Effect of Calcium Hydroxide as an Intracanal Medication on Dentine Fracture Resistance: A Systematic Review and Network Meta-Analysis.

IF 3.5 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Chayanit Sunlakawit, Chitpol Chaimanakarn, Natchalee Srimaneekarn, Sittichoke Osiri
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引用次数: 0

Abstract

Introduction: Bacterial infections necessitate effective root canal disinfection during endodontic therapy. Calcium hydroxide (CH), a widely used intracanal medication, shows conflicting effects on dentine fracture resistance in different studies. This study aimed to perform a comprehensive systematic review and network meta-analysis to evaluate the effects of CH on the fracture resistance of dentine in human teeth across different periods.

Methods: PubMed, EMBASE, MEDLINE (EBSCO), Cochrane Library, Scopus, Google Scholar, and ProQuest databases were exhaustively searched to identify studies published until February 29, 2024, with no language restrictions. Laboratory studies that investigated dentine fracture resistance in human permanent teeth following intracanal CH exposure were included. The risk of bias was evaluated using modified criteria derived from previous studies. Network meta-analysis was performed using the frequentist method. Prespecified subgroup analyses focused on simulating immature teeth.

Results: The search yielded 2,265 studies from all databases, and 27 met the inclusion criteria, involving 3,879 teeth or roots. The overall results from network meta-analysis indicated that CH affected the fracture resistance of human dentine. Subgroup analysis revealed that the duration influencing fracture resistance was ≥4 weeks for mature teeth, but no specific time limitation for immature teeth. The overall quality of the evidence showed a moderate to high risk of bias.

Conclusions: Short-term use of CH does not compromise human root dentine strength, supporting its routine application in clinical practice. CH remains a viable treatment strategy for over 4 weeks of medication needs but requires carefully considering the associated risks and benefits emphasizing on preservation and disease resolution.

Registration: PROSPERO database (CRD 42024513199).

氢氧化钙作为牙槽骨内药物对牙本质抗折性的影响:系统综述和网络荟萃分析。
引言细菌感染要求在牙髓治疗过程中进行有效的根管消毒。氢氧化钙(CH)是一种广泛使用的根管内药物,不同的研究显示其对牙本质抗折性的影响存在冲突。本研究旨在进行全面的系统综述和网络荟萃分析,以评估不同时期氢氧化钙对人类牙齿牙本质抗折性的影响:对 PubMed、EMBASE、MEDLINE (EBSCO)、Cochrane Library、Scopus、Google Scholar 和 ProQuest 数据库进行了详尽检索,以确定 2024 年 2 月 29 日之前发表的研究,语言不限。纳入了调查人类恒牙牙本质抗折性的实验室研究。根据以往研究的修改标准对偏倚风险进行了评估。采用频数法进行网络荟萃分析。预设的亚组分析侧重于模拟未成熟的牙齿:搜索结果显示,所有数据库中共有 2265 项研究,27 项符合纳入标准,涉及 3879 颗牙齿或牙根。网络荟萃分析的总体结果表明,CH 会影响人类牙本质的抗折断性。亚组分析表明,影响成熟牙齿抗折性的持续时间≥4周,但对未成熟牙齿没有具体的时间限制。证据的总体质量显示存在中度到高度的偏倚风险:短期使用CH不会影响牙根牙本质强度,支持其在临床实践中的常规应用。对于超过 4 周的用药需求,CH 仍然是一种可行的治疗策略,但需要仔细考虑相关的风险和益处,重点是保护和解决疾病问题。
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来源期刊
Journal of endodontics
Journal of endodontics 医学-牙科与口腔外科
CiteScore
8.80
自引率
9.50%
发文量
224
审稿时长
42 days
期刊介绍: The Journal of Endodontics, the official journal of the American Association of Endodontists, publishes scientific articles, case reports and comparison studies evaluating materials and methods of pulp conservation and endodontic treatment. Endodontists and general dentists can learn about new concepts in root canal treatment and the latest advances in techniques and instrumentation in the one journal that helps them keep pace with rapid changes in this field.
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