部分去腐治疗乳牙急性龋的Meta分析

Partial caries removal foracute caries of primary teeth: A Meta-analysis

目的比较部分和完全去腐治疗乳牙急性龋的效果。方法计算机检索The Cochrane Library、Pub Med、EMbase、Wan Fang Data、CBM、CNKI数据库,查找相关随机对照实验(RCT),检索时限为1978年—2015年8月。由2位评价员独立筛选文献、提取资料和评价研究质量后,采用Rev Man 5.3软件进行Meta分析。结果最终纳入6个RCT,共计562例患者,758个患牙。Meta分析结果显示:部分去腐的牙髓暴露可能性低于完全去腐,差异有统计学意义[RR=0.13,95%CI(0.05,0.37)];在术后牙髓病变(RR=0.92,95%CI(0.34,2.50))和修复失败(RR=1.07,95%CI(0.67,1.70))方面,两者差异没有统计学意义。结论部分去腐法治疗乳牙急性龋的效果是肯定的,值得在临床工作中推广使用。由于纳入研究设计存在一些缺陷,还需要今后开展更多高质量,大样本的随机对照实验来验证此结论。

Objective To compare the effectiveness of partial caries removal and complete caries removal for acute caries of primary teeth. Methods The Cochrane Library、Pub Med,EMbase、Wan Fang Data,CBM、CNKI were searched for randomized controlled trials from 1978 to August 2015.Quality assessment,literature screening and data extraction were performed by two reviewers independently.Meta-analysis was performed by Rev Man 5.3 software. Results 6 RCTs were included at last,including 562 patients and 758 teeth.Meta analysis indicated that partial caries removal could relieve the pulp exposure and was significant[RR = 0. 13,95% CI（ 0. 05,0.37） ].There were no significant differences between partial and complete caries removal in postoperative pulpal disease [RR = 0.92,95%CI（ 0.34,2.50） ]and failure of restorations [RR = 1.07,95%CI（ 0.67,1.70） ]. Conclusion Partial caries removal is effective for acute caries of primary teeth and is worth of promotion in clinical work. Due to the limitations of the included RCTs,more large-sample and high-quality RCTs are needed to confirm the reliability of this study.