Evaluación comparativa de la eficacia de la eliminación quimiomecánica de caries y el tratamiento restaurativo atraumático dental en la reacción al dolor en niños: una revisión sistemática y síntesis cuantitativa
Palabras clave:
Caries dental, Tratamiento restaurativo atraumático dental, Papaína, Dolor, Niño, Revisión sistemáticaResumen
Objetivo: El objetivo de esta revisión sistemática y síntesis cuantitativa fue evaluar y comparar la eficacia de la eliminación quimiomecánica de caries (EQMC) y el Tratamiento restaurativo atraumático dental (TRAD) en la reacción al dolor en niños.
Materiales y métodos: Se realizaron búsquedas en Scopus, PubMed, Cochrane, Science Direct, EBSCOhost, Lilacs, Web of Science y Google Scholar desde el año más antiguo disponible hasta el 15 de julio de 2024. Estrategia PICO: P: Niños; I: Eliminación quimiomecánica de caries; C: Tratamiento restaurador atraumático; O: Reacción al dolor. La revisión incluyó únicamente ensayos controlados aleatorizados y estudios clínicos. La evaluación del riesgo de sesgo y la calidad de la evidencia se realizaron mediante las herramientas RoB-2 y GRADE, respectivamente.
Resultados: Cinco publicaciones de texto completo que cumplían los criterios de elegibilidad se sometieron a un procesamiento adicional para la extracción de datos. Los resultados generales de la revisión sugieren que no existe diferencia en el efecto de la EQMC y la TRAD sobre la reacción al dolor en niños, con un intervalo de confianza del 95% para la OR: 0,12 [0,01, 1,68]; p=0,12. Sin embargo, los datos combinados mostraron una alta heterogeneidad (p<0,0001; I²=89%) entre los estudios.
Conclusión: La presente revisión concluye que el efecto de la EQMC y la TRAD sobre la reacción al dolor en niños es comparable. No obstante, la certeza es baja debido a la alta heterogeneidad entre los estudios incluidos. Futuros estudios que combinen escalas subjetivas y objetivas podrían ayudar a determinar la verdadera reacción al dolor y proporcionar evidencia más concluyente sobre la reacción al dolor con la EQMC y la TRAD.
Descargas
Citas
Pitts NB, Twetman S, Fisher J, Marsh PD. Understanding dental caries as a non-commu-nicable disease. Br Dent J. 2021;231(12):749-753. https://doi.org/10.1038/s41415-021-3775-4. Epub 2021 Dec 17. PMID: 34921271; PMCID: PMC8683371.
Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005;83(9):661-9. Epub 2005 Sep 30. PMID: 16211157; PMCID: PMC2626328.
Corrêa FN, Rocha Rde O, Rodrigues Filho LE, Muench A, Rodrigues CR. Chemical versus con-ventional caries removal techniques in primary teeth: a microhardness study. J Clin Pediatr Dent. 2007 Spring;31(3):187-92. https://doi.org/10.17796/jcpd.31.3.l440852707v3g1u0. PMID: 1755004 5.
Ganesh M, Parikh D. Chemomechanical caries removal (CMCR) agents: Review and clinical application in primary teeth. J Dent Oral Hyg. 2011;3:34–5.
Dahlander A, Soares F, Grindefjord M, Dahllöf G. Factors Associated with Dental Fear and Anxiety in Children Aged 7 to 9 Years. Dent J (Basel). 2019;7(3):68.
Ladewig NM, Tedesco TK, Gimenez T, Braga MM, Raggio DP. Patient-reported outcomes associated with different restorative techniques in pediatric dentistry: A systematic review and MTC meta-analysis. PLoS One. 2018;13(12):e0208437. https://doi.org/10.1371/journal.pone. 0208437. PMID: 30521577; PMCID: PMC6283634.
Leal SC, Abreu DM, Frencken JE. Dental anxiety and pain related to ART. J Appl Oral Sci. 2009;17 Suppl(spe):84-8. https://doi.org/10.1590/s1678-77572009000700015. PMID: 21499661; PMCID: PMC5467370.
Ganesh M, Parikh D. Chemomechanical caries removal (CMCR) agents: review and clinical application in primary teeth. J Dent Oral Hyg. 2011;3:34–45.
Mohapatra S, Mohandas R. Clinical Outcome Success of Silver-Modified Atraumatic Resto-rative Treatment (SMART) in Treating Children with Dental Caries in Primary Teeth: A Systematic Review. Journal of Health and Allied Sciences NU. 15(01): 004-010.
