选择哪种去除的方法?
Jacqueline Fraser1, Andrew MacInnes2
1Dental Core Trainee 3 in Restorative Dentistry and Research, Glasgow Dental Hospital, Glasgow, UK. jacquelinefraser95@gmail.com.
Evidence-based dentistry
|January 22, 2024
概括
对于永久牙的深腔,建议进行选择性或逐步的牙切除,比非选择性切除提供更好的结果. 选择性去除显示了短期的优势,而长期的结果在各种方法中都是可比的.
科学领域:
- 牙科 牙科是指牙科的专业.
- 皮肤病学 皮肤病学 皮肤病学
- 恢复性牙科 恢复性牙科
背景情况:
- 永久牙的深层牙 presents一个临床挑战,关于牙组织去除的程度.
- 传统的非选择性除可能会增加脉暴露的风险,并损害恢复寿命.
- 保守的方法,如选择性和逐步的除,旨在保持纸活力和改善治疗结果.
研究的目的:
- 系统地审查和比较非选择性,选择性和阶段性牙去除在永久牙深病变的有效性.
- 评估临床结果,如恢复寿命,边际完整性和脉活力,基于不同的虫除去策略.
主要方法:
- 在PubMed/MEDLINE和Web of Science数据库中进行系统的文献搜索 (2008年1月 - 2023年1月) 查找英语随机对照试验.
- 纳入标准:RCT比较总和选择性/逐步切除的永久牙与深层虫,至少6个月的随访.
- 数据提取和偏差风险评估遵循PRISMA指南和Cochrane风险偏差工具.
主要成果:
- 五项随机对照试验 (2010-2021) 符合资格标准,随访时间从1个月到5年.
- 三项研究报告了统计学上显著的差异,有利于选择性或逐步消除长寿,边际完整性和成功率.
- 选择性去除表明短期内 (1.5年) 脉暴露的风险较低,结果与5年后非选择性去除相似.
结论:
- 对于深层病变,不建议进行非选择性除,因为它们具有侵入性和脉暴露的风险.
- 选择性和逐步牙切除被认为是管理永久牙深牙的保守和有效方法.
- 选择性去除似乎是最佳的短期管理选择,而长期成功率在保守方法中是可比的.
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