银汞合金充填修复相关临床研究的循证医学分析

目的评价银汞合金充填修复各类牙体缺损的临床效果及其对人体的不良影响。方法检索中国医院数字图书馆数据库中从1994年至今与银汞合金充填修复各类牙体缺损相关的临床研究及流行病学研究文献,用循证医学的方法和Meta分析进行分析评价。结果共检索到与银汞合金充填修复各类牙体缺损相关的临床研究文章78篇,符合入选条件的25篇。研究的主要内容涉及4个方面①银汞合金充填修复与其他充填修复材料的效果比较;②粘接性银汞合金修复的疗效评价;③银汞合金与其他充填材料联合应用的研究;⑤银汞合金充填修复对人体不良影响和研究。结论①随着高分子材料的发展和进步,银汞合金充填逐渐失去其抗力性好、耐磨性能好等优势,但其在美观效果、边缘密合性、牙髓刺激性等方面明显逊于复合树脂、复合体、玻璃离子等充填修复;②粘接性银汞合金充填技术能有效地增强充填边缘密合性、减少继发龋的形成,使充填效果明显优于常规的银汞合金充填;③现有的研究尚不能证实银汞合金充填会对人体造成明显的损害。

AN EVIDENCE-BASED MEDICINE STUDY ON CLINICAL RESEARCH FOR THE AMALGAM RESTORATION

Objective To study the clinical results of amalgam restoration and to evaluate side effects of amalgam. Methods Relevant literatures were searched from chkd.cnki.net and selected with randomized controlled trial(RCT) criteria. Evidence-based analysis was performed to the identified literatures and Meta analysis was applied when there were more than 5 identified articles. Results There were totally 78 articles obtained and only 25 of them met the criteria. Main studies aimed at ①Comparison between amalgam and composite resin or glass ionomer restorations;②Effectiveness of bonded amalgam restoration;③Combined restoration of amalgam and other filling materials;④Side effects of amalgam to human bodies. Conclusion With the development of polymer materials, amalgam gradually lost its advantages in compressive and wear resistance, and it’s no better in marginal sealing, pulp respond and aesthetics than composite resin, glass ionomer and so forth. Bonded amalgam restoration result much better than traditional filling by reducing secondary caries and microleakage. No strong evidence shows there is side effect of amalgam on human bodies.