Chiu Hilton Hiu Chun, Lam Phoebe Pui Ying, Yiu Cynthia Kar Yung
Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
Healthcare (Basel). 2023 Aug 9;11(16):2241. doi: 10.3390/healthcare11162241.
This review aimed to systematically investigate the effect of minimal intervention dentistry on patient-reported and observation-based outcomes of anxiety, pain and patient cooperation in the pediatric population. Microinvasive treatments (MITs) were compared to conventional treatments, home-based and professionally applied non-invasive treatments (NITs), and between MITs. Two reviewers independently screened studies from four electronic databases, extracted data, assessed the risk of bias and certainty of evidence with the GRADE approach. Ultimately, 26 studies were included for qualitative synthesis, with the data from 12 studies being incorporated into the meta-analysis. No statistically significantly differences in terms of anxiety were noted between MITs and conventional treatments, or between MITs from the meta-analyses. The treatment durations of MITs were not necessarily shorter than conventional treatments but varied with the use of local anesthesia, behavioral and clinical approach, and other confounding factors. The certainties of evidence were deemed low due to high risk of bias of the included studies. NITs evoked less anxiety and pain compared to MITs. Minimal intervention dentistry is an alternative treatment to manage dental caries among children and does not arouse different levels of dental anxiety and pain compared to other treatment modalities. However, further well-designed studies are required to draw an evidence-based conclusion.
本综述旨在系统研究微创牙科对儿童患者报告的焦虑、疼痛及患者合作情况的观察结果的影响。将微创治疗（MITs）与传统治疗、家庭式和专业应用的非侵入性治疗（NITs）以及不同的MITs进行比较。两名评审员独立从四个电子数据库中筛选研究，提取数据，采用GRADE方法评估偏倚风险和证据确定性。最终，纳入26项研究进行定性综合分析，其中12项研究的数据纳入荟萃分析。荟萃分析结果显示，MITs与传统治疗之间或不同MITs之间在焦虑方面未发现统计学显著差异。MITs的治疗时间不一定比传统治疗短，而是因局部麻醉的使用、行为和临床方法以及其他混杂因素而有所不同。由于纳入研究的偏倚风险高，证据确定性被认为较低。与MITs相比，NITs引起的焦虑和疼痛更少。微创牙科是治疗儿童龋齿的一种替代疗法，与其他治疗方式相比，不会引起不同程度的牙科焦虑和疼痛。然而，需要进一步设计良好的研究来得出基于证据的结论。
