儿童龋损恒牙使用三氧化矿物凝聚体（MTA）进行活髓切断术的疗效和安全性：一项系统评价和Meta分析

Efficacy and safety of mineral trioxide aggregate (MTA) pulpotomy for caries-exposed permanent teeth in children: a systematic review and meta-analysis.

作者信息

Wang Yan, Luo Sha, Tang Weiwei, Yang Luping, Liao Yue, Liu Fan

机构信息

Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China.

Department of Nursing, West China Hospital of Stomatology, Sichuan University, Chengdu, China.

出版信息

Transl Pediatr. 2022 Apr;11(4):537-546. doi: 10.21037/tp-22-68.

DOI:10.21037/tp-22-68

PMID:35558967

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9085940/

Abstract

BACKGROUND

This study aimed to evaluate the effect of mineral trioxide aggregate (MTA) pulp capping for caries-exposed permanent teeth. However, the efficacy of MTA in the treatment of children's gums is still controversial, and different studies have shown different efficacy. Therefore, it is necessary to systematically review the efficacy and safety of MTA pulp incision in the treatment of pediatric caries using meta methods.

METHODS

We used meta-analysis to compare differences in the efficacy of MTA and calcium hydroxide (CH) for treating caries in permanent teeth. The mean treatment success rate of MTA for reversible and irreversible pulpitis groups was calculated, and the effect of apical opening condition and surgical type on success rate were investigated.

RESULTS

A total of 15 studies were included, and meta-analysis showed that there was a significant statistical difference between the MTA group and CH group in efficacy [odds ratio (OR) =1.87, 95% confidence interval (CI): 1.28, 2.73, P=0.001, I=63%, Z=3.25], success rate (OR =3.20, 95% CI: 1.93, 5.30, P<0.00001, I=0%, Z=4.52), influence of apical foramen condition on success rate (OR =1.77, 95% CI: 1.14, 2.73, P=0.01, I=15%, Z=2.56), and surgical procedure on success rate (OR =2.64, 95% CI: 1.65, 4.23, P<0.0001, I=45%, Z=4.05).

DISCUSSION

Our results showed that MTA pulpotomy was superior to CH. Nonclosure of apical openings and complete coronal pulpotomy may be more beneficial than partial pulpotomy.

摘要

背景

本研究旨在评估三氧化矿物凝聚体（MTA）用于龋损恒牙盖髓术的效果。然而，MTA治疗儿童牙龈的疗效仍存在争议，不同研究显示出不同的疗效。因此，有必要采用Meta分析方法系统评价MTA牙髓切断术治疗儿童龋齿的疗效和安全性。

方法

我们采用Meta分析比较MTA和氢氧化钙（CH）治疗恒牙龋齿疗效的差异。计算MTA治疗可逆性和不可逆性牙髓炎组的平均治疗成功率，并研究根尖孔状况和手术类型对成功率的影响。

结果

共纳入15项研究，Meta分析显示，MTA组和CH组在疗效[比值比（OR）=1.87，95%置信区间（CI）：1.28，2.73，P=0.001，I=63%，Z=3.25]、成功率（OR =3.20，95%CI：1.93，5.30，P<0.00001，I=0%，Z=4.52）、根尖孔状况对成功率的影响（OR =1.77，95%CI：1.14，2.73，P=0.01，I=15%，Z=2.56）以及手术操作对成功率的影响（OR =2.64，95%CI：1.65，4.23，P<0.0001，I=45%，Z=4.05）方面存在显著统计学差异。