Simon AK, Bhumika TV, Nair NS. Does atraumatic restorative treatment reduce dental anxiety in children? A systematic review and meta-analysis. Eur J Dent. 2015;9(2):304-309. https://doi.org/10.4103/1305-7456.156841. PMID: 26038668; PMCID: PMC4439864.
Venkataraghavan K, Kush A, Lakshminarayana C, Diwakar L, Ravikumar P, Patil S, Karthik S. Chemomechanical Caries Removal: A Review & Study of an Indigen-ously Developed Agent (Carie Care (TM) Gel) In Children. J Int Oral Health. 2013;5(4):84-90. Epub 2013 Aug 28. PMID: 24155626; PMCID: PMC3780371.
Souza TF, Martins ML, Magno MB, Vicente-Gomila JM, Fonseca-Gonçalves A, Maia LC. Worldwide research trends on the use of chemical-me-chanical caries removal products over the years: a critical review. Eur Arch Paediatr Dent. 2022;23(6):869-883.
Rao D, Panwar S, Narula H. An in-vivo comparative evaluation of the efficacy of two different pa-pain based chemo-mechanical caries removal agents in primary molars. International Journal of Scientific Research. 2020;9(3):43–45.
de Menezes Abreu DM, Leal SC, Mulder J, Frencken JE. Pain experience after conventional, atraumatic, and ultraconservative restorative treatments in 6- to 7-yr-old children. Eur J Oral Sci. 2011;119(2):163-8. https://doi.org/10.1111/j.1600-0722.201 1.00806.x. Epub 2011 Mar 3. PMID: 21410 557.
de Menezes Abreu DM, Leal SC, Frencken JE. Self-report of pain in children treated according to the atraumatic restorative treatment and the conventional restorative treatment--a pilot study. J Clin Pediatr Dent. 2009 Winter;34(2):151-5. https://doi.org/10.17796/jcpd.34.2.9k67p786l7126263. PMID: 20297707.
Alkhouli MM, Al Nesser SF, Bshara NG, AlMidani AN, Comisi JC. Comparing the efficacies of two chemo-mechanical caries removal agents (2.25% sodium hypochlorite gel and brix 3000), in caries removal and patient cooperation: A randomized controlled clinical trial. J Dent. 2020;93:103280.https://doi.org/10.1016/j.jdent.2020.103280. Epub 2020 Jan 22. PMID: 31981604.
Gupta N, Marwah N, Nigam A, Vishwanathaiah S, Alessa N, Almeslet A, Alhakami K, Dawood T, Masha FM, Maganur PC. Evaluation of Papacarie®, Carie-Care™, BRIX3000™ and conventional hand instrumentation for caries removal in primary teeth: a randomized control study. J Clin Pediatr Dent. 2024;48(3):131-138. https://doi.org/10.22514/jocpd.2024.066. Epub 2024 May 3. PMID: 38755991.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hróbjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021 Mar 29;372:n71. https://doi.org/10.1136/bmj.n71. PMID: 33782057; PMCID: PMC8005924.
Balk EM, Chung M, Chen ML, Trikalinos TA, Kong Win Chang L. Assessing the Accuracy of Google Translate to Allow Data Extraction From Trials Published in Non-English Languages [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013. Report No.: 12(13)-EHC145-EF. PMID: 23427350..
Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, Thomas J. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Syst Rev. 2019;10(10):ED000142. https://doi.org/10.1002/14651858.ED0 00142. PMID: 31643080; PMCID: PMC10284251.
Sterne JA, Hernán MA, Reeves BC, Savovi? J, Berkman ND, Viswanathan M, Henry D, Altman DG, Ansari MT, Boutron I, Carpenter JR, Chan AW, Churchill R, Deeks JJ, Hróbjartsson A, Kirkham J, Jüni P, Loke YK, Pigott TD, Ramsay CR, Regidor D, Rothstein HR, Sandhu L, Santaguida PL, Schünemann HJ, Shea B, Shrier I, Tugwell P, Turner L, Valentine JC, Waddington H, Waters E, Wells GA, Whiting PF, Higgins JP. ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions. BMJ. 2016;355:i4919. https://doi.org/10.1136/bmj.i4919. PMID: 27733354; PMCID: PMC5062054.
Granholm A, Alhazzani W, Møller MH. Use of the GRADE approach in systematic reviews and guidelines. Br J Anaesth. 2019;123(5):554-559. doi: 10.1016/j.bja.2019.08.015. Epub 2019 Sep 24. PMID: 31558313.
