Gluma脱敏剂对牙本质黏结强度影响的系统评价

Influence of Gluma desensitizing agents on dentin bond strength: a Meta-analysis

背景:临床上多使用脱敏剂来缓解活髓牙牙体预备后患者出现的敏感症状,但脱敏剂中的某些成分可能影响牙本质的黏结效果,对修复体的固位力有一定影响。临床医生在使用脱敏剂后对牙本质黏接剂的选择尚无定论。目的:通过系统评价方法了解临床常用的Gluma脱敏剂对牙本质黏结效果的影响。方法:计算机检索PubM ed、EMbase、EBSCO EDLINE、The chrane Library、ScienceD irect、Web Of Science、OVID、中国期刊全文数据库、中文科技期刊数据库和万方数据库,结合手工检索有关于脱敏剂对牙本质黏结强度研究的随机或半随机对照实验。检索时限均为从建库至2016年6月18日,无地区和语言限制。由2位研究者根据纳入与排除标准独立筛选文献、提取资料和评价纳入研究的方法学质量后,采用RevM an5.2软件进行Meta分析。结果与结论:(1)与不用Gluma脱敏剂处理相比,Gluma脱敏剂处理后运用自酸蚀黏接剂或者全酸蚀黏接剂的牙本质抗剪切强度差异无显著性意义;(2)Gluma脱敏剂处理后分别运用自酸蚀黏结剂与全酸蚀黏结剂进行牙本质黏结的抗剪切强度差异无显著性意义;(3)Gluma脱敏剂处理后运用自黏结型黏结剂对牙本质进行黏结后的抗剪切强度大于未用Gluma脱敏剂处理者;(4)因此在临床上选择应用Gluma脱敏剂做牙本质脱敏的时候,首先可以考虑自黏结材料,其次,自酸蚀和全酸蚀黏结材料要先分析具体的成分,含有酸或者可以溶解掉蛋白晶体的优先考虑。

BACKGROUND：Desensitization agent is widely used to relieve tooth sensitivity after tooth preparation. However, some components in the desensitization agent for certain affect the dentin bond strength between prosthesis and dentin. Given this, choosing a proper desensitization agent is under discussion. OBJECTIVE：To investigate the influence of Gluma desensitizing agents on bond strength to dentin by Meta-analysis. METHODS：A computer-based retrieval of PubMed, EMbase, EBSCO EDLINE, The chrane Library, ScienceDirect, Web Of Science, OVID, CBMbase, CJFD, CqVip and WanFang databases combined with manual searching was performed for randomized control ed trials or control ed clinical trials about effect of desensitizing agents on dentin bond strength. The retrieval time ranged from the creation date to June 18, 2016, without region and language limits. In accordance with inclusion/exclusion criteria, related data were extracted, and the qualitative and quantitative analysis of the included studies was performed by two researchers independently, and then the Meta-analysis was conducted using RevMan 5.2 software. RESULTS AND CONCLUSION：There was no significant difference in the shear bond strength of self-etching or total-etching adhesive to dentin between two groups, and the same results were found when comparing the shear bond strength of self-etching and total-etching adhesive to dentin. The Gluma had a beneficial effect on the shear bond strength of self-adhesive. These results indicate that when Gluma used as the desensitizing agent, self-adhesive materials are the first choice, and secondly the self-etching or total-etching adhesive materials containing acid or able to dissolve protein crystals are preferred.