Cebula Marcus, Göstemeyer Gerd, Krois Joachim, Pitchika Vinay, Paris Sebastian, Schwendicke Falk, Effenberger Susanne
Clinical Research Department, DMG Dental Material Gesellschaft mbH, Elbgaustraße 248, 22547 Hamburg, Germany.
Department of Restorative, Preventive and Pediatric Dentistry, Charité-Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany.
J Clin Med. 2023 Jan 16;12(2):727. doi: 10.3390/jcm12020727.
The present study aimed to meta-analyze and evaluate the certainty of evidence for resin infiltration of proximal carious lesions in primary and permanent teeth. While resin infiltration has been shown efficacious for caries management, the certainty of evidence remains unclear. The protocol was registered with PROSPERO (CRD42018080895), and PRISMA guidelines have been followed. The databases PubMed, Embase, and Cochrane CENTRAL were systematically screened, complemented by hand searches and cross-referencing. Eleven relevant articles were identified and included, i.e., randomized controlled trials (RCTs) comparing the progression of resin infiltrated proximal caries lesions (combined with non-invasive measures) in primary or permanent teeth with non-invasive measures. Random-effects meta-analyses and trial sequential analyses (TSA) were performed for per-protocol (PP), intention-to-treat (ITT), and best/worst case (BC/WC) scenarios. Six included trials assessed lesions in permanent teeth and five trails assessed lesions in primary teeth. The trials had a high or unclear risk of bias. Risk of caries progression was significantly reduced for infiltrated lesions in the PP, ITT, and BC scenarios in both permanent teeth and primary teeth, but not in the WC scenario. According to the TSA, firm evidence was reached for all of the scenarios except the WC. In conclusion, there is firm evidence for resin infiltration arresting proximal caries lesions in permanent and primary teeth.
本研究旨在对乳牙和恒牙邻面龋损树脂渗透的证据进行荟萃分析并评估其确定性。虽然树脂渗透已被证明对龋病管理有效，但证据的确定性仍不明确。该方案已在国际前瞻性注册系统（PROSPERO，注册号：CRD42018080895）注册，并遵循了系统评价和Meta分析的首选报告项目（PRISMA）指南。对PubMed、Embase和Cochrane CENTRAL数据库进行了系统筛选，并辅以手工检索和交叉引用。共识别并纳入了11篇相关文章，即比较乳牙或恒牙中树脂渗透邻面龋损（结合非侵入性措施）与非侵入性措施进展情况的随机对照试验（RCT）。对符合方案（PP）、意向性分析（ITT）和最佳/最差情况（BC/WC）进行随机效应荟萃分析和试验序贯分析（TSA）。纳入的试验中有6项评估恒牙病变，5项评估乳牙病变。这些试验存在高偏倚风险或偏倚风险不明确。在恒牙和乳牙的PP、ITT和BC情况下，渗透病变的龋病进展风险均显著降低，但在WC情况下未降低。根据TSA，除WC情况外，所有情况均获得了确凿证据。总之，有确凿证据表明树脂渗透可阻止恒牙和乳牙的邻面龋损。
