国际口腔医学杂志

国际口腔医学杂志 ›› 2023, Vol. 50 ›› Issue (2): 177-185.doi: 10.7518/gjkq.2023005

• 论著 • 上一篇    下一篇

牙髓血运重建术和根尖诱导成形术疗效对比的Meta分析

李转转1(),格根塔娜1,2()   

  1. 1.内蒙古医科大学口腔医学院 呼和浩特 010059
    2.内蒙古医科大学附属医院口腔科 呼和浩特 010050
  • 收稿日期:2022-02-13 修回日期:2022-07-19 出版日期:2023-03-01 发布日期:2023-03-14
  • 通讯作者: 格根塔娜
  • 作者简介:李转转，医师，硕士，Email：158787309@qq.com

OSID）

revascularization Meta-analysis of the efficacy comparison between endodontic1(),Zhuanzhuan apexification Li1,2()   

  1. 1.School of Stomatology, Inner Mongolia Medical University, Hohhot 010059, China
    2.Dept. of Stomatology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China
  • Received:2022-02-13 Revised:2022-07-19 Online:2023-03-01 Published:2023-03-14
  • Contact: apexification Li Zhuanzhuan

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摘要：

目的 采用 Meta 分析探讨牙髓血运重建术和根尖诱导成形术治疗年轻恒牙牙髓不可逆性损伤的疗效。 方法 从外文数据库（PubMed、Embase、Cochrane library）和中文数据库（中国知网、中国生物医学文献服务系统、万方和维普）中检索2001年1月—2021年10月公开发表的关于2种方法治疗年轻恒牙牙髓不可逆性损伤的随机对照试验研究（RCT），并由2名成员严格按照纳入和排除标准独立进行筛选、数据提取和质量评价，采用RevMan 5.3和 STATA 12.0软件进行Meta分析。 结果 最终纳入19篇RCT研究，Meta分析结果显示牙髓血运重建术治疗年轻恒牙牙髓不可逆性损伤成功率显著高于根尖诱导成形术（P<0.05），且在促进管壁厚度增加（P<0.05）、牙根延长（P<0.05）并发症的发生率（P<0.05）方面更有优势。 结论 与根尖诱导成形术相比，牙髓血运重建术的成功率更高，且在促进牙根发育方面的疗效更佳。

关键词: Meta分析, 年轻恒牙, 牙髓不可逆性损伤, 牙髓血运重建术, 根尖诱导成形术

Abstract:

Objective To explore the efficacy of pulp revascularization and apexification in the treatment of irrever-sible pulp damage in young permanent teeth by Meta-analysis. Methods Foreign language databases (PubMed, Embase, and Cochrane library) and Chinese databases (China National Knowledge Infrastructure, SinoMed, Wanfang, and VIP) were searched from January 2001 to October 2021 for the randomized controlled trial (RCT) of two methods for the treatment of irreversible damage to young permanent dental pulp. The screening, data extraction, and quality evaluation were conducted by two members of the research team independently and in strict accordance with the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.3 and STATA 12.0 software. Results A total of 19 RCT studies were included, and the results of the meta-analysis showed the significantly higher success rate of pulp revascularization in the treatment of irreversible damage to the pulp of young permanent teeth compared with that of apexification (P<0.05). Pulp revascularization also promoted the increase in tube wall thickness (P<0.05), root extension (P<0.05), and the incidence of complications (P<0.05). Conclusion Pulp revascularization has a higher success rate and a better efficacy in promoting root development than apexification.

Key words: Meta-analysis, young permanent teeth, irreversible damage to the dental pulp, pulp revascularization, apexification

中图分类号: 

  • R 781.34

图 1

文献筛选流程图"

表 1

纳入研究患者的基线特征"

参考

文献

发表时

间/年

随机

方法

病例

总数

病程/d年龄/岁总有效率/%结局指标
研究组对照组研究组对照组研究组对照组

[13]

[17]

[1]

[24]

[22]

[21]

[20]

[23]

[25]

[2]

[14]

[16]

[10]

[15]

[11]

[18]

[12]

[19]

[26]

