本文選題：根管沖洗劑 + MTAD��； 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:目前對(duì)于根管沖洗劑的研究大多拘泥于MTAD與次氯酸鈉的各自原始研究上,研究指出兩者存在去除玷污層、殺滅細(xì)菌以及溶解牙髓這三點(diǎn)共性,基于此本文通過(guò)循證醫(yī)學(xué)系統(tǒng)評(píng)價(jià)的方法來(lái)客觀判定MTAD能否取代(部分取代)次氯酸鈉在臨床上的使用,探索MTAD與次氯酸鈉在玷污層去除能力以及殺菌能力方面能否替代;對(duì)MTAD與次氯酸鈉在玷污層去除能力、殺滅糞腸球菌能力、殺菌有效率三者的差異進(jìn)行統(tǒng)計(jì)學(xué)假設(shè)檢驗(yàn);方法:通過(guò)檢索Pubmed、Embase、Ovid MEDLINE(R)In-ProcessOther Non-Indexed Citations,Ovid MEDLINE(R)Daily and Ovid MEDLINE(R)(via.ovid)、Cochranelibrary、CNKI、WANFANGDATA、SinoMed等數(shù)據(jù)庫(kù),并手工檢索山西醫(yī)科大學(xué)圖書(shū)館以及山西醫(yī)科大學(xué)口腔醫(yī)院牙周科藏書(shū),相關(guān)會(huì)議文獻(xiàn),以及所有納入研究的參考文獻(xiàn)。嚴(yán)格按照PICOS原則、納入和排除標(biāo)準(zhǔn),對(duì)所納入文獻(xiàn)進(jìn)行數(shù)據(jù)提取以及偏倚風(fēng)險(xiǎn)評(píng)估。分別選擇SMD、OR作為效應(yīng)量指標(biāo)對(duì)MTAD與次氯酸鈉之間玷污層去除能力以及其殺菌有效率采用revman5.3進(jìn)行META分析。當(dāng)50%I275%對(duì)其實(shí)驗(yàn)設(shè)計(jì)、實(shí)驗(yàn)器械及實(shí)驗(yàn)地點(diǎn)進(jìn)行分析,未能找到者選擇隨機(jī)效應(yīng)模型,謹(jǐn)慎接受結(jié)果;當(dāng)I275%且異質(zhì)性無(wú)法找出之者,進(jìn)行描述性系統(tǒng)評(píng)價(jià)報(bào)道各個(gè)文獻(xiàn)的研究過(guò)程及結(jié)果,對(duì)效應(yīng)量不進(jìn)行合并,采用Greadpro3.6.1對(duì)結(jié)局指標(biāo)進(jìn)行評(píng)級(jí),使用AMSTAR量表評(píng)估方法學(xué)。結(jié)果:本課題共檢出文章220篇,經(jīng)過(guò)初篩剩余文獻(xiàn)21篇,復(fù)篩之后排除6篇,最終納入15篇,對(duì)照組與試驗(yàn)組總共483例樣本,根據(jù)各結(jié)局指標(biāo)分組,分別進(jìn)行META分析及系統(tǒng)評(píng)價(jià),META分析結(jié)果顯示:在玷污層去除能力納入4項(xiàng)研究,樣本共計(jì)60例,其合并效應(yīng)量95%可信區(qū)間是:-1.58[-2.35,-0.82],Z檢驗(yàn)結(jié)果Z=4.07,P0.0001,說(shuō)明在次氯酸鈉組與MTAD組在玷污層去除能力上差異具有統(tǒng)計(jì)學(xué)意義;殺滅糞腸球菌能力納入研究3項(xiàng),樣本量在103例,其合并效應(yīng)量95%CI:0.26[-0.14,0.65],其結(jié)果P=0.2,說(shuō)明研究結(jié)果次氯酸鈉組與MTAD組在殺滅糞腸球菌能力上差異不具有統(tǒng)計(jì)學(xué)意義;抑菌環(huán)直徑納入研究4項(xiàng),樣本量100例,因異質(zhì)性為96%故放棄合并統(tǒng)計(jì)量的計(jì)算,轉(zhuǎn)作描述性評(píng)價(jià),針對(duì)異質(zhì)性討論結(jié)果來(lái)說(shuō),本課題并未將四者做合并,而是分述四者的結(jié)果統(tǒng)計(jì):Tay組未通過(guò)無(wú)效線,95%CI:3.89[2.62,5.17];而李新軍組通過(guò)無(wú)效線,95%CI:-0.43[-1.15,0.30];于鑫未通過(guò)無(wú)效線,95%CI:16.17[11.10,21.23];Torabinejad,通過(guò)無(wú)效線,95%CI:0.36[-0.63,1.35];在殺菌有效率OR這一指標(biāo)中,納入研究4項(xiàng),樣本量共計(jì)220例,其合并效應(yīng)量Z=4.72、95%CI:14.80[4.84,45.29],說(shuō)明在次氯酸鈉組與MTAD組在殺菌有效率上差異具有統(tǒng)計(jì)學(xué)意義。結(jié)論:通過(guò)META分析可以得出:MTAD在玷污層去除能力和殺菌有效率就目前資料來(lái)說(shuō)是優(yōu)于次氯酸鈉,兩者在殺滅糞腸球菌能力上不認(rèn)為有差別;對(duì)于兩者在抑菌環(huán)指標(biāo)上所展現(xiàn)的性能優(yōu)劣,就目前所獲的資料中尚不能得出一個(gè)如是或者否一樣有明確意義的清晰結(jié)論。
[Abstract]:Objective: at present, most of the studies on root canal flushing agents are based on the original studies of MTAD and sodium hypochlorite. The results show that there are three commonalities in removing smear layer, killing bacteria and dissolving dental pulp. Based on this, this paper objectively determines whether MTAD can replace (partially replaced) sodium hypochlorite in clinical use, and explores whether MTAD and sodium hypochlorite can be substituted in the removal of smear layer and bactericidal ability through the method of Evidence-based medicine system evaluation. The differences of MTAD and sodium hypochlorite removal ability in smear layer, killing ability of Enterococcus faecalis and bactericidal efficiency were tested by statistical hypothesis. The library of Shanxi Medical University and the dental department of Stomatology Hospital of Shanxi Medical University were searched by hand. Data extraction and