{"title":"有无化学机械制剂辅助的抗逆转录病毒疗法：系统综述。","authors":"Luísa Buoro da Silva, Marcela Baraúna Magno, Andréa Fonseca-Gonçalves, Andréa Vaz Braga Pintor","doi":"10.1007/s00784-024-05931-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether the use of chemo-mechanical carious tissue removal (CMCTR) agents is effective for Atraumatic Restorative Treatment (ART).</p><p><strong>Materials and methods: </strong>Searches were conducted in 6 databases for inclusion of clinical studies. Risk of bias was assessed (RoB 2 and ROBINS-I), a meta-analysis was performed with data from time of carious tissue removal (TCTR), and the certainty of evidence was estimated. ART + CMCTR was compared to ART for the treatment of caries lesions in primary teeth (pt) and permanent teeth (PT) of humans, considering acceptability, pain/discomfort, survival and success of restorations (SSR), Oral Health-Related Quality of life (OHRQol), satisfaction, TCTR, total treatment time (TTT), carious tissue removal efficacy and adverse effects.</p><p><strong>Results: </strong>Of 12 included studies, 4 showed low risk of bias, considering pain, TTT and TCTR outcomes. ART + CMCTR was similar or more accepted than ART for pt, causing similar or less pain/discomfort for both dentitions. There was no difference in SSR, OHRQol for PT, and adverse effects (pt), although greater satisfaction was reported after ART + CMCTR in case of PT. ART + CMCTR was better or as effective as ART in removing carious tissue (pt). TTT for pt was divergent between the groups, but without difference of TCTR for both, pt and PT (MD 0.11 [-1.56, 1.77] p = 0.90, I <sup>2</sup> =93%).</p><p><strong>Conclusions: </strong>In general, ART + CMCTR is effective, providing greater satisfaction, with no difference in SSR, OHRQol and adverse effects compared to ART, which did not present advantages in relation to pain/discomfort and efficacy in removing carious tissue. The TTT was influenced by the CMCTR agent; however, there was no difference for TCTR in the overall quantitative synthesis with Papacárie DuoGel<sup>®</sup>.</p><p><strong>Clinical relevance: </strong>The use of chemo-mechanical agents for carious tissue removal in the ART may benefit patients with reduced pain/discomfort.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"28 11","pages":"581"},"PeriodicalIF":3.1000,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"ART with or without the aid of chemo-mechanical agents: a systematic review.\",\"authors\":\"Luísa Buoro da Silva, Marcela Baraúna Magno, Andréa Fonseca-Gonçalves, Andréa Vaz Braga Pintor\",\"doi\":\"10.1007/s00784-024-05931-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To investigate whether the use of chemo-mechanical carious tissue removal (CMCTR) agents is effective for Atraumatic Restorative Treatment (ART).</p><p><strong>Materials and methods: </strong>Searches were conducted in 6 databases for inclusion of clinical studies. Risk of bias was assessed (RoB 2 and ROBINS-I), a meta-analysis was performed with data from time of carious tissue removal (TCTR), and the certainty of evidence was estimated. ART + CMCTR was compared to ART for the treatment of caries lesions in primary teeth (pt) and permanent teeth (PT) of humans, considering acceptability, pain/discomfort, survival and success of restorations (SSR), Oral Health-Related Quality of life (OHRQol), satisfaction, TCTR, total treatment time (TTT), carious tissue removal efficacy and adverse effects.</p><p><strong>Results: </strong>Of 12 included studies, 4 showed low risk of bias, considering pain, TTT and TCTR outcomes. ART + CMCTR was similar or more accepted than ART for pt, causing similar or less pain/discomfort for both dentitions. There was no difference in SSR, OHRQol for PT, and adverse effects (pt), although greater satisfaction was reported after ART + CMCTR in case of PT. ART + CMCTR was better or as effective as ART in removing carious tissue (pt). TTT for pt was divergent between the groups, but without difference of TCTR for both, pt and PT (MD 0.11 [-1.56, 1.77] p = 0.90, I <sup>2</sup> =93%).</p><p><strong>Conclusions: </strong>In general, ART + CMCTR is effective, providing greater satisfaction, with no difference in SSR, OHRQol and adverse effects compared to ART, which did not present advantages in relation to pain/discomfort and efficacy in removing carious tissue. The TTT was influenced by the CMCTR agent; however, there was no difference for TCTR in the overall quantitative synthesis with Papacárie DuoGel<sup>®</sup>.