纤维桩和金属螺纹桩修复效果的系统评价

上海口腔医学 ›› 2014, Vol. 23 ›› Issue (2): 237-242.

纤维桩和金属螺纹桩修复效果的系统评价

张胜楠¹, 杜庆², 韩凉¹, 刘萍¹, 李婷¹, 张莉莉¹

1.济南市口腔医院修复科, 山东济南 230001;
2.济南市第四人民医院急救中心, 山东济南 230013

收稿日期:2013-07-19 出版日期:2014-04-20 发布日期:2014-05-21
作者简介:张胜楠(1983-), 女, 硕士, E-mail:nancybaby-001@163.com杜庆, E-mail:duqing0325@126.com

Fiber post versus metal screw post for repair of residual crowns and roots: a systematic review

ZHANG Sheng-nan¹, DU Qing², HAN Liang¹, LIU Ping¹, LI Ting¹, ZHANG Li-li¹

1.Department of Prosthodontics, Jinan Stomatological Hospital. Jinan 250001;
2. Department of Emergency, No.4 People’s Hospital of Jinan. Jinan 250010, Shandong Province, China

Received:2013-07-19 Online:2014-04-20 Published:2014-05-21

摘要/Abstract

摘要： 目的: 系统评价纤维桩和金属螺纹桩修复残根、残冠的效果。方法: 计算机检索MEDLINE(Ovid)、PubMed、The Cochrane Libary、Embase、万方、维普、CNKI和CBM等数据库, 检索时限均从建库至2013年6月, 收集比较纤维桩和金属螺纹桩修复残根、残冠的随机对照试验(RCT)。由2名研究者对纳入研究进行资料提取和质量评价后, 采用RevMan 5.1.0软件和GRADEprofiler 3.2.2软件进行数据分析。结果: 共纳入10个RCT, 其中英文1篇, 中文9篇。Meta分析4个主要结局的结果显示, 纤维桩与金属螺纹桩比较, 纤维桩修复成年恒牙和年轻恒牙的留存率均显著高于金属螺纹桩, 根折发生率差异显著。桩脱落发生率、牙龈炎发生率差异无显著性。每个结局的GRADE系统推荐分级均为低等级。结论: 利用纤维桩进行修复较金属螺纹桩保存率高, 根折发生率低。但纳入研究较少, 样本量小, 质量不高且研究方法有差异, 需要今后开展更多经过科学设计、大样本量、多中心的RCT研究予以证实。

关键词: 纤维桩, 金属螺纹桩, 残根, 残冠, 随机对照试验, 系统评价, Meta分析

Abstract: PURPOSE:To evaluate the restorative effectiveness of fiber post versus metal screw post through systematical review. METHODS: Randomized controlled trials (RCTs) data from the establishment of the database up to June 2013 were searched from MEDLINE (Ovid), PubMed, The Cochrane Library, Embase, Wanfang Data, VIP, CNKI and CBM using the designed strategy. After data extraction and quality review of the retrieved articles by two independent investigators, the softwares of RevMan 5.1.0 and GRAED profiler 3.2.2 were employed to process data analysis. RESULTS: Ten RCTs were finally included, of which 1 was English literature and 9 were Chinese literatures. Meta analysis suggested that the survival rate of repair of adult and young permanent teeth was significantly higher using fiber post than metal screw post , and the results root fracture rate was significantly lower . No significant difference was found in the rate of post-core fall off and gingivitis . All outcomes were of low quality in the GRADE system. CONCLUSIONS:Compared with metal screw post, the survival rate is significantly higher and the root fracture rate is significantly lower by using fiber post. However, the conclusion is limited by lack of relevant studies, small sample sizes, inadequate quality and diversified methodology. Further study is needed by employing more well-designed, large-sample and multi-center RCTs to verify the conclusion.

Key words: Fiber post, Metal screw post, Residual crown, Residual roots, Randomized controlled trial, Systematic review, Meta-analysis

中图分类号:

R783.3

张胜楠, 杜庆, 韩凉, 刘萍, 李婷, 张莉莉. 纤维桩和金属螺纹桩修复效果的系统评价[J]. 上海口腔医学, 2014, 23(2): 237-242.

ZHANG Sheng-nan, DU Qing, HAN Liang, LIU Ping, LI Ting, ZHANG Li-li. Fiber post versus metal screw post for repair of residual crowns and roots: a systematic review[J]. Shanghai Journal of Stomatology, 2014, 23(2): 237-242.

参考文献

[1] 赵铱民.口腔修复学[M]. 第6版. 北京: 人民卫生出版社, 2008: 5-6.
[2] Hochman N, Zalkind M. New all-ceramic indirect post-and-core system [J]. J Prosthet Dent, 1999, 81(5): 625-629.
[3] Schmitter M, Hamadi K, Rammelsberg P. Survival of two post systems-five-year results of a randomized clinical trial[J]. Quintessence intl, 2011, 42(10): 843-850.
[4] 付振君, 贾宏薇, 王丽玲, 等. 玻璃纤维桩核与金属桩核修复残根残冠临床比较研究 [J]. 中国伤残医学, 2009, 17(3): 60-62.
[5] 任丽萍, 谢伟丽, 李天侠, 等. 不同桩核在残根残冠修复中的疗效比较 [J]. 现代生物医学进展, 2012, 12(20): 3928-3929.
[6] 刘启成, 牛卫东, 刘智新. 后牙残根和残冠三种桩核冠修复的疗效观察 [J]. 吉林大学学报(医学版), 2009, 35(4): 630-631.
[7] 周磊, 臧艳君, 符大勇, 等. 三种形式桩核冠修复后临床疗效观察[J]. 广西医学, 2008, 30(2): 196-197.
[8] 孙琦. 石英纤维桩在年轻恒前牙冠折中应用的疗效观察 [J]. 中国实用医药, 2012, 7(11): 117-118.
[9] 王春风, 吴占敖, 吴纲, 等. 玻璃纤维桩修复下颌前磨牙残根、残冠的临床疗效 [J]. 东南国防医, 2010, 12(3): 209-211.
[10] 蔡永海, 卢长寿. 三种形式桩核冠修复的临床疗效观察 [J]. 口腔颌面修复学杂志, 2010, 11(5): 285-287.
[11] 郅洁云, 张凤英. 玻璃纤维桩修复年轻恒牙外伤冠折的体会 [J]. 实用口腔医学杂志, 2008, 24(1): 134-135.
[12] 韩菲. 外伤儿童恒牙两种桩核修复的临床观察 [J]. 实用医学杂志, 2010, 26(4): 608.
[13] Monticelli F, Goracci C, Ferrari M. Micromorphology of the fiber post-resin core unit: a scanning electron microscopy evaluation[J]. Dent Mater, 2004, 20(2): 176-183.
[14] Stewardson DA. Non-metal post systems [J]. Dent Update, 2001, 28(7): 326-336.
[15] O’Keefe KL, Miller BH, Powers JM. In vitro tensile bond strength of adhesive cements to new post materials[J]. Int J Prosthodont, 2000, 13(1): 47-51.
[16] Ottl P, Hahn L, Lauer HCh, et al. Fracture characteristics of carbon fiber, ceramic and non-palladium endodontic post systems at monotonously increasing loads [J]. J Oral Rehabil, 2002, 29(2): 175-183.