多联抗生素糊剂与Vitapex治疗乳牙牙髓病及根尖周病疗效的系统评价

Comparison of Curative Effect of Polyantibiotic Paste and Vitapex for Pulp Infection and Periradicular Lesion of Primary Teeth:a Systematic Review

目的:系统评价多联抗生素糊剂与Vitapex用于乳牙牙髓病及根尖周病的疗效。方法:计算机检索Cochrane Library、EMbase、PubMed、CBM、CNKI及VIP数据库,检索从建库到2016年6月30日国内外公开发表的关于比较多联抗生素糊剂与Vitapex治疗乳牙牙髓及根尖周病的随机对照试验,由2名研究者根据纳入及排除标准独立筛选文献、提取数据并对纳入文献进行方法学质量评价,最后采用RevMan 5.0软件进行Meta分析,Stata12.0进行发表偏倚的衡量。结果:最终纳入16个研究3852颗牙齿。Meta分析结果显示,整体成功率[RR=1.02,95%CI(1.00-1.04),Z=1.85,P=0.06]及12个月成功率[RR=1.01,95%CI(0.98-1.03),Z=0.60,P=0.55]比较差异无统计学意义,6个月成功率[RR=1.02,95%CI(1.00-1.04),Z=2.15,P=0.03]及24个月及以上成功率[RR=1.07,95%CI(1.01-1.12),Z=2.42,P=0.02]比较差异有统计学意义。结论:对于乳牙根管治疗,多联抗生素糊剂与Vitapex具有可比性,且随访2年及以上的长期效果较Vitapex更稳定。

Objective：To compare the curative effect of polyantibiotic paste and Vitapex for primary teeth of pulp infection and periradicular lesions by systematical review.Methods：The data up to June 30,2016 were collected by searching in Cochrane Library,EMbase,PubMed,CBM,CNKI and VIP.Two reviewers independently screened the literatures according to the inclusion and exclusion criteria and extracted data from the literatures.The methodological quality of selected studies was assessed.The RevMan 5.0software was used for Meta-analysis and the Stata 12.0was for evaluating the publication bias.Results：A total of 16 studies were selected and 3852 teeth were involved.The results of Meta-analysis showed that the total successful rate between two groups[RR=1.02,95%CI（1.00-1.04）,Z=1.85,P=0.06]and the successful rate of 12months[RR=1.01,95%CI（0.98-1.03）,Z=0.60,P=0.55]were not significantly different;the successful rate of 6months[RR=1.02,95%CI（1.00-1.04）,Z=2.15,P=0.03]and the successful rate of over 24months[RR=1.75,95%CI（1.11-2.76）,Z=2.42,P=0.02]were significantly different.Conclusion：Compared with the curative effect of Vitapex for primary teeth of pulp infection and periradicular lesions,the successful rate of polyantibiotic paste was superior,especially for the cases observed over two years.