primary molars: systematic review and meta-analysis.

作者信息

Siokis V, Michailidis T, Kotsanos N

机构信息

Department of Paediatric Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Eur Arch Paediatr Dent. 2021 Dec;22(6):1003-1013. doi: 10.1007/s40368-021-00632-3. Epub 2021 May 28.

DOI:10.1007/s40368-021-00632-3

PMID:34046871

Abstract

PURPOSE

The aim of this systematic review was to compare the success rate of five tooth-coloured materials, namely Glass Ionomer (GI), Resin-Modified Glass Ionomer (RMGI), Composite Resin (CR), Polyacid-Modified Composite Resin or Compomer (CO) and High-Viscosity Glass Ionomer (HVGI) in primary molar Class II restorations.

METHODS

Five databases were searched from inception to April 23, 2020 for randomized clinical trials comparing the failure rate of these materials. After duplicate study removal, data extraction and risk of bias assessment with the Cochrane tool, data synthesis was conducted, comparing all five tooth-coloured materials in pairs and computing the overall success rate for each one, respectively.

RESULTS

A total of 5615 articles were obtained by electronic and hand literature search. After the application of the eligibility criteria, ten RCTs were included in this systematic review and six RCTs for meta-analysis. Their risk of bias was assessed to be high to moderate. Due to the small number of RCTs comparing the five restorative materials in pairs investigated in the same study, only three MAs were available for heterogeneity assessment. These were: (1) between CO-RMGI (RR 1.04 [0.59, 1.84]; p = 0.88; I = 1%), (2) CR-CO (RR 1.12 [0.41, 3.02]; p = 0.83; I = 57%), and (3) between CR-RMGI (RR 1.10 [0.74, 1.63]; p = 0.65; I = 0%). No statistically significant differences were found between the two materials in all three comparisons.

CONCLUSION

CR, RMGI and CO presented no statistical differences. In comparison to other tooth-coloured materials, studies on GI were too few to allow recommendations about its use. More studies on HGVI are needed for evidence-based recommendations to be made. The evidence extracted from this meta-analysis was not strong enough (moderate), due to the small number of RCTs and the risk of bias ranging from high to moderate. More, well-designed RCTs comparing tooth-coloured materials for primary molar Class II restorations are necessary.

摘要

目的

本系统评价旨在比较五种牙色材料，即玻璃离子水门汀（GI）、树脂改性玻璃离子水门汀（RMGI）、复合树脂（CR）、聚酸改性复合树脂或复合体（CO）以及高粘度玻璃离子水门汀（HVGI）用于乳磨牙Ⅱ类洞修复的成功率。

方法

检索五个数据库自建库至2020年4月23日的随机临床试验，比较这些材料的失败率。在去除重复研究、进行数据提取并用Cochrane工具评估偏倚风险后，进行数据合成，对所有五种牙色材料进行两两比较，并分别计算每种材料的总体成功率。

结果

通过电子和手工文献检索共获得5615篇文章。应用纳入标准后，本系统评价纳入了10项随机对照试验，6项随机对照试验用于荟萃分析。评估其偏倚风险为高到中度。由于在同一研究中对五种修复材料进行两两比较的随机对照试验数量较少，仅有三项荟萃分析可用于异质性评估。这些比较分别为：（1）CO与RMGI之间（相对危险度RR为1.04[0.59，1.84]；p = 0.88；I² = 1%），（2）CR与CO之间（RR为1.12[0.41，3.02]；p = 0.83；I² = 57%），以及（3）CR与RMGI之间（RR为1.10[0.74，1.63]；p = 0.65；I² = 0%）。在所有三项比较中，两种材料之间均未发现统计学上的显著差异。

结论

CR、RMGI和CO之间无统计学差异。与其他牙色材料相比，关于GI的研究太少，无法就其使用提出建议。需要更多关于HVGI的研究以做出循证推荐。由于随机对照试验数量较少且偏倚风险为高到中度，从该荟萃分析中提取的证据不够有力（中等）。有必要开展更多设计良好的随机对照试验，比较用于乳磨牙Ⅱ类洞修复的牙色材料。