冠修复与直接生物材料填充牙齿生存率的Meta分析

背景：临床研究表明,根管治疗后冠修复能有效防止牙齿折裂。目的：应用系统评价的方法分析冠修复是否提高不同材料填充根管治疗后牙齿的长期成功率。方法：通过Medline数据库和手动检索1980/2010有关根管治疗后冠修复的相关文献,根据纳入和排除标准,分两步选择适用文献12篇进行质量评估。对＂失败＂作了统一的定义,作为统一的研究结果。对文献进行均衡性检测,将各文献数据合并计算出根管治疗后冠修复的总体平均成功率。结果与结论：所有文献按0～1标准的平均加权质量分为0.607,将各篇文献的质量分分别作为其合并样本量的权数。根管治疗后冠修复的5篇文献10年生存率为80%。根管治疗后生物材料直接充填的文献8篇,10年生存率仅为65%（直接充填的材料包括复合树脂和银汞合金）。说明根管治疗后冠修复的牙齿10年成功率较高,而直接生物材料填充仅能在短期内获得较满意的效果。

Meta-analysis of survival rate of crown restoration and direct biomaterial filing

BACKGROUND：Clinical studies show that after root canal therapy,crown prosthesis can effectively prevent the teeth from jackknifing.OBJECTIVE：To verify whether crown restoration can increase long-term survival rate of teeth treated by root canal therapy using different materials through a systematic review.METHODS：Papers referring to single crowns on endodontically treated teeth were located by a MEDLINE search and hand searching.In accordance with inclusive and exclusive criteria,12 papers were selected in a two-step procedure and were subjected to quality assessment.The ＂failure＂ was given uniform definition,as the investigation results.After a homogeneity test,the mean overall success rates of crown restoration following root canal therapy were calculated by pooling the data from the studies.RESULTS AND CONCLUSION：On a 0-1 scale,the weighed overall mean quality score of the studies was 0.607.The quality score was used as weight for pooling the samples studies.These data showed a 10-year survival rate of 80% for five studies of crown restoration after root canal therapy and a 10-year survival rate of 65% for eight studies of direct biomaterials filling（resin composites,amalgam） after root canal therapy.Root canal therapy restored with crowns shows an acceptable long-term survival of 10 years,while direct biomaterials restorations have a satisfactory survival only for a short period.