光固化流体复合树脂与光固化窝沟封闭剂比较预防儿童龋病的Meta分析

Efficacy of light cured flowable composite resin and light cured pit and fissure sealant for prevention of dental caries in children: a meta-analysis

目的系统评价光固化流体复合树脂与光固化窝沟封闭剂比较预防儿童龋病的临床疗效。方法计算机检索EMbase、CBM、The Cochrane Library、PubMed、Web of Science、CNKI、WanFang Data和VIP数据库,搜集关于光固化流体复合树脂与光固化窝沟封闭剂的临床随机对照试验(RCT)或半随机对照试验(quasiRCT),检索时限均为建库至2017年1月1日。由2位研究员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果最终纳入13个研究(12个RCT和1个quasi-RCT),共计4 689颗牙。Meta分析结果显示,不同随访时间的光固化流体复合树脂组的完全保留率[RR_(6月)=1.03,95%CI(1.00,1.06),P=0.03;RR_(12月)=1.09,95%CI(1.04,1.13),P=0.000 3;RR_(24月)=1.22,95%CI(1.13,1.31),P<0.000 01]均高于光固化窝沟封闭剂组,差异均具有统计学意义。不同随访时间的光固化流体树脂组的患龋率[Peto OR_(12月)=0.30,95%CI(0.16,0.56),P=0.000 2;Peto OR_(24月)=0.44,95%CI(0.31,0.63),P<0.000 01]均明显低于光固化窝沟封闭剂组,差异均具有统计学意义。结论光固化流体复合树脂在封闭材料保留及预防儿童龋病方面,疗效明显优于光固化窝沟封闭剂。受纳入研究质量和质量的限制,上述结论尚需更多高质量研究予以验证。

Objective To evaluate the efficacy of the light cured flowable composite resin and the light cured pit and fissure sealant in the prevention of dental caries in children. Methods EMbase, CBM, The Cochrane Library, PubMed, Web of Science, CNKI, WanFang Data and VIP databases were searched from inception to January 1st, 2017 for randomized controlled trials （RCTs） or quasi-RCTs about the application of the light cured flowable composite resin and the light cured pit and fissure sealants. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, the RevMan 5.3 software was applied to conduct meta-analysis. Results A total of 13 studies were included. The results of meta-analysis showed that the complete retention rate of the light cured flowable composite resin group was higher than that of the light cured pit and fissure sealant group （6 months： RR^I.03, 95%CI 1.00 to 1.06, P=0.03; 12 months： RR=I.09, 95%CI 1.04 to 1.13, P=0.000 3; 24 months： RR=l.22, 95%CI 1.13 to 1.31, P〈0.000 01）. The incidence of caries of the light cured flowable composite resin group was lower than that of the light cured pit and fissure sealant group （12 months： Peto OR=0.30, 95%CI 0.16 to 0.56, P=0.000 2; 24 months： Peto OR=0.44, 95%CI 0.31 to 0.63, P〈0.000 01）. Conclusion The light cured flowable composite resin is superior to the light cured pit and fissure sealant in the complete retention and caries prevention. The above conclusions are needed to be verified by more high-quality clinical studies because of the limitation of the quality and foUow-up time of studies.