背景:在乳牙中缺乏明确定义的根尖收缩引起了人们对用于测量工作长度的电子根尖定位器(EAL)的准确性的担忧。
目的:评估EAL在确定乳牙牙髓切除术工作长度方面的准确性。
方法:截至2021年9月,两名审阅者搜索了10个数据库。包括评估原发性牙髓切除术中工作长度电子测量准确性的临床研究。没有对照组的研究,样本小于十个根管,且未使用多频EAL的被排除。进行荟萃分析以评估通过电子和比较方法获得的测量之间的平均长度的成对差异。此外,根据测量值之间的差异水平对比例进行荟萃分析.使用QUADAS-2工具评估研究的偏倚风险和适用性。通过建议分级评估证据的确定性,评估,开发和评估(等级)方法。
结果:29项研究被纳入定性分析,23项研究被纳入定量分析。电子测量的比较方法是射线照相法,放射照相,扫描电子显微镜,直接可视化。荟萃分析表明,电子测量往往比射线照相测量短,而其他方法没有差异。比例分析显示在-0.5至+0.5mm(69.31%)内电子测量和比较测量之间的差值的合并比例较高。证据的确定性表明,对估计结果的信心很低。
结论:这篇综述的结果表明,EAL在确定乳牙牙髓切除术的工作长度方面表现良好。然而,这些结果是基于低方法学质量和高异质性的临床研究,这需要临床实践的仔细解释。
结论:尽管结果表明EAL在确定乳牙牙髓切除术的工作长度方面的准确性可接受,纳入研究的质量低且证据的确定性非常低,需要临床医师谨慎解释这些结果.需要更有力的证据来支持这些设备对乳牙是准确的。
背景:CRD42021277414(PROSPERO)。
BACKGROUND: The lack of a well-defined apical constriction in primary teeth raises concerns regarding the accuracy of electronic apex locators (EALs) for measuring working length.
OBJECTIVE: To evaluate the accuracy of EALs in determining working length in primary teeth pulpectomies.
METHODS: Two reviewers searched ten databases up to September 2021. Clinical studies evaluating the accuracy of the electronic measurement of working length in primary teeth pulpectomies were included. Studies without a comparison group, with samples smaller than ten root canals, and that did not use a multiple frequency EAL were excluded. A meta-analysis was conducted to assess the paired differences in mean lengths between measurements obtained by electronic and comparative methods. In addition, a meta-analysis of proportion was applied according to the level of difference between the measures. The risk of bias and applicability of the studies were assessed using the QUADAS-2 tool. The certainty of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
RESULTS: Twenty-nine studies were included in the qualitative analysis and twenty-three in the quantitative analysis. The methods of comparison for the electronic measurement were the radiographic method, radiovisiographic, scanning electron microscopy, and direct visualization. The meta-analysis showed that the electronic measurement tends to be shorter than radiographic measurement, while the other methods showed no difference. The proportion analysis showed a higher pooled proportion of difference values between electronic and comparative measurements within -0.5 to +0.5 mm (69.31%). The certainty of the evidence suggested very low confidence in estimating the outcome.
CONCLUSIONS: The results of this
review denote a good performance of the EALs in determining working length in primary teeth pulpectomies. However, these results are based on clinical studies with low methodological quality and high heterogeneity, which require careful interpretation for clinical practice.
CONCLUSIONS: Although the results suggest acceptable accuracy of EALs in determining working length in primary teeth pulpectomies, the low quality of the included studies and the very low certainty of the evidence require clinicians to interpret these results with caution. More robust evidence is required to support that these devices are accurate for primary teeth.
BACKGROUND: CRD42021277414 (PROSPERO).