活髓保存治疗在成熟恒牙不可复性牙髓炎治疗中的临床效果的Meta分析  

A meta-analysis of the clinical effects of vital pulp therapy in the treatment of irreversible pulpitis in mature permanent teeth

作　　者：孙新新 米拉·巴合提 王梦琪 张蓓[1,2] 耿继文 刘佳 SUN Xin-xin;MI La baheti;WANG Meng-qi;ZHANG Bei;GENG Ji-wen;LIU Jia(Pediatric Stomatology-Oral prophylaxis,The First Affiliated Hospital of Xinjiang Medical University(Affiliated Stomatological Hospital),Xinjiang Urumqi 830054,China;Xinjiang Uygur Autonomous Region Institute of Stomatology,Xinjiang Urumqi 830054,China.)

机构地区：[1]新疆医科大学第一附属医院(附属口腔医院)儿童口腔科-口腔预防科,新疆乌鲁木齐830054 [2]新疆维吾尔自治区口腔医学研究所,新疆乌鲁木齐830054

出　　处：《临床口腔医学杂志》2024年第12期758-762,共5页Journal of Clinical Stomatology

基　　金：中国牙病防治基金会“爱笑少年”科研项目(A2021-056)。

摘　　要：目的:对活髓保存治疗(vital pulp therapy, VPT)在治疗成熟恒牙不可复性牙髓炎的临床效果及冠髓切断术和部分冠髓切断术两种活髓保存术式的疗效差异的Meta分析。方法:在PubMed、EMbase、Web of science、The Cochrane Library、CNKI、万方、维普、中国生物医学文献数据库等数据库,查找有关比较VPT与根管治疗术用于成熟恒牙不可复性牙髓炎的随机对照试验(randomized controlled trials, RCT),检索时限均为建库至2024年9月。采用RevMan5.4.1软件进行固定效应模型分析。结果:共纳入了11项RCTs, 2121颗恒牙。结果显示:VPT与根管治疗术在治疗成熟恒牙不可复性牙髓炎的成功率方面无统计学差异(P=0.66,I~2=0%),长期临床成功率相当;患者报告的术后第7天疼痛发生率VPT与根管治疗术无统计学差异(P=0.91,I~2=0%);对比部分冠髓切断术与冠髓切断术的成功率发现,结果无统计学差异(P=0.77,I~2=0%)。结论:当前证据显示,VPT可能成为潜在的治疗成熟恒牙不可复性牙髓炎的一种可行方案。部分冠髓切断术兼具微创的优势,可以获得与冠髓切断术相当的效果。但本研究也存在一定的局限性,仍需大量高质量的临床研究。Objective:The present study aims to conduct a meta-analysis on the clinical effectiveness of vital pulp therapy(VPT)in the treatment of irreversible pulpitis in mature permanent teeth.Methods:Databases such as PubMed,EMbase,Web of Science,The Cochrane Library,CNKI,Wanfang,VIP and China Biology Medicine(CBM)were searched for randomized controlled trials(RCTs)comparing VPT with root canal therapy for irreversible pulpitis in mature permanent teeth,with a retrieval period from the inception of the databases to September 2024.RevMan 5.4.1 software was used for fixed-effects model analysis.Results:A total of 11 RCTs involving 2,121 permanent teeth were included.The results showed no statistical difference in success rates between VPT and root canal therapy in treating irreversible pulpitis in mature permanent teeth(P=0.66,I2=0%),indicating comparable long-term clinical success rates.There was also no statistical difference in patient-reported pain incidence on the 7th day after surgery between VPT and root canal therapy(P=0.91,I2=0%).When comparing the success rates of partial pulpotomy with coronal pulpotomy,no statistical difference was found(P=0.77,I2=0%).Conclusion:Current evidence suggests that VPT may be a potential feasible program for the treatment of irreversible pulpitis in mature permanent teeth.Partial pulpotomy,with its minimally invasive advantage,can achieve comparable effects to coronal pulpotomy.However,this study also has certain limitations,and further high-quality clinical research is needed.

关 键 词：活髓保存治疗(VPT) 根管治疗术 成熟恒牙 不可复性牙髓炎 META分析 

分 类 号：R781.05[医药卫生—口腔医学]