Department of Chemistry, Faculty of Art and Science, Ordu University, Ordu, Turkey.
Department of Endodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey.
Microsc Res Tech. 2024 Feb;87(2):181-190. doi: 10.1002/jemt.24423. Epub 2023 Sep 21.
The purpose of this systematic review of meta-analysis was to compare the effectiveness of removing the smearing layer using EDTA versus Chitosan (Ch) and Chitosan nanoparticles (Ch-NPs). A search was performed in four electronic databases (Web of Science, PubMed, Scopus, and Cochrane). The included studies were assessed by two reviewers using Joanna Briggs Institute's critical appraisal checklist for the quasi-experimental studies. Outcomes obtained by scanning electron microscopy (SEM) and conventional methods were presented as standardized mean differences alongside 95% confidence intervals. Seven investigations employed 212 single-root teeth. In the apical section (p = .317, 95% CI = -0.820 to 0.266, Tau = 0.387), middle segment (p = .914, 95% CI = -1.019 to 0.912, Tau = 1.027), and coronal segment (p = .277, 95% CI = -1.008 to 0.289, Tau = 0.378). This meta-analysis found no difference between Ch, Ch-NPs, and EDTA in removing the smear layer in the three segments. This systematic review is designed to show evidence related to the PICO question, in which our outcome is smear layer removal and not the clinical success of such a treatment. RESEARCH HIGHLIGHTS: The study aimed to compare the effectiveness of chitosan and chitosan nanoparticles with ethylenediaminetetraacetic acid (EDTA) in removing the smear layer, a layer of debris and organic material on the tooth surface, through a systematic review and meta-analysis. The removal of the smear layer is crucial for successful dental treatments, as it enhances the adhesion of restorative materials and improves the penetration of antimicrobial agents into dentinal tubules. The researchers conducted a systematic review and meta-analysis, searching various databases of electron microscopy results for relevant in vitro studies comparing the effects of chitosan or chitosan nanoparticles with EDTA on smear layer removal. The results encourage further exploration of chitosan and chitosan nanoparticles for clinical use in dentistry, while considering their specific applications and long-term effects.
本系统评价的目的是比较使用 EDTA 与壳聚糖（Ch）和壳聚糖纳米颗粒（Ch-NPs）去除玷污层的效果。在四个电子数据库（Web of Science、PubMed、Scopus 和 Cochrane）中进行了检索。使用 Joanna Briggs Institute 的半实验研究批判性评价清单对纳入的研究进行了两位审查员的评估。使用扫描电子显微镜（SEM）和常规方法获得的结果以标准化均数差值（SMD）和 95%置信区间（CI）表示。有 7 项研究采用了 212 颗单根牙。在根尖段（p=.317，95%CI=−0.820 至 0.266，Tau²=0.387）、中段（p=.914，95%CI=−1.019 至 0.912，Tau²=1.027）和冠段（p=.277，95%CI=−1.008 至 0.289，Tau²=0.378）。这项荟萃分析发现，壳聚糖、壳聚糖纳米颗粒和 EDTA 在去除三个部位的玷污层方面没有差异。本系统评价旨在展示与 PICO 问题相关的证据，我们的结果是去除玷污层，而不是这种治疗的临床效果。研究亮点：该研究旨在通过系统评价和荟萃分析比较壳聚糖和壳聚糖纳米颗粒与乙二胺四乙酸（EDTA）在去除玷污层方面的效果，玷污层是牙面的一层碎屑和有机物质。去除玷污层对于成功的牙科治疗至关重要，因为它可以增强修复材料的附着力，并提高抗菌剂进入牙本质小管的渗透能力。研究人员进行了系统评价和荟萃分析，检索了比较壳聚糖或壳聚糖纳米颗粒与 EDTA 对玷污层去除效果的电子显微镜结果的各种数据库中的相关体外研究。研究结果鼓励进一步探索壳聚糖和壳聚糖纳米颗粒在牙科临床应用中的应用，同时考虑其具体应用和长期效果。
