不同冲洗方法对根管内氢氧化钙清理效果的文献分析

Literature analysis of cleaning effect of calcium hydroxide in root canal by different flushing methods

目的通过文献分析探究在根管治疗中将氢氧化钙Ca(OH)_(2)从根管系统中清除的最佳方法。方法以根管治疗、氢氧化钙、冲洗方法为检索词,在知网、万方、维普中文数据库中对2014年1月-2024年7月收录的相关文献进行随机对照试验(RCT)筛选,对原始数据进行分组归类,采用SPSS 22.0软件和RevMan 5.3.5软件对数据进行系统评价。结果共获得去除根管内封药Ca(OH)_(2)的8篇RCT离体牙实验案例,对543颗离体牙进行研究,6个RCT研究的Wilcoxon检验分析结果显示,EDDY声波荡洗、PUI超声荡洗和注射器3种冲洗方法冲洗后根管内残余Ca(OH)_(2)面积,差异无统计学意义(P>0.05)。PIPS激光荡洗和PUI超声荡洗冲洗后根管内残余Ca(OH)_(2)面积,差异有统计学意义(P<0.05)。对PIPS与PUI对根管内残余Ca(OH)_(2)的清除率进行异质性检验,结果表明PIPS较PUI清洗效率高,95%CI:=4.35%~12.24%。3%NaClO+17%EDTA冲洗液对根管内Ca(OH)_(2)的清洗效果优于单一冲液,联用EDTA冲洗后,根管内残留Ca(OH)_(2)明显减少。结论在相同冲洗液的情况下PIPS激光荡洗清除根管内Ca(OH)_(2)的能力最强。

Objective To explore the best way to completely remove calcium hydroxide from the root canal system in root canal therapy through literature analysis.Methods Using root canal therapy,calcium hydroxide and irrigation methods as search terms,randomized controlled trials(RCTs)were conducted on relevant literature collected from January 2014 to July 2024 in CNKI,Wanfang,and VIP Chinese databases.The raw data were grouped and classified,and the data were systematically evaluated using SPSS 22.0 software and RevMan 5.3.5 software.Results A total of 8 randomized controlled trials(RCTs)were conducted to remove calcium hydroxide Ca(OH)_(2) from the root canal.543 isolated teeth were studied,and the Wilcoxon test analysis of 6 RCT studies showed that the residual calcium hydroxide area in the root canal after rinsing with EDDY acoustic wave washing,PUI ultrasonic wave washing,with no statistically significant difference(P>0.05).There was a statistically significant difference(P<0.05)in the residual Ca(OH)_(2) area in the root canal between PIPS laser rinsing and PUI ultrasonic rinsing. Heterogeneity test was conducted on the removal rate of residual calcium hydroxide in root canals by PIPS and PUI. The re-sults showed that PIPS had a higher cleaning efficiency than PUI, 95%CI:=4.35%~12.24%. The cleaning effect of 3% NaClO+17% EDTA flushing solution on calcium hydroxide in the root canal was better than that of a single flushing solution. After flushing with EDTA in combination, the residual calci-um hydroxide in the root canal was significantly reduced. Conclusion Under the same rinsing solution, PIPS laser has the strongest ability to remove calcium hydroxide from the root canal.