永久歯における GIOMER の臨床的性能の評価と他の従来型修復材料との比較：システマティックレビューとメタ分析

Evaluation of the clinical performance of GIOMERs and comparison with other conventional restorative materials in permanent teeth: a systematic review and meta-analysis.

抄録

方法 PubMed、Web of Science、Scopus、Ovid、Cochrane Libraryの検索を行った。灰色文献検索も行った。コンポジットレジン、グラスアイオノマーセメント、レジンモディファイドグラスアイオノマーセメント(RMGIC)、その他のGIOMERと比較し、永久歯におけるGIOMER修復用コンポジットレジンによる修復の臨床的パフォーマンスを評価した臨床試験を対象とした。GIOMER修復用コンポジットレジンとRMGICを6ヵ月および12ヵ月のフォローアップで比較したメタアナリシス、および2種類のGIOMERを比較したメタアナリシスは実行可能であった。これらの研究では、GIOMERが異なるタイプの歯科修復材料と比較された。すべての研究において、歯科修復物は米国公衆衛生局（United States Public Health Service）の基準で評価された。その結果、6ヵ月後（オッズ比［OR］＝6.56；95％信頼区間［CI］＝2.38～18.13）および12ヵ月後（OR＝8.76；CI＝3.19～24.07）の追跡調査において、GIOMERとRMGICの表面粗さに有意差が認められた。GIOMER修復用コンポジットレジストとRMGICの間には、6ヵ月後および12ヵ月後の追跡調査において、マージナル適合に関する有意差は認められなかった。2種類のGIOMERを比較した場合、36ヵ月後の経過観察において、マージナルステイン（OR = 2.58; CI = 1.42-23.27; I = 0%）と表面粗さ（OR = 4.59; CI = 1.11-18.97; I = 0%）について、Beautifil IIとBeautifil Flowable Plus F00の間に有意差が認められた。結論 ジオマーはRMGICと比較した場合、マージナル適合と表面粗さに関して同程度の性能を示した。GIOMER Beautifil II は、Beautifil Flowable Plus F00 と比較して、辺縁適合と解剖学的形態に関して GIOMER Beautifil Flow Plus F00 と同程度の性能を示し、辺縁着色と表面粗さは悪化した。

Aim The aim of this systematic review and meta-analysis was to analyse the clinical performance of GIOMER restorative composites and compare them with other conventional restorative materials in permanent teeth.Methods Searches in PubMed, Web of Science, Scopus, Ovid and Cochrane Library were conducted. Grey literature search was also performed. Clinical trials that evaluated the clinical performance of restorations with GIOMER restorative composites in permanent teeth compared to those using composite resin, glass ionomer cement, resin-modified glass ionomer cement (RMGIC) and other GIOMERs were included. Meta-analyses comparing GIOMER restorative composites with RMGIC at 6- and 12-month follow-ups and comparing two types of GIOMER were feasible.Results Ten studies fulfilled the inclusion criteria. In these studies, GIOMER was compared to different types of dental restoration materials. Dental restorations were evaluated by United States Public Health Service criteria in all included studies. Four studies were suitable for meta-analysis, which showed significant differences between GIOMER and RMGIC surface roughness at 6-month (odds ratio [OR] = 6.56; 95% confidence interval [CI] = 2.38-18.13) and 12-month (OR = 8.76; CI = 3.19-24.07) follow-ups. No significant differences between GIOMER restorative composites and RMGIC for marginal adaptation were found at 6- and 12-month follow-ups. When comparing two GIOMERs, significant differences were seen between Beautifil II and Beautifil Flowable Plus F00 for marginal staining (OR = 2.58; CI = 1.42-23.27; I = 0%) and surface roughness (OR = 4.59; CI = 1.11-18.97; I = 0%) at the 36-month follow-up. No significant differences between Beautifil II and Beautifil Flowable Plus F00 were seen for marginal adaptation and anatomic form at 6-, 18- and 36-month follow-ups.Conclusions GIOMER restorative composites presented similar performance concerning marginal adaptation and better surface roughness when compared to RMGIC. GIOMER Beautifil II presented similar performance to GIOMER Beautifil Flow Plus F00 concerning marginal adaptation and anatomic form and worse marginal staining and surface roughness when compared to Beautifil Flowable Plus F00.