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比较用玻璃纤维增强或金属桩修复的根管治疗牙的存活率:系统评价和荟萃分析。

Comparing survival rates of endodontically treated teeth restored either with glass-fiber-reinforced or metal posts: A systematic review and meta-analyses.

机构信息

PhD student, Department of Medical Biotechnologies, University of Siena, Policlinico Le Scotte, Viale Bracci, Siena, Italy.

Assistant Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass.

出版信息

J Prosthet Dent. 2024 Apr;131(4):567-578. doi: 10.1016/j.prosdent.2022.01.003. Epub 2022 Apr 13.

Abstract

STATEMENT OF PROBLEM

When restoring endodontically treated teeth, a post system is indicated to retain a core. Clinicians can choose from different post materials and types. However, the literature is inconclusive on the long-term clinical performance of available post systems.

PURPOSE

The purpose of this systematic review and meta-analysis was to analyze the survival and failure rates of endodontically treated teeth restored either with glass-fiber-reinforced or metal posts.

MATERIAL AND METHODS

The research question was formulated by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by using the Population, Intervention, Comparison, Outcome, Study Type (PICOS) tool. Medline (PubMed), Embase, and Scopus searches complemented by manual search were performed for randomized controlled clinical trials with a follow-up of at least 2 years. Two independent authors performed screening and data extraction of the articles. Meta-analyses were performed with the RevMan software program. Homogeneity was checked by using chi and I tests, and random-effects meta-analyses were applied. Odds ratio and 95% confidence interval were calculated (α=.05). The publication bias was evaluated by using funnel plots and the Begg and Egger tests.

RESULTS

A total of 184 studies were retrieved through the electronic searches, and an additional 4 through the hand search. After title- and abstract-level exclusion, 23 studies remained for full-text analyses, of which 7 were selected for data extraction. Meta-analyses revealed an overall survival rate of 92.8% for endodontically treated teeth restored with glass-fiber-reinforced posts compared with 78.1% of those restored with metal posts. No statistically significant difference (P>.05) was found in the survival, success, or failure rates.

CONCLUSIONS

No statistically significant differences were found between the survival and failure rates of endodontically treated teeth restored either with glass-fiber-reinforced or metal posts. The overall survival rate was 92.8% for glass fiber posts and 78.1% for metal posts. Both are reliable materials when a significant amount of coronal tooth structure is missing and treatment with a post is indicated.

摘要

问题陈述

在修复根管治疗过的牙齿时,需要使用桩系统来保留核。临床医生可以选择不同的桩材料和类型。然而,目前文献对于可用的桩系统的长期临床性能尚无定论。

目的

本系统评价和荟萃分析的目的是分析用玻璃纤维增强或金属桩修复的根管治疗过的牙齿的生存率和失败率。

材料和方法

研究问题是根据系统评价和荟萃分析的首选报告项目(PRISMA)指南,使用人群、干预、比较、结局、研究类型(PICOS)工具制定的。通过 Medline(PubMed)、Embase 和 Scopus 搜索,并辅以手动搜索,纳入了至少随访 2 年的随机对照临床试验。两位独立作者对文章进行了筛选和数据提取。采用 RevMan 软件程序进行荟萃分析。使用卡方和 I 检验检查同质性,并应用随机效应荟萃分析。计算比值比和 95%置信区间(α=.05)。通过漏斗图和贝格和埃格检验评估发表偏倚。

结果

通过电子搜索共检索到 184 项研究,通过手动搜索额外检索到 4 项研究。经过标题和摘要排除后,有 23 项研究进入全文分析,其中 7 项被选入数据提取。荟萃分析显示,用玻璃纤维增强桩修复的根管治疗过的牙齿的总体生存率为 92.8%,而用金属桩修复的牙齿的生存率为 78.1%。在生存率、成功率或失败率方面,没有发现统计学上的显著差异(P>.05)。

结论

用玻璃纤维增强或金属桩修复的根管治疗过的牙齿在生存率和失败率方面没有发现统计学上的显著差异。玻璃纤维桩的总体生存率为 92.8%,金属桩为 78.1%。当牙冠结构缺失较多且需要桩治疗时,这两种材料都是可靠的。

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