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使用三氧化矿物凝聚体及其他材料修复乳牙医源性穿孔的临床成功率:一项系统评价与Meta分析

Clinical Success of Iatrogenic Perforation Repair Using Mineral Trioxide Aggregate and Other Materials in Primary Molars: A Systematic Review and Meta-analysis.

作者信息

Mungekar-Markandey Sahili, Mistry Laresh, Jawdekar Ashwin

机构信息

Department of Pediatric and Preventive Dentistry, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India.

出版信息

Int J Clin Pediatr Dent. 2022 Sep-Oct;15(5):610-616. doi: 10.5005/jp-journals-10005-2038.

Abstract

AIM

This study aimed at systematically reviewing the clinical success of repaired iatrogenic perforations using different materials in primary teeth.

OBJECTIVES

To compare mineral trioxide aggregate (MTA) with other biomaterials for the repair of iatrogenic perforations in primary molars during endodontic procedures.

SEARCH METHODS

A comprehensive literature search was conducted by using three electronic databases (PubMed, Cochrane Library, Google Scholar) to identify articles that evaluated the different intervention materials for the repair of iatrogenic perforation in primary molars. Selection criteria: The articles reporting perforation repair in primary molars having clinical and radiographic success, as their outcome measures with a follow-up period of at least 1 year were included in this review. Studies and case reports with insufficient or unstated follow-up periods, in vitro, and animal studies were excluded.

DATA COLLECTION AND ANALYSIS

Two reviewers (SM, LM) independently screened all titles and abstracts according to the inclusion and exclusion criteria. Full texts of the selected studies were obtained for the second stage screening. The consensus was achieved by discussion with the third reviewer (AJ). Data extraction included study design, sample size, age of the patient, year of the study, follow-up period, outcome assessment criteria, material for repair, and success and failure.

REVIEW RESULTS

A total of seven publications were included in this review. Of which, one was case series, three were case reports, and three were interventional studies. The combined success rate of MTA (80.55%) was inferior to other materials-premixed bioceramics, Atelocollagen, and calcium-enriched mixture (96.07%); the same being statistically significant ( = 0.011).

CONCLUSION

Within the limitations of our study, it can be concluded that newer biomimetic materials are superior to MTA for iatrogenic perforation repair in primary molars in terms of clinical success.

CLINICAL SIGNIFICANCE

This paper is a first-of-its-kind investigation comparing different materials used in the repair of perforations in primary molars. It can be a foundation for further research on the topic. In absence of any available guidelines, the above study can be applied in clinical situations with appropriate judgment and caution.

HOW TO CITE THIS ARTICLE

Mungekar-Markandey S, Mistry L, Jawdekar A. Clinical Success of Iatrogenic Perforation Repair Using Mineral Trioxide Aggregate and Other Materials in Primary Molars: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2022;15(5):610-616.

摘要

目的

本研究旨在系统评价使用不同材料修复乳牙医源性穿孔的临床成功率。

目标

比较三氧化矿物凝聚体(MTA)与其他生物材料在牙髓治疗过程中修复乳牙医源性穿孔的效果。

检索方法

通过使用三个电子数据库(PubMed、Cochrane图书馆、谷歌学术)进行全面的文献检索,以识别评估修复乳牙医源性穿孔不同干预材料的文章。选择标准:本综述纳入报告乳牙穿孔修复且具有临床和影像学成功结果、随访期至少为1年的文章。排除随访期不足或未说明的研究和病例报告、体外研究及动物研究。

数据收集与分析

两名研究者(SM、LM)根据纳入和排除标准独立筛选所有标题和摘要。在第二阶段筛选中获取所选研究的全文。通过与第三位研究者(AJ)讨论达成共识。数据提取包括研究设计、样本量、患者年龄、研究年份、随访期、结果评估标准、修复材料以及成功与失败情况。

综述结果

本综述共纳入7篇文献。其中,1篇为病例系列,3篇为病例报告,3篇为干预性研究。MTA的综合成功率(80.55%)低于其他材料——预混生物陶瓷、脱细胞胶原和富钙混合物(96.07%);差异具有统计学意义(P = 0.011)。

结论

在本研究的局限性范围内,可以得出结论,就临床成功率而言,新型仿生材料在修复乳牙医源性穿孔方面优于MTA。

临床意义

本文是首次比较用于修复乳牙穿孔的不同材料的研究。它可为该主题的进一步研究奠定基础。在没有任何可用指南的情况下,上述研究可在适当判断和谨慎的基础上应用于临床情况。

如何引用本文

Mungekar-Markandey S, Mistry L, Jawdekar A. Clinical Success of Iatrogenic Perforation Repair Using Mineral Trioxide Aggregate and Other Materials in Primary Molars: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2022;15(5):610-616.

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