中国循证医学杂志

中国循证医学杂志

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

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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(quasi-RCT),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[RR6月=1.03,95%CI(1.00,1.06),P=0.03;RR12月=1.09,95%CI(1.04,1.13),P=0.000 3;RR24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 OR12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=1.03, 95%CI 1.00 to 1.06, P=0.03; 12 months: RR=1.09, 95%CI 1.04 to 1.13, P=0.000 3; 24 months: RR=1.22, 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 follow-up time of studies.

关键词: 光固化流体复合树脂; 窝沟封闭剂; Meta 分析; 随机对照试验

Key words: Light cured flowable composite resin; Pit and fissure sealant; Meta-analysis; Randomized controlled trial

引用本文: 刘燕清, 许强, 张福军. 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. 中国循证医学杂志, 2018, 18(2): 178-184. doi: 10.7507/1672-2531.201704048 复制

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1. Asefi S, Eskandarion S, Hamidiaval S. Fissure sealant materials: wear resistance of flowable composite resins. Dent Res Dent Clin Dent Prospect, 2016, 10(3): 194-199.
2. Bhushan U, Goswami M. Evaluation of retention of pit and fissure sealants placed with and without air abrasion pretreatment in 6-8 year old children-an in vivo study. J Clin Exp Dent, 2017, 9(2): 211-217.
3. Martin LS, Huertos-Marchante A, Galvan-Martos J, et al. Dental sealant knowledge, opinion, values and practice of Spanish dental hygienists. BMC Oral Health, 2017, 15(1): 46-52.
4. 刘怡然, 吴晓晗, 周红艳, 等. 第一恒磨牙窝沟封闭 3 年临床效果观察. 口腔医学, 2016, 36(8): 749-752.
5. 谢妮娜, 宋文婷, 魏路明, 等. 磷酸酸蚀结合流动树脂对年轻恒牙窝沟封闭的疗效分析. 口腔医学, 2015, 35(12): 1045-1048.
6. 张元, 周洲, 于金华. 流动树脂的研究进展. 口腔医学, 2016, 36(5): 475-477.
7. Jafarzadeh M, Malekafzali B, Tadayon N, et al. Retention of aflowable composite resin in comparison to a conventional resinbasedsealant: one-year follow-up. J Dent, 2010, 7(1): 1-5.
8. 史艳芬, 刘伟伟, 刘雪. 年轻恒牙应用不同窝沟封闭材料临床观察. 济宁医学院学报, 2015, 38(2): 114-116.
9. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med, 2002, 21(11): 1539-1558.
10. 俞少玲, 葛久禹, 杨如美, 等. 两种光固化材料行窝沟封闭术后 3 年临床效果. 广东牙病防治, 2008, 16(10): 448-449.
11. 刘海燕. 窝沟封闭剂与流体树脂的临床应用对比. 中国疗养医学, 2010, 19(8): 732-732.
12. 陈述, 王亚. 流动树脂与窝沟封闭剂对年轻恒牙封闭效果的临床评价. 华北煤炭医学院学报, 2011, 13(6): 812-813.
13. 李相如, 王海滨, 刘爱莲. 自酸蚀粘接剂结合流动树脂对年轻恒牙窝沟封闭的临床评. 口腔医学研究, 2011, 27(7): 603-605.
14. 邱利华. 流体树脂预防性充填和窝沟封闭的临床疗效观察. 临床医学与护理研究, 2011, 10(5): 22-23.
15. 蒲寒秋, 肖世芳, 勾京东. 3M Filtek Z350 流动树脂与 Pekaseal 光固化窝沟封闭剂预防儿童龋病的临床效果研究. 中国医药指南, 2013, 11(9): 39-40.
16. 王跃岩, 高朗. 两种窝沟封闭剂防治儿童龋病的疗效比较. 中国现代医生, 2013, 51(25): 138-139.
17. 张志银. 流体树脂预防性充填防龋疗效观察. 航空航天医学杂志, 2014, 25(7): 920-921.
18. 高丹. 光固化流体树脂与可见光固化窝沟封闭剂防治儿童龋病的疗效对比. 临床医学工程, 2014, 21(2): 177-178.
19. 韩静, 于洪波, 焦菲菲. 光固化流体树脂窝沟封闭防龋疗效的评价. 口腔医学, 2016, 36(2): 132-134.
20. Sundfeld D, Machado LS, Franco LM, et al. Clinical/photographic/scanning electron microscopy analysis of pit and fissure sealants after 22 years: a case series. Oper Dent, 2017, 42(1): 10-18.
21. Gawali PN, Chaugule VB, Panse AM. Comparison of microleakage and penetration depth between hydrophilic and ydrophobic sealants in primary second molar. Int J Clin Pediatr Den, 2016, 9(4): 291-295.
22. Erdemir U, Sancakli HS, Yaman BC, et al .Clinical comparison of a flowable composite and fissure sealant: a 24-month split-mouth, randomized, and controlled study. J Dent, 2013, 42(2): 149-157.