Hall技术治疗乳磨牙龋坏疗效的系统评价
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摘要
目的:评价Hall技术用于治疗乳磨牙龋坏的疗效。方法:计算机检索Cochrane图书馆(Cochrane Library)、PUBMED、荷兰医学文摘数据库(Excerpta Medical Database,Embase)、中国知网(China National Knowledge Infrastructure,CNKI)、中国生物医学文献数据库(China Biology Medicine disc,CBM)、维普数据库(VIP database,VIP)、万方数据库(Wanfang Database),同时对检索结果的参考文献进行检索,检索时间均为建库至2018年3月20日,搜集Hall技术和其他技术对比治疗乳磨牙龋坏的随机对照试验(randomized controlled trials,RCTs)。两位研究者对检索结果进行独立质量评估和数据提取,用RevMan 5.3软件进行分析,并采用GRADEpro 3.6软件对证据质量进行评价。结果:共纳入6个RCTs涉及Hall技术与其他4种方法的对比。结果显示,Hall技术与传统金属预成冠技术和改良Hall技术(Carisolv去龋+Hall技术)治疗乳磨牙龋坏疗效比较差异无统计学意义(P>0.05);Hall技术与常规充填和非修复方式治疗乳磨牙龋坏疗效比较差异有统计学意义(P<0.05)。定量证据质量评价分级(The Grading of Recommendations Assessment,Development and Evaluation,GRADE)显示,4组Meta分析结局质量为中或低。结论:Hall技术无需局部麻醉、不去龋、不备牙的方法治疗儿童乳磨牙龋坏疗效好,在临床应用中有一定优势,但还需更多高质量RCTs支持。
Objective:To assess the efficacy of the Hall technique on carious primary molars.Methods:The Cochrane Library,PUBMED,Embase,CNKI,CBM,VIP and Wanfang Database(from the date of establishment of the databases to March 20,2018)were searched for RCTs on the Hall technique for carious primary molars.References of the included studies were also checked.Quality assessment and data extraction were performed by two reviewers independently.Metaanalysis was performed by RevMan5.3,and the evidences were graded by GRADEpro3.6.Results:Six studies involving the Hall technique and the other 4 methods were included.The results showed that there was no statistically significant difference of efficacy between the Hall technique and traditional crown technique or the improved Hall technique(P>0.05).The results showed the efficacy of the Hall technique was better than conventional restorations and nonrestorative caries treatment(P<0.05).The qualities of evidence for outcomes of the four groups were rated as moderate or low.Conclusion:The Hall technique with no local anesthesia,no caries removal,and no teeth preparation has excellent curative effects,and it has some advantages in clinical application.But more high-quality RCTs are needed.
Objective:To assess the efficacy of the Hall technique on carious primary molars.Methods:The Cochrane Library,PUBMED,Embase,CNKI,CBM,VIP and Wanfang Database(from the date of establishment of the databases to March 20,2018)were searched for RCTs on the Hall technique for carious primary molars.References of the included studies were also checked.Quality assessment and data extraction were performed by two reviewers independently.Metaanalysis was performed by RevMan5.3,and the evidences were graded by GRADEpro3.6.Results:Six studies involving the Hall technique and the other 4 methods were included.The results showed that there was no statistically significant difference of efficacy between the Hall technique and traditional crown technique or the improved Hall technique(P>0.05).The results showed the efficacy of the Hall technique was better than conventional restorations and nonrestorative caries treatment(P<0.05).The qualities of evidence for outcomes of the four groups were rated as moderate or low.Conclusion:The Hall technique with no local anesthesia,no caries removal,and no teeth preparation has excellent curative effects,and it has some advantages in clinical application.But more high-quality RCTs are needed.
