不同清洁方式对氧化锆粘接强度影响的meta分析

Effect of different cleaning methods on bonding strength of zirconia:a meta-analysis

目的系统评价水冲洗、喷砂处理、磷酸酸蚀、次氯酸钠清洁、Ivoclean清洁对唾液污染的氧化锆与树脂之间粘接强度的影响。方法计算机检索Pubmed、Cochrane图书馆、Embase、中国知网(CNKI)、万方医学网、维普资讯中文期刊服务平台(VIP)等数据库从建库至2020年12月发表的相关文献,手工检索作为补充。由2名研究人员独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用RevMan5.3软件进行meta分析。结果共纳入10篇文献,均为随机对照试验。对照组无唾液污染,水冲洗组、次氯酸钠组、磷酸组剪切强度(SBS)均低于对照组,差异均有统计学意义[加权均数差(WMD)=6.61、3.76、6.75,95%可信区间(95%CI):2.37~10.85、0.27~7.26、1.88~11.63,P=0.002、0.030、0.007];喷砂组、Ivoclean组SBS与对照组比较,差异均无统计学意义(WMD=0.14、0.73,95%CI:-1.13~1.40、-0.19~1.65,P=0.830、0.120)。结论唾液污染的氧化锆经水、次氯酸钠、磷酸清洁后与树脂之间粘接强度低于无污染水平;喷砂、Ivoclean能提高唾液污染后氧化锆与树脂之间的粘接强度,达到无唾液污染水平。

Objective To systematically evaluate the influence of five cleaning methods(water washing,sandblasting,phosphoric acid corrosion,sodium hypochlorite clean and Ivoclean clean)on the bonding strength of zirconia contaminated by saliva and resin.Methods The related literatures published in the databases of PubMed,Cochrane Library,Embase,CNKI,Wanfang and VIP were retrieved from the date of establishment to December 2020.The manual retrieval served as a supplement.Two reviewers independently screened the literatures,extracted the data and assessed the risk of bias of included studies.Then the meta-analysis was performed by using the RevMan 5.3 software.Results A total of 10 randomized controlled trials were included.The control group had no saliva contamination.The shearing strength(SBS)of the water washing group,sodium hypochlorite solution group and phosphoric acid group were significantly lower than that of the control group,and the differences were statistically significant(WMD=6.61,3.76,6.75,95%CI:2.37-10.85,0.27-7.26,1.88-11.63,P=0.002,0.030,0.007).There were no statistically significant differences in SBS between the sandblasting group and Ivovlean group with the control group(WMD=0.14,0.73,95%CI:-1.13-1.40,-0.19-1.65,P=0.830,0.120).Conclusion The bonding strength between zirconia contaminated by saliva and resin after cleaning with water,sodium hypochlorite solution and phosphoric acid is lower than that without pollution;sandblasting and Ivoclean could improve the bonding strength between zirconia and resin to reach the level of saliva free contamination.