インクリメンタルレジンコンポジットとバルクフィルレジンコンポジットの臨床性能は異なるか？

Is the clinical performance of incremental and bulk-fill resin composite different?

抄録

データソース PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature, Brazilian Bibliography in Dentistry, Cochrane Library.灰色文献は，System for Information on Grey Literature in Europeデータベースを用いて検索した。International Association for Dental Researchとその地域別サブグループの年次総会（1990～2020年）の抄録を検索した。学位論文（全文）はProQuestデータベースとCapesデータベースで検索した。未発表および進行中の研究は、臨床試験データベース（Current Controlled Trials, International Clinical Trials Registry Platform, ClinicalTrials.gov, Registro Brasileiro de Ensaios Clínicos, EU Clinical Trials Register）を検索した。データ抽出と統合 研究プロジェクト、参加者、介入、結果に関する関連情報は、3人の研究著者が抽出フォームを使用して収集した。データ抽出は、データが特定のリサーチクエスチョンと一致していることを確認するために、4つの研究のサンプルを用いてパイロットテストが行われた。結果 主要アウトカムと副次アウトカム（保定率・破折率、解剖学的形態、表面性状、色調、辺縁適合、辺縁変色、カリエス、術後感受性）を考慮すると、クラスIIとI腔では漸増充填と一括充填レジンコンポジットの手法に差がなかったと言える。結論 システマティックレビューとメタアナリシス（エビデンスの質は中程度）により、バルクフィル法とインクリメンタル法は、臼歯部レジン複合修復物において同様の臨床性能を示すことが示された。

Data sources PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature, Brazilian Bibliography in Dentistry and Cochrane Library. The grey literature was searched using the System for Information on Grey Literature in Europe database. Abstracts from the Annual Session of the International Association for Dental Research and its regional subgroups (1990-2020) were searched. Theses and dissertations (full texts) were searched in the ProQuest and Capes databases. Unpublished and ongoing studies were searched in clinical trial databases (Current Controlled Trials, International Clinical Trials Registry Platform, ClinicalTrials.gov, Registro Brasileiro de Ensaios Clínicos and EU Clinical Trials Register).Study selection In total, 14 randomised clinical trials comparing the clinical performance of composite resin restorations in posterior teeth placed with the incremental or the bulk-filling techniques were evaluated.Data extraction and synthesis Relevant information on the research project, participants, interventions and outcomes was collected using extraction forms by three study authors. Data extraction was pilot-tested using a sample of four studies to ensure that the data were consistent with the specific research question. To avoid overlapping, multiple reports of the same study with different follow-ups were extracted into a single form.Results Considering the primary and secondary outcomes (retention/fracture rate, anatomical form, surface texture, colour match, marginal adaption, marginal discoloration, caries and postoperative sensitivity), it is possible to state that there was no difference between incremental or bulk fill resin composite techniques in Class II and I cavities.Conclusions A systematic review and meta-analysis with moderated quality of evidence bulk fill and incremental techniques showed similar clinical performance on posterior resin composite restorations.