PDF(Sci-hub)
Abstract：
Adequate hemostasis is a critical step in endodontic surgery. It facilitates the procedure and affects the success and prognosis of the operation. This systematic review and network meta-analysis (NMA) aimed to systematically assess the efficacy of hemostatic agents in endodontic surgery and to identify the most effective ones.
PubMed, Scopus, Embase, Cochrane Library, Web of Science, ProQuest, and EBSCOhost databases were searched up to December 2020. We included randomized controlled trials (RCTs) evaluating the efficacy of different hemostatic measures in endodontic surgery, and their risk of bias was assessed using Cochrane\'s randomized trial tool (RoB 2.0). Frequentist network meta-analysis was conducted, with Odds Ratios and 95% confidence intervals (OR, 95% CI) as effect estimates using the \"netmeta\" package in R. The quality of evidence was assessed using the CINeMA approach.
Six RCTs involving 353 patients (mean age 48.12 y) were included. NMA revealed that aluminum chloride achieved higher hemostatic efficacy than epinephrine (OR = 2.55, 95% CI [1.41, 4.64]), while there was non-significant difference when compared with PTFE strips + epinephrine (OR = 1.00, 95% CI [0.35, 2.90]), electrocauterization (OR = 2.67, 95% CI [0.84, 8.46]), or ferric sulfate (OR = 8.65, 95% CI [0.31, 240.92]). Of all hemostatic agents, aluminum chloride ranked first in control bleeding during endodontic surgery (P-score = 0.84), followed by PTFE strips + epinephrine (P-score = 0.80), electrocauterization (P-score = 0.34), epinephrine (P-score = 0.34), ferric sulfate (P-score = 0.18). The quality of evidence was very low.
Based on the limited data, aluminum chloride provides better hemostasis than epinephrine, while there was no significant difference between the remaining hemostatic agents used in endodontic surgery, which could help clinicians choose the hemostatic agent that achieves adequate hemostasis. achieve adequate hemostasis. Given insufficient evidence, future RCTs addressing this evidence gap are required.
PubMed, Scopus, Embase, Cochrane Library, Web of Science, ProQuest, and EBSCOhost databases were searched up to December 2020. We included randomized controlled trials (RCTs) evaluating the efficacy of different hemostatic measures in endodontic surgery, and their risk of bias was assessed using Cochrane\'s randomized trial tool (RoB 2.0). Frequentist network meta-analysis was conducted, with Odds Ratios and 95% confidence intervals (OR, 95% CI) as effect estimates using the \"netmeta\" package in R. The quality of evidence was assessed using the CINeMA approach.
Six RCTs involving 353 patients (mean age 48.12 y) were included. NMA revealed that aluminum chloride achieved higher hemostatic efficacy than epinephrine (OR = 2.55, 95% CI [1.41, 4.64]), while there was non-significant difference when compared with PTFE strips + epinephrine (OR = 1.00, 95% CI [0.35, 2.90]), electrocauterization (OR = 2.67, 95% CI [0.84, 8.46]), or ferric sulfate (OR = 8.65, 95% CI [0.31, 240.92]). Of all hemostatic agents, aluminum chloride ranked first in control bleeding during endodontic surgery (P-score = 0.84), followed by PTFE strips + epinephrine (P-score = 0.80), electrocauterization (P-score = 0.34), epinephrine (P-score = 0.34), ferric sulfate (P-score = 0.18). The quality of evidence was very low.
Based on the limited data, aluminum chloride provides better hemostasis than epinephrine, while there was no significant difference between the remaining hemostatic agents used in endodontic surgery, which could help clinicians choose the hemostatic agent that achieves adequate hemostasis. achieve adequate hemostasis. Given insufficient evidence, future RCTs addressing this evidence gap are required.
摘要：
充分的止血是牙髓手术的关键步骤。它有助于手术并影响手术的成功和预后。本系统综述和网络荟萃分析（NMA）旨在系统地评估止血剂在牙髓手术中的疗效，并确定最有效的止血剂。
PubMed,Scopus,Embase,科克伦图书馆,WebofScience,ProQuest,和EBSCOhost数据库进行了搜索，直到2020年12月。我们纳入了评价不同止血措施在牙髓手术中疗效的随机对照试验(RCT),他们的偏倚风险使用Cochrane的随机试验工具(RoB2.0)进行评估.进行了频繁的网络荟萃分析，具有赔率比和95%置信区间(OR，95%CI）作为使用R中的“netmeta”软件包的效果估计。使用CINeMA方法评估证据质量。
纳入6个RCT，涉及353例患者（平均年龄48.12岁）。NMA显示氯化铝的止血效果高于肾上腺素（OR=2.55,95%CI[1.41,4.64]），而与PTFE条+肾上腺素相比无显著差异(OR=1.00,95%CI[0.35,2.90]),电灼烧（OR=2.67，95%CI[0.84，8.46]），或硫酸铁（OR=8.65，95%CI[0.31，240.92]）。在所有止血剂中,氯化铝在牙髓手术期间的控制出血中排名第一（P评分=0.84），其次是PTFE条+肾上腺素（P分数=0.80），电灼烧（P分数=0.34），肾上腺素（P分数=0.34），硫酸铁（P分数=0.18）。证据质量很低。
基于有限的数据，氯化铝提供比肾上腺素更好的止血，虽然在牙髓手术中使用的其余止血剂之间没有显着差异，这可以帮助临床医生选择达到足够止血的止血剂。达到足够的止血。鉴于证据不足,未来需要解决这一证据差距的RCT。
PubMed,Scopus,Embase,科克伦图书馆,WebofScience,ProQuest,和EBSCOhost数据库进行了搜索，直到2020年12月。我们纳入了评价不同止血措施在牙髓手术中疗效的随机对照试验(RCT),他们的偏倚风险使用Cochrane的随机试验工具(RoB2.0)进行评估.进行了频繁的网络荟萃分析，具有赔率比和95%置信区间(OR，95%CI）作为使用R中的“netmeta”软件包的效果估计。使用CINeMA方法评估证据质量。
纳入6个RCT，涉及353例患者（平均年龄48.12岁）。NMA显示氯化铝的止血效果高于肾上腺素（OR=2.55,95%CI[1.41,4.64]），而与PTFE条+肾上腺素相比无显著差异(OR=1.00,95%CI[0.35,2.90]),电灼烧（OR=2.67，95%CI[0.84，8.46]），或硫酸铁（OR=8.65，95%CI[0.31，240.92]）。在所有止血剂中,氯化铝在牙髓手术期间的控制出血中排名第一（P评分=0.84），其次是PTFE条+肾上腺素（P分数=0.80），电灼烧（P分数=0.34），肾上腺素（P分数=0.34），硫酸铁（P分数=0.18）。证据质量很低。
基于有限的数据，氯化铝提供比肾上腺素更好的止血，虽然在牙髓手术中使用的其余止血剂之间没有显着差异，这可以帮助临床医生选择达到足够止血的止血剂。达到足够的止血。鉴于证据不足,未来需要解决这一证据差距的RCT。
