Objective

To answer the following PICOS question: “Is the risk of retention loss, marginal discoloration, marginal adaptation and postoperative sensitivity (POS) equal for etch-and-rinse (EAR) compared to self-etch (SE) or selective-enamel etch (SEE) mode when restoring non carious cervical lesions (NCCLs) with universal adhesives?”.

Methods

PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, LILACS, OpenGrey and Google Scholar™ were searched. Randomized controlled clinical trials in which resin composites and universal adhesives were used for restoration of NCCLs were considered. Cochrane Risk of Bias Tool was used to assess the risk of bias. Meta-analyses were performed using Revman; random-effects models were applied, and heterogeneity was tested using the I² index. The significance level was set at p < 0.05. Certainty of evidence was assessed by GRADE tool.

Results

After screening, 20 articles were included in qualitative, while 14 articles were used for quantitative synthesis. Twelve studies ranked as “low”, while 8 studies scored as “unclear” for risk of bias. At 12- and 18/24-months the risk for retention loss was higher for SE than for EAR groups (p = 0.005; RR = 0.22, 95% CI [0.08, 0.63],[moderate certainty of evidence and p = 0.0002; RR = 0.32, 95% CI [0.17, 0.58], moderate certainty of evidence, respectively). No significant differences were observed for marginal discoloration and adaptation (p > 0.05). The probability of POS occurrence was less in SE than in EAR groups (RR = 2.12, 95% CI [1.23, 3.64], moderate certainty of evidence). The certainty of evidence for other outcomes was scored as “low” or “moderate”, depending on the follow-up period.

Significance

Using universal adhesives in EAR or SEE mode provides more predictable retention, while SE strategy reduces the risk of POS occurrence.

中文翻译：

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复合修复体置入非龋性颈椎病灶的临床行为是否受万能胶应用方式的影响？系统评价和荟萃分析

客观的

回答以下 PICOS 问题：“与自蚀刻 (SE) 或选择性搪瓷蚀刻相比，蚀刻和冲洗 (EAR) 的保留损失、边缘变色、边缘适应和术后敏感性 (POS) 的风险是否相等？使用通用粘合剂修复非龋性宫颈病变 (NCCL) 时的 SEE) 模式？”。

方法

检索了 PubMed、Scopus、Web of Science、Cochrane Central Register of Controlled Trials、Scientific Electronic Library Online、LILACS、OpenGrey 和 Google Scholar™。考虑了使用树脂复合材料和通用粘合剂修复 NCCL 的随机对照临床试验。Cochrane 偏倚风险工具用于评估偏倚风险。使用 Revman 进行荟萃分析；应用随机效应模型，并使用 I ²指数测试异质性。显着性水平设定为 p < 0.05。证据的确定性通过 GRADE 工具进行评估。

结果

经过筛选，20篇文章被纳入定性，14篇文章被用于定量综合。12 项研究的偏倚风险评分为“低”，而 8 项研究的偏倚风险评分为“不清楚”。在 12 个月和 18/24 个月时，SE 组的保留损失风险高于 EAR 组（p = 0.005；RR = 0.22, 95% CI [0.08, 0.63]，[中等质量证据和 p = 0.0002； RR = 0.32, 95% CI [0.17, 0.58]，证据质量中等）。边缘变色和适应没有显着差异（p > 0.05）。SE 发生 POS 的概率低于 EAR 组（RR = 2.12, 95% CI [1.23, 3.64]，中等质量证据）。其他结果的证据确定性被评为“低”或“中等”，具体取决于随访期。

意义

在 EAR 或 SEE 模式下使用通用粘合剂可提供更可预测的保留，而 SE 策略可降低 POS 发生的风险。