国际口腔医学杂志

国际口腔医学杂志 ›› 2024, Vol. 51 ›› Issue (2): 176-186.doi: 10.7518/gjkq.2024036

• 论著 • 上一篇    下一篇

生物陶瓷材料iRoot BP Plus与三氧化矿物聚合物在活髓切断术中疗效对比的Meta分析

杨岩朵(),陈红,许祖达,赵媛()   

  1. 兰州大学口腔医学院 兰州 730000
  • 收稿日期:2023-05-09 修回日期:2023-12-20 出版日期:2024-03-01 发布日期:2024-03-11
  • 通讯作者: 赵媛
  • 作者简介:杨岩朵，医师，硕士，Email：Yangyd21@lzu.edu.cn
  • 基金资助:
    甘肃省卫生健康行业科研项目(GSWSKY2023-33);兰州大学医学教育创新发展项目(lzuyxcx-2022-166)

A meta-analysis of the efficacy between bioceramic material iRoot BP Plus and mineral trioxide aggregate in pulpo-tomy

Yanduo Yang(),Hong Chen,Zuda Xu,Yuan Zhao()   

  1. School of Stomatology, Lanzhou University, Lanzhou 730000, China
  • Received:2023-05-09 Revised:2023-12-20 Online:2024-03-01 Published:2024-03-11
  • Contact: Yuan Zhao
  • Supported by:
    Research Projects in the Healthcare Industry in Gansu Province(GSWSKY2023-33);Lanzhou University Medical Education Innovation and Development Project(Lzuyxcx-2022-166)

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摘要：

目的 比较生物陶瓷材料iRoot BP Plus与三氧化矿物聚合物（MTA）用作牙齿活髓切断术盖髓剂的疗效差异。 方法 检索PubMed、Web of Science、Cochrane Library、CNKI、万方数据库和维普数据库中收录的iRoot BP Plus与MTA用于牙齿活髓切断术治疗的随机对照试验（RCT），检索时间为数据库建库至2023年3月。由2名成员严格按照纳入和排除标准独立进行筛选，结局指标包括临床成功率、盖髓操作时间、牙本质桥形成率及牙变色率。利用Cochrane偏倚风险评价工具进行文献质量评价，使用Stata 15.0软件对被纳入的文献进行Meta分析。 结果 最终纳入18篇RCT，Meta分析结果显示：1）术后 3、6、12个月iRoot BP Plus组与MTA组之间临床成功率的差异无统计学意义（P>0.05）；2）iRoot BP Plus组的盖髓操作时间明显小于MTA组（P<0.05）；3）术后3个月，iRoot BP Plus组的牙本质桥形成率高于MTA组（P<0.05）；4）末次随访iRoot BP Plus组牙变色率显著低于MTA组（P<0.05）。 结论 iRoot BP Plus用于牙齿活髓切断术的临床成功率与MTA相近，但较MTA盖髓操作时间更短，发生牙变色的概率更低。

关键词: Meta分析, 活髓切断术, 生物陶瓷材料, iRoot BP Plus, 三氧矿物聚合物, 盖髓材料

Abstract:

Objective This study aims to compare the efficacy of iRoot BP Plus and MTA as pulp capping agents for vital pulp therapy. Methods Randomized controlled trials (RCTs) of iRoot BP Plus and MTA in the treatment of pulpo-tomy were searched in PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP databases from the establishment to March 2023. Two members conducted independent screening according to the inclusion and exclusion criteria. The outcome indicators included clinical success rate, pulp capping operation time, dentin bridge formation rate, and tooth discoloration rate. The Cochrane bias risk assessment tool was used to evaluate the quality of the literature, and Stata 15.0 was used for meta-analysis. Results A total of 18 RCTs were included. The results of meta-analysis showed 1) no significant difference in the clinical success rate between iRoot BP Plus group and MTA group at 3, 6, and 12 months after the operation (P> 0.05). 2) The operation time of iRoot BP Plus was significantly shorter than that of MTA (P<0.05). 3)The formation rate of dentin calcified bridge in the iRoot BP Plus group was higher than that in the MTA group at 3 months after the operation (P<0.05). 4) At the last follow-up, the tooth discoloration rate of the iRoot BP Plus group was significantly lower than that of the MTA group (P<0.05). Conclusion The clinical success rate of iRoot BP Plus for pulpotomy is similar to that of MTA, but it has shorter pulp-capping operation time and lower probability of tooth discoloration than MTA pulp capping.