引文
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[16]高朋杰,潘多,魏丽,等.HALL技术结合Carisolv修复乳磨牙大面积缺损的临床研究[J].中国美容医学,2014,23(2)∶154-156
[17]王帅,高玉光,刘玉三,等.3种方式修复乳磨牙大面积缺损的临床疗效[J].口腔疾病防治,2018,26(2)∶109-112
[18]徐娟.儿童乳磨牙修复中传统预成冠技术与HALL技术应用的效果对比[J].中国社区医师,2017,33(27)∶88-89
[19]郑忠立,王朝阳,李柄辉,等.牙周病与结直肠癌发病风险相关性的Meta分析[J].中国循证医学杂志,2018,18(3)∶300-304
[20]Innes NP,Evans DJ,Bonifacio CC,et al.The hall technique 10years on:questions and answers[J].Br Dent J,2017,222(6)∶478-483
[21]Hashim Nainar SM.Success of hall technique crowns questioned[J].Pediatr Dent,2012,34(2)∶103
[22]Clark W,Geneser M,Owais A,et al.Success rates of Hall technique crowns in primary molars:a retrospective pilot study[J].Gen Dent,2017,65(5)∶32-35
[23]Vand ZV,van Amerongen WE.Short communication:Influence of preformed metal crowns(Hall technique)on the occlusal vertical dimension in the primary dentition[J].Eur Arch Paediatr Dent,2010,11(5)∶225-227
[2]田芝娟,黄蕊,何翔,等.乳磨牙龋坏对前磨牙萌出的影响[J].口腔医学研究,2018,34(4)∶367-370
[3]Gruythuysen RJ.Non-restorative cavity treatment.Managing rather than masking caries activity[J].Ned Tijdschr Tandheelkd,2010,117(3)∶173-180
[4]葛立宏.儿童口腔医学[M].第4版.北京:人民卫生出版社,2012∶116-128
[5]Ricketts DN,Pitts NB.Traditional operative treatment options[J].Monogr Oral Sci,2009,21(3)∶164-173
[6]郑黎薇,邹静,夏斌,等.儿童乳磨牙金属预成冠的修复治疗[J].国际口腔医学杂志,2017,44(2)∶125-129
[7]Innes NP,Stirrups DR,Evans DJP,et al.A novel technique using preformed metal crowns for managing carious primary molars in general practice-A retrospective analysis[J].Br Dent J,2006,200(8)∶451-454
[8]Higgins JP,Green S.Cochrane handbook for systematic reviews of interventions version 5.1.0(updated March 2011)[M].Chichester,UK:John Wiley&Sons Ltd,2011
[9]王骥,邝亦元,周铸民.Hall技术治疗乳磨牙龋齿的临床研究[J].华夏医学,2017,30(3)∶90-92
[10]罗杰.系统评价/Meta分析理论与实践[M].第1版.北京:军事医学科学出版社,2013∶97-117
[11]曾宪涛,冷卫东,李胜,等.如何正确理解及使用GRADE系统[J].中国循证医学杂志,2011,11(9)∶985-990
[12]Innes NP,Evans Dafydd JP,Stirrups DR.The Hall Technique;a randomized controlled clinical trial of a novel method of managing carious primary molars in general dental practice:acceptability of the technique and outcomes at 23months[J].BMC Oral Health,2007,7(1)∶18
[13]Innes NP,Evans DJ,Stirrups DR.Sealing caries in primary molars:Randomized control trial,5-year results[J].J Dent Res,2011,90(12)∶1405-1410
[14]Santamaria RM,Innes NP,Machiulskiene V,et al.Caries management strategies for primary molars:1-Yr randomized control trial results[J].J Dent Res,2014,93(11)∶1062-1069
[15]Santamaria RM,Innes NP,Machiulskiene V,et al.Alternative caries management options for primary molars:2.5-year outcomes of a randomised clinical trial[J].Caries Res,2017,51(6)∶605-614
[16]高朋杰,潘多,魏丽,等.HALL技术结合Carisolv修复乳磨牙大面积缺损的临床研究[J].中国美容医学,2014,23(2)∶154-156
[17]王帅,高玉光,刘玉三,等.3种方式修复乳磨牙大面积缺损的临床疗效[J].口腔疾病防治,2018,26(2)∶109-112
[18]徐娟.儿童乳磨牙修复中传统预成冠技术与HALL技术应用的效果对比[J].中国社区医师,2017,33(27)∶88-89
[19]郑忠立,王朝阳,李柄辉,等.牙周病与结直肠癌发病风险相关性的Meta分析[J].中国循证医学杂志,2018,18(3)∶300-304
[20]Innes NP,Evans DJ,Bonifacio CC,et al.The hall technique 10years on:questions and answers[J].Br Dent J,2017,222(6)∶478-483
[21]Hashim Nainar SM.Success of hall technique crowns questioned[J].Pediatr Dent,2012,34(2)∶103
[22]Clark W,Geneser M,Owais A,et al.Success rates of Hall technique crowns in primary molars:a retrospective pilot study[J].Gen Dent,2017,65(5)∶32-35
[23]Vand ZV,van Amerongen WE.Short communication:Influence of preformed metal crowns(Hall technique)on the occlusal vertical dimension in the primary dentition[J].Eur Arch Paediatr Dent,2010,11(5)∶225-227