化学机械法与传统牙钻法去腐效果对比的Meta分析

Comparison of the clinical efficacy of Carisolv chemo-mechanical caries removal and traditional rotary drill:An updated Meta-analysis

目的比较Carisolv化学机械技术与传统牙钻在临床龋齿去腐应用中的效果差异,为临床选择最佳的龋病治疗方式提供循证学参考。方法计算机检索Cochrane Library、Wiley Online Library、PubMed、CNKI和万方数据库,查找比较Carisolv化学机械技术与传统牙钻去腐效果的临床随机对照研究。检索时限均为建库至2019年1月。2名评价员按照纳入标准选择文献、提取资料和评价纳入研究方法学质量后,应用RevMan 5.3软件进行Meta分析。结果共纳入10个随机对照研究,880例患者。Meta分析结果显示:Carisolv化学机械技术组和传统牙钻组在去腐效率方面差异无显著性[CCR:RR=0.98,95%CI(0.88,1.08);量化CCR:SMD=1.29,95%CI(-0.59,3.17)]。Carisolv化学机械技术组患者无痛率明显高于传统牙钻组[RR=1.58,95%CI(1.08,2.31)]。Carisolv化学机械技术组患者VAS评分明显低于传统牙钻组[RR=-4.98,95%CI(-8.14,-1.82)]。Carisolv化学机械技术组患者局麻药物使用率明显低于传统牙钻组[RR=0.20,95%CI(0.13,0.32)]。Carisolv化学机械技术组患者去腐操作时间明显长于传统牙钻组[SMD=2.82,95%CI(1.96,3.69)]。结论Carisolv化学机械技术虽操作时间有所延长,但临床去腐效率与传统牙钻相当,且患者疼痛程度及局麻药物使用率明显降低,可以作为一种值得普遍推广的微创龋病治疗技术。

Objective To compare the efficiency of the Carisolv and rotary methods for caries removal.Methods Electronic databases such as Cochrane Library,Wiley Online Library,PubMed,CNKI and WanFang Data were searched.Two reviewers screened literature according to pre-selected criteria.After data extraction and research quality assessment,the meta-analysis was conducted using RevMan 5.3 software.Results 10 RCT studies involving 880 patients were included.The results revealed that there was no difference in clinical efficiency between Carisolv and rotary methods.The painless rate of Carisolv was significantly higher than that of rotary methods.The VAS score of Carisolv was significantly lower than that of rotary methods.The utilization rate of local anesthetic of Carisolv was significantly lower than that of rotary methods.The operative time of Carisolv was longer than that of rotary methods.Conclusion The meta-analysis indicates that the clinical efficiency of Carisolv seems as reliable as the rotary method,in spite of the longer operative time.Carisolv method is a minimal-invasive caries removal approach.