| Objective: The root development and apical closure of immature permanent teeth relies on vital dental pulp in root canal.It's necessary to keep the exposed pulps of immature permanent teeth be vital as far as possible in order to avoid root development stopping whether iatrogenic or traumatic damage.The pulpotomy is one of the clinical common ways of preserving vital dental pulps.This study is a systematic review on different agents applicated for pulpotomy in immature permanent teeth by clinical randomized controlled trials,use Meta analysis method to compare the clinical curative effect between them.Methods:Computer combined with manual retrieval database as follows: Foreign language database:Pubmed,the Cochrane library,EMBASE database,EBSCO database;Chinese database:CNKI,CBM,VIP and Wanfang database.The literature of observation on the clinical curative effect about pulpotomy agents in immature permanent teeth were collected which include Chinese and English only.The retrieval time are built from the database begin to March 2017.Screen the included literature which were done by clinical randomized controlled trials and compare the clinical efficacy about two or more medicines applicated for pulpotomy agents in immature permanent teeth at the same time.Meta-analysis was performed by RevMan5.3 software.Results:Combining computer and manual retrieval,preliminary detected 1407 references of clinical trials about pulpotomy agents in immature permanent teeth which include 114 references from Pubmed database,257 references from Cochrane library,202 references from EMBASE database,225 references from EBSCO,183 references from CNKI,138 references from CBM,134 references from VIP,154 references from Wanfang database.After reading the title,abstract and full text filtering process,20 articles were finally included.According to the intervention of different medicines,there were four groups,the first experimental group was MTA and the control group was calcium hydroxide powder formulations,namely single-component calcium hydroxide;the second experimental group was MTA and the control group was Dycal paste;the third experimental group was the Vitapex paste and the control group was single component of calcium hydroxide;the fourth experimental group was MTA,and the control group was self-setting calcium phosphate cement.Meta analysis results in that the clinical curative effect of MTA was significantly higher than that of calcium hydroxide powder,and have significant difference OR=3.00,95% CI(1.57,5.70),the combined effect of inspection Z = 3.34,P = 0.0008;Comparison of the clinical curative effect of MTA and Dycal paste,MTA has significantly higher success rate than that of Dycal paste,and have significant difference OR=3.30,95% CI(1.95,5.57),the combined effect of inspection Z = 4.46,P < 0.00001;Comparison of the clinical curative effect of Vitapex paste and calcium hydroxide powder,Vitapex paste has significantly higher success rate than that of calcium hydroxide powder,and have significant difference OR=3.63,95 % CI(2.16,6.10),the combined effect of inspection Z = 4.85,P<0.00001;The first three groups were using random effects model for sensitivity analysis,the results were consistent with the fixed effects model results.Comparison of the clinical curative effect of MTA and self-setting calcium phosphate cement,there is not enough clinical evidence that relative merits because of less included literature.Conclusion:1.The quality of randomized controlled trials about pulpotomy agents in immature permanent teeth generally was low,and the standard of the included research was not fully unified and clinical curative effect evaluation index was relatively single,which made the study has poor homogeneity.So in the future it is necessary to formulate unified inclusion and exclusion criteria in clinical research and need more detailed evaluation index and need to increase multicenter and high quality clinical RCT to study pulpotomy agents in immature permanent teeth.2.The study of meta-analysis results showed that as pulpotomy agents in immature permanent teeth,MTA was significantly improved the success rate than that of calcium hydroxide powder and Dycal paste,and Vitapex paste was significantly improved the success rate than that of calcium hydroxide powde.There is not enough clinical evidence that relative merits about the clinical curative effect of MTA and self-setting calcium phosphate cement applicated for pulpotomy agents in immature permanent teeth,so it's still need high quality clinical randomized controlled trials for further research. |
PDF Full Text Request