家庭漂白治疗效果及安全性的系统评价和 Meta 分析

The efficiency and safty of home-bleaching: A systematic review and Meta-analysis

目的:评估家庭漂白疗效及安全性。方法:对CBM、CNKI、MEDLINE、Embase、Cochrane Library进行检索,纳入所有对外源性着色牙进行家庭漂白的随机对照试验。按纳入标准筛选,用Cochrane系评价文献质量、用固定效应模型进行Meta分析。结果:最终纳入文献12篇,包括患者611例。分析结果显示10%过氧化脲(CP)漂白效果优于15%CP(MD,0.21;CI:[0.03,0.38];Z=1.92;P=0.002),35%过氧化氢(HP)诊室漂白导致的短期牙敏感强度明显强于10%CP家庭漂白(MD,-1.68;95%CI:[-2.75,-0.61];Z=3.09;P=0.002),38%HP诊室漂白结论相同(MD,-2.64;95%CI:[-3.96,-1.32];Z=3.93;P<0.000 1)。但HP、CP家庭漂白的牙敏感无统计学差异(OR,1.94;95%CI:[0.84,4.44];Z=1.56;P=0.12)。结论:低浓度CP家庭漂白效果优于高浓度CP,诊室漂白较家庭漂白更易导致牙敏感。

Objective：To evaluate the efficiency and safty of home-bleaching.Methods：Randomised controlled trials on home-bleaching were searched using CBM,CNKI,Medline,EMBASE and Cochrane Library up to April,201 3.The articles were selected by inclusion criterion,qualified by Cochrane system and analysed by Meta method.Results：1 2 studies with 61 1 cases were finally includ-ed and analysed.The results showed that 1 0% carbamide peroxide （CP）produced better bleaching efficiency than 1 5% CP（MD, 0.21 ;CI：[0.03,0.38];Z =1 .92;P =0.002）.Hydrogen peroxide（HP）at 35% lead to higher tooth sensitivity in office-bleaching than CP at 1 0% in home-bleaching（MD,-1 .68;95%CI：[-2.75,-0.61 ];Z =3.09;P =0.002）;home-bleaching were asso-ciated with less tooth sensitivity than office-bleaching（MD,-2.64;95%CI：[-3.96,-1 .32];Z =3.93;P〈0.000 1 ）,while there was no significance of tooth sensitivity between home-bleaching using CP and HP （OR,1 .94;95%CI：[0.84,4.44];Z =1 .56;P =0.1 2）.Conclusion：1 0% CP home-bleaching may produce better bleaching efficiency;home-bleaching is associated with less tooth sensitivity than office-bleaching.