Key words: meta-analysis, pulpotomy, bioceramic material, iRoot BP Plus, mineral trioxide aggregate, pulp capping material

中图分类号: 

  • R781.05

表 1

Pubmed检索式"

序号检索式
#1“pulpotomy”[Mesh Terms]
#2“vital pulp therapy”[Title/Abstract] OR“pulp capping”[Title/Abstract]
#3#1 OR #2
#4(“iRoot BP Plus”[Title/Abstract] OR “iRoot BP”[Title/Abstract] OR “Endosequence Root Repair Material”[Title/Abstract]) OR (“MTA”[Title/Abstract] OR “Mineral Trioxide Aggregate”[Title/Abstract] OR “bioceramic”[Title/Abstract] OR “MTA cement”[Title/Abstract] OR “aggregate ProRoot”[Title/Abstract] OR “ProRoot MTA”[Title/Abstract])
#5“randomized controlled trial”[Title/Abstract] OR “randomized controlled study”[Title/Abstract] OR “clinical trial”[Title/Abstract] OR “clinical study”[Title/Abstract]
#6#3 AND #4 AND #5

图 1

文献筛选流程图"

表 2

纳入文献的基本情况"

作者发表年随访时间/月随机方法样本数/例年龄/岁患牙类型露髓原因活髓切断术式是否行橡皮障隔离术结局指标
iRoot BP PlusMTAiRoot BP PlusMTA
张海龙等[13]20223、6、12③30306~177~18年轻恒牙外伤部分冠髓切断术是①②④
梁秋娟等[14]20183、6④8080——年轻恒牙深龋全部冠髓切断术否①
方溢云等[15]202112③4040

14.83.6

13.23.4

成熟恒牙深龋全部冠髓切断术是①④
赵燕霞等[16]202112②5051

9.131.2

9.191.6

年轻恒牙外伤不明是①③④
翟利云[17]20193、6②2525

10.191.71

10.321.62

年轻恒牙深龋不明不明①②④
雷金霞等[18]20193、6②40408~108~10年轻恒牙外伤全部冠髓切断术否①③④
Kiranmayi等[19]20223、6、12①30304~94~9乳磨牙深龋全部冠髓切断术是①
杜姣等[20]20203、6、12①45473~73~7乳磨牙深龋全部冠髓切断术是①
钱芳等[21]20213、6、12①4545——成熟恒牙深龋部分冠髓切断术是①
王菲菲等[22]20223、6、12②7574

7.241.06

7.181.02

乳磨牙深龋全部冠髓切断术是①②④
王爽等[23]20223、6、12①26263~83~8乳磨牙深龋全部冠髓切断术是①
杨京宇等[24]20223、6、12②3535

6.611.25

6.421.16

乳磨牙深龋全部冠髓切断术否①④
向珊珊等[25]20193、6、12①2020

6.271.23

6.581.19

乳磨牙深龋全部冠髓切断术否①②
张小芳等[26]20226、12①41417~117~11年轻恒牙外伤全部冠髓切断术是①④
刘鹏等[27]20226②40503~83~8乳磨牙深龋全部冠髓切断术是①
李文文等[28]202212①7173

9.311.06

9.591.12

年轻恒牙外伤不明是①②③④
严恒[29]202012①23207~117~11年轻恒牙龋或外伤部分冠髓切断术是①④
钱锟等[30]202212①222116~5921~55成熟恒牙深龋不明是①④

表 3

纳入文献的偏倚风险评估"

纳入文献随机化过程中的偏倚干预分配干预依从结局数据缺失偏倚结局测量偏倚结果选择性报告偏倚
张海龙等[13]①②②③③③
梁秋娟等[14]①①①③③②
方溢云等[15]①①①③③②
赵燕霞等[16]②①②③③②
翟利云[17]②①②②③③
雷金霞等[18]②②②③③③
Kiranmayi等[19]③③③②③③
杜姣等[20]③②②②③③
钱芳等[21]③②②③③③
王菲菲等[22]②②②②③③
王爽等[23]③③③③③③
杨京宇等[24]②②②③③③
向珊珊等[25]③②②③③③
张小芳等[26]③②②③③③
刘鹏等[27]②②②②③③
李文文等[28]③②②②③②
严恒[29]③②②③③③
钱锟等[30]③③③③③③

图 2

iRoot BP Plus组与MTA组临床成功率的比较A：随访3个月；B：随访6个月；C随访12个月。"

图 3

iRoot BP Plus与MTA临床成功率比较的漏斗图A：随访3个月；B：随访6个月；C：随访12个月。SE：标准误。"

图 4

术后12个月，iRoot BP Plus与MTA临床成功率比较的亚组分析A：患牙的类型；B：牙髓炎的病因；C：牙髓切断术式；D：操作过程是否行橡皮障隔离术。"

图 5

iRoot BP Plus与MTA盖髓操作时间的比较"

图 6

随访3个月iRoot BP Plus与MTA牙本质钙化桥形成率的比较"

图 7

iRoot BP Plus与MTA牙变色率的比较A：森林图；B：漏斗图；C：剔除有发表偏倚的4篇研究后的森林图。"

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