Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
Department of Conservative Dentistry, Faculty of Dentistry, MAHSA University, Selangor, Malaysia.
J Prosthodont. 2022 Feb;31(2):102-114. doi: 10.1111/jopr.13433. Epub 2021 Sep 30.
This is a systematic review to identify the incidence of pulp necrosis and/or periapical changes among vital teeth which are used as an abutment for crown and fixed partial dentures (FPDs).
Two reviewers independently searched two electronic databases, PubMed and Scopus. The search was complemented from references of included studies and published reviews. Studies published in the English language through January 2021 that had assessed and documented the clinical and radiographic failure of crown or FPD in vital permanent teeth due to pulpal or periapical pathology with a follow-up of at least 12 months were selected. Data screening, data collection and extraction of data was performed. Quality of studies involved was analyzed using the Newcastle-Ottawa Quality Assessment Scale for cohort studies. Meta-analysis was done using random effects model. Publication bias was assessed using funnel plots.
Electronic searches provided 10,075 records among which 20 studies were selected for systematic review and 7 studies were selected for meta-analysis. With respect to quality assessment, all the studies involved were considered as high quality as the score in scale ranged between 6 and 9 as per the Newcastle-Ottawa Quality Assessment Scale for cohort studies. The meta-analyses showed that there was no statistically significant difference in the incidence of the loss of pulp vitality or pulp necrosis through clinical and radiographic examination with the follow up period of 5 years: p < 0.001, 95% CI: 0.96-1.00, I = 77.84%; 10 years: p < 0.001, 95% CI: 0.88-0.95, I = 93.59%; 15 years: p < 0.001, 95% CI: 0.92-0.96, I = 94.83%; and 20 years: p < 0.001, 95% CI: 0.94-0.96, I = 95.01%.
The meta-analysis revealed clinical and radiographic success rate ranging between 92% to 98% at different follow up periods ranging between 5 years and 20 years. Future high-quality randomized clinical controlled trials with a larger population are required to confirm the evidence as only observational studies were considered in this paper.
这是一项系统评价，旨在确定用作牙冠和固定局部义齿（FPD）基牙的活髓牙发生牙髓坏死和/或根尖周病变的发生率。
两名评审员独立检索了两个电子数据库PubMed 和 Scopus。并从纳入研究的参考文献和已发表的综述中补充了检索。选择了 2021 年 1 月之前以英文发表的评估并记录了因牙髓或根尖周病变导致牙冠或 FPD 临床和影像学失败的活髓恒牙的研究，其随访时间至少为 12 个月。进行了数据筛选、数据收集和提取。使用纽卡斯尔-渥太华质量评估量表（Newcastle-Ottawa Quality Assessment Scale for cohort studies）对所涉及的研究质量进行了分析。使用随机效应模型进行荟萃分析。使用漏斗图评估发表偏倚。
电子检索提供了 10075 条记录，其中 20 项研究被选为系统评价，7 项研究被选为荟萃分析。关于质量评估，根据纽卡斯尔-渥太华质量评估量表（Newcastle-Ottawa Quality Assessment Scale for cohort studies），所有研究的评分均在 6 到 9 之间，因此被认为是高质量的。荟萃分析显示，在 5 年、10 年、15 年和 20 年的随访期内，通过临床和影像学检查评估，牙髓活力丧失或牙髓坏死的发生率没有统计学意义：p<0.001，95%CI：0.96-1.00，I=77.84%；p<0.001，95%CI：0.88-0.95，I=93.59%；p<0.001，95%CI：0.92-0.96，I=94.83%；p<0.001，95%CI：0.94-0.96，I=95.01%。
荟萃分析显示，在 5 年至 20 年的不同随访期内，临床和影像学成功率在 92%至 98%之间。需要未来进行高质量的、包含更大人群的随机对照临床试验来证实这一证据，因为本文只考虑了观察性研究。
