年轻恒牙牙髓血管再生治疗效果的系统评价

Effectiveness of dental pulp revascularization for immature permanent teeth treatment: a systemic review

目的:系统评价有关年轻恒牙牙髓血管再生治疗的临床疗效。方法:计算机检索Cochrane Library、PubMed、EMBASE、CNKI、CBM、VIP和Wan Fang Data中有关牙髓血管再生治疗年轻恒牙感染根管的随机对照试验(RCT),检索年限均为建库至2016年3月。根据Cochrane系统评价的方法,采用RevMan 5.3软件进行Meta分析。结果:共纳入5个RCT,280例患者,Meta分析结果显示,牙髓血管再生治疗感染年轻恒牙的总有效率(91.4%)高于对照组(67.1%)[RR=1.30,95%CI(1.08,1.56),P=0.005];其术后疼痛发生率(6.3%)低于对照组(19.0%)[RR=0.33,95%CI(0.13,0.87),P=0.03],差异均有统计学意义;1个研究报告了牙髓血管再生治愈根尖周病变的平均时间(12.4±1.3)个月,对照组(11.9±2.1)个月,差异无统计学意义(P>0.05)。结论:现有证据提示,牙髓血管再生治疗感染年轻恒牙的疗效较好,术后疼痛发生较常规治疗少,但目前研究存在数量少、质量偏低等情况,其确切疗效尚需高质量、大样本的RCT加以验证。

Objectives： To evaluate the effectiveness of dental pulp revascularization for immature permanent teeth treatment. Methods： The Cochrane Library, PubMed, EMBASE, CNKI, CBM, VIP and Wan Fang Data were searched for the randomized controlled trials （RCT） about the treatment of immature permanent teeth by using dental pulp revascularization from inception to March, 2016. According to the methods of Cochrane Reviewers＇ Handbook recommend by The Cochrane Collaboration, meta-analysis was performed with RevMan5.3 software. Results ： Five studies and a total of 280 patients were included.The results of meta-analysis showed that the total effective rate of dental pulp revascularization for immature permanent teeth treatment group （91.4%） was higher than that of the control group （67.1%） （RR = 1.30, 95% CI 1.08 to 1.56, P = 0.005）, and the rate of post-surg- ery pain occurrence of dental pulp revascularization for immature permanent teeth treatment group （6.3%） was lower than that of the control group （19.0%） （RR = 0.33, 95% CI 0.13 to 0.87, P = 0.03）. One study reported that there was no significant difference in terms of the mean healing time in periapical lesion between the treatment group and the control group. Conclusion： Current evidence shows that the effectiveness of dental pulp revascularization for immature permanent teeth treatment is effective. However, given the low methodological quality of most studies included, this conclusion still needs to be further validated by conducting more high aualitv RCT studies.