光动力疗法辅助机械清创或翻瓣术治疗种植体周围炎短期疗效的Meta分析  

Meta-analysis of short-term efficacy of photodynamic therapy assisted mechanical debridement or flap surgery for peri-implantitis

作　　者：尹凤 孙艳 彭姝媛 向学熔[1,2,3] YIN Feng;SUN Yan;PENG Shuyuan;XIANG Xuerong(Department of Periodontology,Stomatological Hospital Affiliated to Chongqing Medical University,Chongqing401147,China;Chongqing Key Laboratory of Oral Diseases and Biomedicine,Chongqing401147,China;Chongqing College and Municipal Key Laboratory of Oral Biomedical Engineering,Chongqing401147,China)

机构地区：[1]重庆医科大学附属口腔医院牙周科,重庆401147 [2]口腔疾病与生物医学重庆市重点实验室,重庆401147 [3]重庆市高校市级口腔生物医学工程重点实验室,重庆401147

出　　处：《中国现代医生》2020年第9期90-96,共7页China Modern Doctor

基　　金：重庆市科卫联合医学科研项目(2018ZDXM031)。

摘　　要：目的采用Meta分析方法系统评价光动力疗法(PDT)辅助机械清创(MD)或翻瓣清创术(OFD)治疗种植体周围炎的短期临床疗效。方法计算机检索PubMed、The Cochrane Library、Embase、中国知网、万方及维普等数据库,检索PDT辅助MD或OFD治疗种植体周围炎临床疗效观察的随机对照试验(RCTs),检索时限从建库至2019年6月1日。由2名评价员根据纳入排除标准独立筛选文献,进行文献质量评价、提取数据并交叉核对,采用Revman5.3软件进行统计学分析。结果共纳入9篇RCTs,研究对象544例。Meta分析结果显示,与单独的MD或OFD相比,辅助应用PDT种植体周围炎患者的探诊深度(PD)减少[MD=0.52,95%CI(0.13,0.92),P=0.010]、临床附着丧失(CAL)获得[MD=0.36,95%CI(0.11,0.61),P=0.004]、探诊出血指数(BOP)减少[MD=4.96,95%CI(1.87,8.06),P=0.002]、改良龈沟出血指数(m SBI)降低[MD=0.53,95%CI(0.32,0.73),P<0.00001]更加显著,差异有统计学意义(P<0.05),而改良菌斑指数(m PLI)降低[MD=0.05,95%CI(-0.12,0.22),P=0.55]差异无统计学意义。与辅助局部用药(LDD)相比,辅助应用PDT患者各临床指标差异均无统计学意义(P>0.05)。结论 PDT的辅助应用较单独的机械清创或翻瓣清创治疗种植体周围炎的临床疗效更佳,其效果与局部用药相当。Objective To systematically evaluate the short-term clinical efficacy of photodynamic therapy(PDT) assisted mechanical debridement(MD) or open flap debridement(OFD) in the treatment of peri-implantitis by using meta-analysis method. Methods PubMed, The Cochrane Library, Embase, CNKI, Wanfang, and Weipu databases were re trieved.Randomized controlled trials(RCTs) of the clinical efficacy of PDT-assisted MD or OFD in the treatment of peri-implantitis were retrieved from the establishment of the database to June 1, 2019. The literature were screened according to the inclusion and exclusion criteria, evaluated, extracted and cross-checked by 2 reviewers independently. Statistical analysis was performed using Revman 5.3 software. Results A total of 9 RCTs were included and 544 patients were studied. Meta-analysis results showed that compared with MD or OFD alone, the probing depth(PD) of adjuvant PDT for patients with peri-implantitis reduced[MD=0.52,95%CI(0.13,0.92),P=0.010],clinical attachment loss(CAL) obtained[MD=0.36,95%CI(0.11, 0.61), P=0.004], bleeding on probing(BOP) reduced [MD=4.96,95%CI(1.87,8.06),P=0.002],modified sulcus bleeding index(mSBI) decreased [MD=0.53, 95%CI(0.32,0.73),P<0.00001] more significantly,and the difference was statistically significant(P <0.05), but the modified plaque index(mPLI) decreased [MD =0.05,95% CI(-0.12,0.22),P =0.55], and there was no significant difference. Compared with adjuvant local drug delivery(LDD),there was no significant difference in clinical indicators of patients with adjuvant PDT(P>0.05). Conclusion The auxiliary application of PDT is better than MD or OFD alone in the treatment of peri-implantitis. The effect is equivalent to that of LDD.

关 键 词：种植体周围炎 光动力疗法 机械清创 翻瓣术 META分析 

分 类 号：R783.6[医药卫生—口腔医学]