Bussadori SK, Guedes CC, Bachiega JC, Santis TO, Motta LJ. Clinical and radiographic study of chemical-mechanical removal of caries using Papacárie: 24-month follow up. J Clin Pediatr Dent. 2011 Spring;35(3):251-4. https://doi.org/10.17796/jcpd.35.3.75803m02524625h5. PMID: 21678665.
Abdul Khalek A, Elkateb MA, Abdel Aziz WE, El Tantawi M. Effect of Papacarie and Alternative Restorative Treatment on Pain Reaction during Caries Removal among Children: A Randomized Controlled Clinical Trial. J Clin Pediatr Dent. 2017;41(3):219-224. https://doi.org/10.17796/1053-4628-41.3. 219. PMID: 28422591.
Pascareli-Carlos AM, Martins LF, Silva Gonçalves MD, Pettorossi Imparato JC, Tedesco TK. Pain perception of children after restorative treatments: Atraumatic restorative treatment versus chemomechanical removal - A non-inferiority randomized clinical trial. J Indian Soc Pedod Prev Dent. 2021;39(2):202-207. https://doi.org/10.4103/jisppd.jisppd_426_20. PMID: 34341242.
Gupta N, Chowdhary N, Reddy VR, Nk K, Peddi R, Kumar M. Evaluation of Caries Removal Efficacy Using BRIX 3000 and Atraumatic Restorative Treatment in Primary Molars: A Clinical Comparative Study. J Contemp Dent Pract. 2022 Apr 1;23(4):419-424. PMID: 35945835.
Ghanem AY, Talaat DM, Essawy MM, Bakry N. The effectiveness of Carie-Care™, chemomechanical caries removal technique in primary teeth: randomized controlled clinical trial. BMC Oral Health. 2023;23(1):882. https://doi.org/10.1186/s12903-023-03594-8. PMID: 37980471; PMCID: PMC10657635.
Abdelaziz E, Badran A, Allam G. Chemome-chanical caries removal agents and their applications in pediatric dentistry. Adv. Dent. J. 2022;4(1):11–18.
Hamama HH, Yiu CK, Burrow MF, King NM. Systematic Review and Meta-Analysis of Randomized Clinical Trials on Chemo-mecha-nical Caries Removal. Oper Dent. 2015; 40(4): E167-78. https://doi.org/10.2341/14-021-LIT. PMID: 26167737.
Dorri M, Martinez-Zapata MJ, Walsh T, Marinho VC, Sheiham Deceased A, Zaror C. Atraumatic restorative treatment versus conventional restorative treatment for managing dental caries. Cochrane Database Syst Rev. 2017 Dec 28;12(12):CD008072. https://doi.org/10.1002/14651858.CD00 8072.pub2. PMID: 29284075; PMCID: PMC64 86021.
Deng Y, Feng G, Hu B, Kuang Y, Song J. Effects of Papacarie on children with dental caries in primary teeth: a systematic review and meta-analysis. Int J Paediatr Dent. 2018 Jul;28(4):361-372. https://doi.org/10.1111/ipd.12364. Epub 2018 Apr 23. PMID: 29682851.
da Silva LB, Magno MB, Fonseca-Gonçalves A, Pintor AVB. ART with or without the aid of chemo-mechanical agents: a systematic review. Clin Oral Investig. 2024;28(11):581. https://doi.org/10.1007/s00784-024-05931-9. PMID: 39382720.
Wright GZ, Weinberger SJ, Marti R, Plotzke O. The effectiveness of infiltration anesthesia in the mandibular primary molar region. Pediatr Dent. 1991 Sep-Oct;13(5):278-83. PMID: 1815200.
Dutra RM, Neves IL, Neves RS, Atik E, Santos Ude P. Peripheral oxygen saturation, heart rate, and blood pressure during dental treatment of children with cyanotic congenital heart disease. Clinics (Sao Paulo). 2014;69(5):314-8. https://doi.org/10.6061/clinics/2014(05)03. PMID: 24838895; PMCID: PMC4012232.
Publicado
Cómo citar
Número
Sección
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Este es una Revista de acceso abierto distribuido bajo los términos de Creative Commons Attribution License (CC BY 4.0). Se permite el uso, distribución o reproducción en otros foros, siempre que se acredite al autor o autores originales y a los propietarios de los derechos de autor y se cite la publicación original en esta revista, de acuerdo con la práctica académica aceptada. No se permite ningún uso, distribución o reproducción que no cumpla con estos términos. © 2023.
