PDF(Pubmed)
Abstract：
Mineral Trioxide Aggregate (MTA) is the gold standard for vital pulp treatment (VPT), but its superiority over novel calcium silicate-based cements in permanent teeth lacks systematic evidence. This study aimed to compare the efficacy of these materials in VPT through a network meta-analysis. A systematic search was conducted in MEDLINE, EMBASE, Cochrane Library, and Web of Science until January 20, 2024. The inclusion criteria were randomized controlled trials involving VPT with biomaterials and reversible or irreversible pulpitis diagnoses in mature permanent teeth. The primary outcome was the odds ratio (OR) of failure rates with 95% confidence intervals. In the 21 eligible trials, failure rates were significantly higher with calcium-hydroxide than MTA at six (OR 2.26 [1.52-3.36]), 12 (OR 2.53 [1.76-3.62]), and 24 months (OR 2.46 [1.60-3.79]). Failure rates for Totalfill at six (OR 1.19 [0.55-2.58]) and 12 months (OR 1.43 [0.71-2.92]), and Biodentine at six (OR 1.09 [0.66-1.78]), 12 (OR 1.21 [0.74-1.96]), and 24 months (OR 1.47 [0.81-2.68]) were not significantly different from MTA. The results were similar in the direct pulp capping subgroup, whereas, in the partial and full pulpotomy subgroup, there was not enough evidence to achieve significant differences. MTA, Biodentine, and Totalfill are the most efficient materials for VPT. However, calcium-hydroxide-based materials are not recommended in VPT.
摘要：
三氧化二矿骨料（MTA）是重要纸浆治疗（VPT）的金标准，但是它在恒牙中优于新型硅酸钙基水泥缺乏系统的证据。本研究旨在通过网络荟萃分析比较这些材料在VPT中的功效。在MEDLINE进行了系统的搜索，EMBASE,科克伦图书馆,和WebofScience，直到2024年1月20日。纳入标准是随机对照试验，涉及生物材料的VPT和成熟恒牙的可逆或不可逆牙髓炎诊断。主要结果是失败率的比值比（OR），95%置信区间。在21项符合条件的审判中，氢氧化钙的失败率明显高于MTA的6（OR2.26[1.52-3.36]），12(OR2.53[1.76-3.62]),和24个月（OR2.46[1.60-3.79]）。6个月(OR1.19[0.55-2.58])和12个月(OR1.43[0.71-2.92])完全填充的故障率,和生物牙本质在6（OR1.09[0.66-1.78]），12(OR1.21[0.74-1.96])，24个月(OR1.47[0.81-2.68])与MTA无显著差异。直接盖髓亚组的结果相似，然而,在部分和完全牙髓切除术亚组中，没有足够的证据来实现显著差异.MTA,Biodentine,和Totalfill是最有效的VPT材料。然而,VPT中不推荐使用氢氧化钙基材料。