2020

2018

2021

2019

2018

2019

2019

2020

2017

2020

2018

2018

2021

2017

2020

2017

2017

2017

2017

①

①

①

①

②

②

①

②

①

①

①

①

①

①

③

④

①

②

⑤

80

136

84

74

74

80

86

76

100

78

84

78

120

67

64

96

80

78

103

28.00±0.34

—

—

—

4.90±1.70

1.70±0.30

—

8.50±2.90

8.20±1.20

8.30±1.70

9.52±1.12

—

—

9.47±0.94

—

3.52±0.66

3.62±0.65

5.51±0.74

—

27.00±0.31

—

—

—

5.40±2.10

1.50±0.20

—

8.60±2.50

8.50±1.50

8.60±1.30

9.49±1.04

—

—

8.69±0.67

—

3.65±0.85

3.56±0.74

5.47±0.72

—

12.10±1.20

10.51±1.09

10.54±0.96

13.14±1.32

13.12±1.10

12.70±0.30

12.30±3.50

13.60±2.40

12.30±2.20

11.20±1.30

11.58±2.14

11.18±2.66

9.42±1.73

12.03±2.18

7~14

9.61

9.27

9.18±2.14

6~18

12.12±1.20

10.20±1.31

10.33±0.82

13.25±1.29

12.73±2.20

12.50±3.20

11.90±3.20

12.50±2.30

11.40±2.50

11.50±1.10

11.6±2.24

11.12±2.13

9.53±1.83

12.03±2.18

7~14

9.04

9.04

9.21±2.16

6~18

80.00

77.49

78.57

83.78

81.08

62.00

81.40

73.68

—

82.05

76.19

76.92

75.00

75.76

75.00

83.00

85.00

76.92

97.00

85.00

94.12

95.24

97.30

94.59

95.00

95.35

94.74

—

97.44

92.86

94.87

90.00

94.12

93.75

97.90

97.50

94.87

89.80

①②

①②④

①②

①②

①②

①②

①②

①②④

②

①②④

①②④

①②④

①②

①②

①②③④

①②③

①②③

①②③

①②③

表 2

纳入文献的风险偏倚评估"

参考

文献

随机

分组

分配

隐藏

盲法

数据

完整

选择

报告

其他

偏倚

[10]212222
[11]012222
[12]212222
[13]212222
[14]212222
[15]212222
[16]212222
[17]212222
[18]012222
[19]212222
[20]112222
[21]112222
[2]212222
[22]112222
[1]212222
[23]112222
[24]212222

[25]

[26]

2

2

1

1

2

2

2

2

2

2

2

2

图 2

牙髓血运重建术和根尖诱导成形术总成功率的比较"

图 3

2种方法治疗前管壁厚度的比较"

图 4

2种方法治疗后管壁厚度的比较"

图 5

2种方法治疗前牙体长度的比较"

图 6

2种方法治疗后牙体长度的比较"

图 7

2种方法治疗后并发症发生率的比较"

图 8

2种方法治疗总成功率比较的漏斗图"

图 9

剪补后的漏斗图"

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[1] 张新春. 桩冠修复与无髓牙的保护[J]. 国际口腔医学杂志, 1999, 26(06): .
[2] 王昆润. 长期单侧鼻呼吸对头颅发育有不利影响[J]. 国际口腔医学杂志, 1999, 26(05): .
[3] 彭国光. 颈淋巴清扫术中颈交感神经干的解剖变异[J]. 国际口腔医学杂志, 1999, 26(05): .
[4] 杨凯. 淋巴化疗的药物运载系统及其应用现状[J]. 国际口腔医学杂志, 1999, 26(05): .
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[6] 柴枫. 可摘局部义齿用Co-Cr合金的激光焊接[J]. 国际口腔医学杂志, 1999, 26(04): .
[7] 孟姝,吴亚菲,杨禾. 伴放线放线杆菌产生的细胞致死膨胀毒素及其与牙周病的关系[J]. 国际口腔医学杂志, 2005, 32(06): 458 -460 .
[8] 费晓露,丁一,徐屹. 牙周可疑致病菌对口腔黏膜上皮的粘附和侵入[J]. 国际口腔医学杂志, 2005, 32(06): 452 -454 .
[9] 赵兴福,黄晓晶. 变形链球菌蛋白组学研究进展[J]. 国际口腔医学杂志, 2008, 35(S1): .
[10] 庞莉苹,姚江武. 抛光和上釉对陶瓷表面粗糙度、挠曲强度及磨损性能的影响[J]. 国际口腔医学杂志, 2008, 35(S1): .