排龈膏和排龈线在固定义齿修复中应用的系统评价

目的：评价排龈膏和排龈线在固定义齿修复中对牙龈保护、牙体预备、印模清晰度及修复体适合性的作用。方法：检索中国生物医学文献数据库、维普数据库、中国期刊全文数据库和万方数据库；同时手工检索纳入文献的参考文献及中文口腔医学杂志。偏倚风险评价由2位评价者使用Cochrane协作网推荐的标准独立完成，同时独立进行数据提取。运用Revman 5.1软件进行Meta分析。结果：共纳入9篇随机对照试验，涉及患者1153例，9个研究均为中度偏倚风险。Meta分析结果显示，排龈膏能够明显保护基牙牙龈健康[RR=1.05，95% CI (1.00,1.11)，P=0.04]，提高临床医师对牙体预备满意度[RR=1.17，95% CI (1.07,1.28)，P=0.0008]，提高印模及模型清晰度[RR=1.08，95% CI(1.03,1.13)，P=0.0009]，且与排龈线相比，有相似的修复体适合性[RR=1.07，95% CI (0.96,1.19)，P=0.21]。结论：排龈膏在保护基牙牙龈健康、提高口腔医师对牙体预备满意度和提高印模及模型清晰度方面优于传统排龈线，在提高修复体适合性上也不逊色于传统排龈线，但还需要多的临床随机对照试验予以验证。

Gingival retraction paste versus gingival retraction cord for fixed prosthodontics: a systematic review

PURPOSE: To assess the efficacy of gingival retraction paste versus gingival retraction cord in fixed prosthodontics on gingiva protection, tooth preparation, clarity of the impression and plaster model, and aptness of the prosthesis. METHODS: Chinese BioMedical Literature Database, VIP, China National Knowledge Infrastructure (CNKI) and Wangfang database were searched on November 15th 2012 for eligible studies. Hand-searching included references of the included studies and Chinese dental journals. Risk of bias of the included studies was assessed by 2 reviewers independently using Cochrane Collaboration’s tool, and data extraction was done by the 2 reviewers. Meta analysis was performed with Revman 5.1 software. RESULTS: Nine randomized controlled trials, involving 1153 participants, were included. All of them had moderate risk of bias. Meta analysis revealed that gingival retraction paste had better effect on gingival health [RR=1.05, 95%CI (1.00, 1.11), P=0.04], tooth preparation [RR=1.17, 95%CI (1.07, 1.28), P=0.0008] and clarity of the impression and plaster model [RR=1.08, 95%CI (1.03, 1.13), P=0.0009] than gingival retraction cord, and the aptness of the prosthesis was as good as the cord [RR=1.07, 95%CI (0.96, 1.19), P=0.21]. CONCLUSIONS: The gingival retraction paste has better effect on gingival health, tooth preparation and clarity of the impression and plaster model, while the aptness of the prosthesis is as good as the cord and can be considered as a good candidate of the gingival retraction cord, but more randomized controlled trials are needed.