</p><p><strong>Clinical relevance: </strong>The use of chemo-mechanical agents for carious tissue removal in the ART may benefit patients with reduced pain/discomfort.</p>\",\"PeriodicalId\":10461,\"journal\":{\"name\":\"Clinical Oral Investigations\",\"volume\":\"28 11\",\"pages\":\"581\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2024-10-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Oral Investigations\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00784-024-05931-9\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Oral Investigations","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00784-024-05931-9","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
目的研究化学机械龋坏组织去除剂（CMCTR）在创伤性修复治疗（ART）中的应用是否有效：在 6 个数据库中搜索临床研究。对偏倚风险进行了评估（RoB 2 和 ROBINS-I），利用龋坏组织去除时间（TCTR）数据进行了荟萃分析，并对证据的确定性进行了估计。在考虑可接受性、疼痛/不适感、修复体的存活率和成功率（SSR）、与口腔健康相关的生活质量（OHRQol）、满意度、TCTR、总治疗时间（TTT）、龋坏组织去除效果和不良反应等因素后，对 ART + CMCTR 与 ART 治疗人类乳牙（pt）和恒牙（PT）龋病进行了比较：在纳入的 12 项研究中，考虑到疼痛、TTT 和 TCTR 结果，4 项研究的偏倚风险较低。ART + CMCTR与ART相比，对pt的接受度相似或更高，对两种牙的疼痛/不适感相似或更低。在 SSR、PT 的 OHRQol 和不良反应（pt）方面没有差异，但 ART + CMCTR 对 PT 的满意度更高。ART + CMCTR 在去除龋坏组织方面的效果更好，甚至与 ART 的效果相当。各组间pt的TTT存在差异，但pt和PT的TCTR均无差异（MD 0.11 [-1.56, 1.77] p = 0.90, I 2 =93%）：总的来说，ART + CMCTR 是有效的，能提供更高的满意度，在 SSR、OHRQol 和不良反应方面与 ART 相比没有差异，而 ART 在疼痛/不适和去除龋坏组织的效果方面没有优势。TTT受CMCTR剂的影响；但在与Papacárie DuoGel®的总体定量综合中，TCTR没有差异：临床相关性：在 ART 中使用化学机械制剂去除龋坏组织可减轻患者的疼痛/不适感。
ART with or without the aid of chemo-mechanical agents: a systematic review.
Objectives: To investigate whether the use of chemo-mechanical carious tissue removal (CMCTR) agents is effective for Atraumatic Restorative Treatment (ART).
Materials and methods: Searches were conducted in 6 databases for inclusion of clinical studies. Risk of bias was assessed (RoB 2 and ROBINS-I), a meta-analysis was performed with data from time of carious tissue removal (TCTR), and the certainty of evidence was estimated. ART + CMCTR was compared to ART for the treatment of caries lesions in primary teeth (pt) and permanent teeth (PT) of humans, considering acceptability, pain/discomfort, survival and success of restorations (SSR), Oral Health-Related Quality of life (OHRQol), satisfaction, TCTR, total treatment time (TTT), carious tissue removal efficacy and adverse effects.
Results: Of 12 included studies, 4 showed low risk of bias, considering pain, TTT and TCTR outcomes. ART + CMCTR was similar or more accepted than ART for pt, causing similar or less pain/discomfort for both dentitions. There was no difference in SSR, OHRQol for PT, and adverse effects (pt), although greater satisfaction was reported after ART + CMCTR in case of PT. ART + CMCTR was better or as effective as ART in removing carious tissue (pt). TTT for pt was divergent between the groups, but without difference of TCTR for both, pt and PT (MD 0.11 [-1.56, 1.77] p = 0.90, I 2 =93%).
Conclusions: In general, ART + CMCTR is effective, providing greater satisfaction, with no difference in SSR, OHRQol and adverse effects compared to ART, which did not present advantages in relation to pain/discomfort and efficacy in removing carious tissue. The TTT was influenced by the CMCTR agent; however, there was no difference for TCTR in the overall quantitative synthesis with Papacárie DuoGel®.
Clinical relevance: The use of chemo-mechanical agents for carious tissue removal in the ART may benefit patients with reduced pain/discomfort.
期刊介绍：
The journal Clinical Oral Investigations is a multidisciplinary, international forum for publication of research from all fields of oral medicine. The journal publishes original scientific articles and invited reviews which provide up-to-date results of basic and clinical studies in oral and maxillofacial science and medicine. The aim is to clarify the relevance of new results to modern practice, for an international readership. Coverage includes maxillofacial and oral surgery, prosthetics and restorative dentistry, operative dentistry, endodontics, periodontology, orthodontics, dental materials science, clinical trials, epidemiology, pedodontics, oral implant, preventive dentistiry, oral pathology, oral basic sciences and more.
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