贵金属、镍铬合金烤瓷修复体与中国人牙周组织健康关系的系统评价

Effect of gold alloy restorations and nickel-chromium restorations to the periodontal tissue of the Chinese: A systematic review

背景:国内许多学者认为贵金属烤瓷修复体较镍铬合金更有利于保持牙周组织的长期健康,但国内外尚无相关的系统评价目的:评价贵金属与镍铬合金烤瓷修复体对中国人牙周组织健康的影响。方法:计算机检索中国生物医学文献数据库(1978-01/2011-03)以及中国期刊全文数据库(1979-01/2011-03)文章,同时手工检索10种中文口腔医学杂志有关金属烤瓷冠、桥修复的临床研究,按照纳入和排除标准选择随机对照试验,由两名研究者独立提取数据,并进行偏倚风险评价与Meta分析。结果与结论:共纳入6篇文献,均存在中等程度偏倚风险。结果显示,贵金属烤瓷修复体能够降低79%由镍铬合金者引起的修复后基牙牙龈炎发生风险(P<0.05),可减少94%由镍铬合金引起的修复后基牙牙龈染色发生风险(P<0.05)。另外,贵金属烤瓷修复体修复后边缘密合度显著高于镍铬合金者(P<0.05)。目前证据显示,使用贵金属烤瓷修复体能够减少国内人群修复后牙龈炎及牙龈染色的发生风险,然而还需要进行高质量的临床研究以增加该结论的可靠性。

BACKGROUND： Chinese researchers have done many corresponding clinical trials and mostly agree that, compared with nickel-chromium restorations, gold alloy restorations are better to the Chinese periodontal tissue in the long term. However, there is still no relevant systematic review analyzing and evaluating those results in a more rigorous and convincing way. OBJECTIVE： To assess the effect of nickel-chromium restorations and gold alloy restorations to the periodontal tissue of the Chinese. METHODS： Electronic searches were conducted in China Biology Medicine disc （CBMdisc, 1978-01/2011-03） and China National Knowledge Infrastructure （CNKI, 1979-01/2011-03）. Hand-searching covered 10 Chinese dental journals. Randomized controlled trials satisfying the eligible criteria were selected and the risks of bias were assessed. With the data extracted by two well-trained investigators independently, Meta-analysis was processed by Revman 5.0. RESULTS AND CONCLUSION： Six studies with moderate risk of bias were included. The results indicated gold alloy restorations could reduce 79% of the risk of post-restorative gingivitis in nickel-chromium restorations （P 0.05）, and gold alloy restorations could also reduce the risk of gingival coloration by 94% of nickel-chromium restorations （P 0.05）. The results on the restoration fitness with four studies pooled indicated better restoration fitness in gold alloy restorations than nickel-chromium restorations （P 0.05）. Present evidences indicated that gold alloy restorations have lower risk in inducing gingivitis and gingival coloration compared to nickel-chromium. But more high quality studies are still needed to confirm the conclusion.