bias risk assessment are performed according to PICOS principles, inclusion and exclusion criteria. The removal ability of smear layer between MTAD and sodium hypochlorite and its bactericidal efficiency were analyzed by META with revman5.3. When 50% of I275% analyzed the design of the experiment, the instrument and the site of the experiment, the person who failed to find the random effect model and accepted the result cautiously, when I 275% and the heterogeneity could not be found, The research process and results of each literature were evaluated by descriptive systematic evaluation. The effect quantity was not combined. Greadpro3.6.1 was used to grade the outcome index and AMSTAR scale was used to evaluate the methodology. Results: a total of 220 articles were detected, 21 articles were screened, 6 articles were excluded after screening again, and 15 articles were included. 483 samples were collected from the control group and the experimental group, and were grouped according to each outcome index. The results of META analysis and systematic evaluation showed that the removal ability of smear layer was included in 4 studies, and 60 samples were collected. The 95% confidence interval of the combined effect was: 1: -1.58 [-2.35- 0.82] Z test results showed that in sodium hypochlorite group and MTAD group, there was statistical difference in the ability of smear layer removal, the ability of killing Enterococcus faecalis was included in the study, the sample size was 103 cases. The combined effect of 95%CI:0.26 [-0.140.65] and P0. 2 showed that there was no significant difference in the ability of killing Enterococcus faecalis between sodium hypochlorite group and MTAD group, and the diameter of bacteriostasis ring was included in the study, and the sample size was 100 cases. Because the heterogeneity is 96%, we give up the calculation of merging statistics and change it to descriptive evaluation. In view of the discussion of heterogeneity, we do not combine the four. The results of the four are as follows: Tay did not pass the invalid line 95CI: 3.89 [2.62n5.17]; the Li Xinjun group passed the invalid line 95CI-0.43 [-1.150.30]; the Yu Xin failed the invalid line 95CI16.17 [11.1021.23] Torabine jadand passed the invalid line 95CI: 0.36 [-0.631.35]; in the index of germicidal efficiency OR, four items were included in the study, with a total sample size of 220 cases. The combined effect of ZH4. 72C95% CI: 14.80 [4.84 + 45.29], which indicated that the bactericidal efficiency of sodium hypochlorite group and MTAD group was significantly different. Conclusion: through META analysis, we can draw the conclusion that the ability of removing smear layer and bactericidal efficiency of WMTAD is better than that of sodium hypochlorite in the present data, but there is no difference in the ability of killing Enterococcus faecalis between them. For the performance of the two in the bacteriostasis index, it is impossible to draw a clear conclusion which has the same meaning as if or not from the data obtained at present.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R781.05

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 何薇薇;安峰;林媛媛;王曉明;商煒娜;;MTAD等根管沖洗劑對(duì)根管內(nèi)糞腸球菌的消毒作用[J];中華老年口腔醫(yī)學(xué)雜志;2015年05期

2 李秀麗;楊s，

本文編號(hào)：1881553