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目的系统评价复合树脂间接修复和直接充填方法对后牙缺损患者修复的临床疗效。方法计算机检索The Cochrane Library(2016年12期)、PubMed、EMbase、WanFang Data、CBM和CNKI数据库,查找复合树脂间接修复和直接充填方法对后牙缺损患者修复疗效的随机对照试验(RCT),检索时限均为从建库至2016年12月。由2名评价员独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果共纳入9个RCT,包括671例患者,1 012例患牙,其中间接修复组544例,直接充填组468例。Meta分析结果显示:复合树脂间接修复和直接充填对后牙缺损患者总修复失败率差异无统计学意义[RR=0.91,95%CI(0.52,1.58),P=0.73]。按修复失败原因进一步分析,两组因修复体折裂[RR=1.71,95%CI(0.76,3.84),P=0.19]和因剩余牙尖折裂[RR=1.27,95%CI(0.62,2.59),P=0.52]导致的修复失败率差异均无统计学意义。直接充填组发生继发龋的可能性高于间接修复组[RR=0.33,95%CI(0.13,0.85),P=0.02]。按前磨牙和磨牙修复牙位进行亚组分析,两组修复失败率差异均无统计学意义。结论复合树脂间接修复和直接充填对后牙缺损患者修复的临床疗效相当。受纳入研究的数量和质量限制,上述结论尚需更多高质量、大样本的随机对照试验予以验证。
Objective To evaluate the clinical effect of composite resin indirect repair and direct filling on the repair of posterior teeth defect. Methods The Cochrane Library (2016 Issue 12), PubMed, EMbase, WanFang Data, CBM and CNKI databases were searched to find out the randomized controlled trials (RCTs) of the composite resin indirect and direct filling methods in repairing the posterior teeth defect. The deadline is from the construction of the library to December 2016. After two reviewers independently screened the literature, extracted data, and assessed the risk of being included in the study, Meta-analysis was performed using Rev Man 5.3 software. Results A total of 9 RCTs were included, including 671 patients and 1 012 teeth. Among them, 544 were indirect repair and 468 were direct injection. The results of Meta analysis showed that there was no significant difference in the total failure rate between CAD and indirect implants [RR = 0.91,95% CI (0.52,1.58), P = 0.73]. According to further analysis of the causes of the failure, the two groups were fractured by the prosthesis (RR = 1.71, 95% CI 0.76, 3.84, P = 0.19) and the remaining cusp fractures [RR = 1.27,95% CI 2.59), P = 0.52] failed to repair the failure rate differences were not statistically significant. The incidence of secondary caries in the direct-filling group was higher than that in the indirect-repair group [RR = 0.33, 95% CI (0.13, 0.85), P = 0.02]. According to the analysis of the premolar and molars, the difference between the two groups in repair failure rate was not statistically significant. Conclusion The composite resin indirect repair and direct filling in the repair of patients with posterior teeth defect clinical efficacy. Due to the quantity and quality limitations of the studies included, the above conclusion still needs more high-quality, large-scale randomized controlled trials to be verified.