中国循证医学杂志

中国循证医学杂志

无机三氧化聚合物用于龋源性露髓年轻恒牙部分活髓切断术的疗效的 Meta 分析

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目的 系统评价无机三氧化聚合物(mineral trioxide aggregate,MTA)用于龋源性露髓年轻恒牙部分活髓切断术治疗的临床疗效。 方法 计算机检索 PubMed、The Cochrane Library(2017 年 2 期)、EMbase、CNKI、CBM 和 WanFang Data 等数据库,搜集有关 MTA 用于龋源性露髓年轻恒牙部分活髓切断术治疗的随机临床对照试验(RCT),检索时限均为建库至 2017 年 2 月。由 2 位研究者独立筛选文献、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 共纳入 3 个 RCT,199 例患牙。Meta 分析结果显示,在术后 3 月、6 月、12 月、24 月和大于 24 月的时间点,MTA 与氢氧化钙的临床疗效差异均无统计学意义。3 个 RCT 均未报道有不良事件发生。 结论 当前证据显示,MTA 与氢氧化钙在龋源性露髓年轻恒磨牙部分活髓切断术中近期和远期临床疗效相当。受纳入研究的数量和质量的限制,上述结论尚需开展更多高质量研究予以验证。

Objective To systematically review the efficacy of mineral trioxide aggregate (MTA) for partial pulpotomy in cariously exposed pulps of young permanent teeth. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 2, 2017), CNKI, CBM and WanFang Data were searched to collect randomized controlled trials (RCTs) about mineral trioxide aggregate for partial pulpotomy in cariously exposed pulps of young permanent teeth from inception to February 2017. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software. Results A total of three RCTs including 199 teeth were finally included. The results of meta-analysis showed that, there were no statistical significant differences between the MTA group and calcium hydroxide treatment groups on 3, 6, 12, 24 and more than 24 months. None study reported adverse events. Conclusion The current evidences shows that MTA and calcium hydroxide have the same short-term and long-term clinical efficacy in cariously exposed pulps of young permanent teeth, but more high quality and large-scale studies are needed to verify the conclusion.

关键词: 无机三氧化聚合物; 氢氧化钙; 活髓切断术; 露髓; 系统评价; 随机对照试验

Key words: Mineral trioxide aggregate; Calcium hydroxide; Pulpotomy; Exposed pulp; Systematic review; Randomized controlled trial

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