矿物三氧化物凝聚体与玻璃离子修补髓室底穿孔的系统评价

Mineral trioxide aggregate and glass ionomer cement in perforation repair:a systematic review

目的系统评价矿物三氧化物凝聚体(MTA)与玻璃离子粘固剂(GIC)修补磨牙或乳磨牙髓室底穿孔的成功率。方法计算机检索中国知网学术总库(CNKI)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、万方数据库、Medline、Pub Med和Cochrane图书馆,语种不限,从纳入研究的参考文献中进行追溯查找,由2名评价者根据纳入和排除标准独立筛选随机或半随机对照试验,提取资料并评价质量后,按Cochrane系统评价方法,采用Rev Man 5.0软件进行Meta分析。结果最初检索到133篇文献,经过筛选最终纳入6篇文献,507例。Meta分析结果显示,与GIC相比,穿孔直径≤2 mm时,MTA可提高髓室底穿孔的临床成功率[OR=5.56(95%CI:3.19,9.70),P=0.000];穿孔直径>2 mm时,MTA的成功率大于GIC[OR=4.52(95%CI:1.98,10.31),P=0.000]。结论该研究结果提示,MTA用于磨牙或乳磨牙髓室底穿孔修补的成功率大于GIC。受纳入研究的质量与数量所限,上述结论还需更多具有统一评价指标、高质量、大样本的随机对照实验予以验证。

[Objective] To apply recta-analysis to compare the successful rate of mineral trioxide aggregate （MTA） with glass ionomer cement （GIC） as pulp chamber perforation materials. [Methods] Relevant randomized control trials and quasi-randomized control trials were retrieved in Chinese CNKI Academic Library, VIP Chinese Scientific Journal Database, Chinese Biomedical Literature Database, Wangfang Database, PubMed, Medline and Cochrane Library. The references were also traced back to collect the relevant trials. Randomized control trials or quasi-randomized control trials reported in either Chinese or English in accord with inclusion criteria were analyzed in this study. The Rev Man 5.0 software was used for meta-analysis. [Results] Six studies were selected and 507 patients were included. Meta-analysis showed that in comparison with GIC, MTA as a perforation material in pulp chamber increased the clinical successful rate when the diameter of pulp chamber ≤ 2mm [OR= 5.56, （95%CI： 3.19, 9.70）, P= 0.000], and had a higher clinical successful rate than GIC when the diameter of pulp chamber 〉 2 mm [OR = 4.52, （95%CI： 1.98, 10.31）, P= 0.000]. [Conclusions] Currently available evidence suggests that MTA as a pulp chamber perforation material has significantly higher clinical and radiographic successful rates than GIC. Because of the small number and uneven qualities of the samples, the conclusion needs further verification by large sample, multi-center, randomized controlled trials.