光动力疗法辅助治疗牙周炎治疗效果的Meta分析  

Photodynamic therapy as an adjunct to periodontitis:a meta-analysis

作　　者：马玉 左玉 张鑫[1] Ma Yu;Zuo Yu;Zhang Xin(Dept.of General Dentistry,The Affiliated Stomatological Hospital of Soochow University,Suzhou 215000,China;Dept.of Prosthodontics,The Affiliated Stomatological Hospital of Guilin Medical College,Guilin 541004,China)

机构地区：[1]苏州大学附属口腔医院综合科,苏州215000 [2]桂林医学院附属口腔医院口腔修复科,桂林541004

出　　处：《国际口腔医学杂志》2022年第3期305-316,共12页International Journal of Stomatology

摘　　要：目的评价光动力疗法(PDT)辅助龈下刮治和根面平整术(SRP)治疗牙周炎的临床效果。方法通过计算机检索PubMed、Embase、Web of science/SCI、万方数据库、中国知网、维普数据库已发表的一次文献,采用布尔运算法则组合医学主题词+自由词,检索时间由建库至2020年12月,语言类型为中文或英文,同时手工检索相关期刊,获取SRP+PDT治疗牙周炎的随机对照试验。根据纳入排除标准筛选文献,利用Cochrane偏倚风险评价工具进行文献质量评价,使用RevMan 5.3软件对被纳入的文献进行Meta分析。结局指标采用临床附着丧失(CAL)、探诊深度(PD)、菌斑指数(PI)、探诊出血(BOP)。结果共纳入21篇文献。Meta分析显示,使用SRP+PDT治疗的试验组在治疗1个月时,PD和BOP的差异有统计学意义(PD:SMD=-0.81,95%CI为-1.40~-0.21,P=0.008;BOP:SMD=-0.61,95%CI为-1.05~-0.16,P=0.008);治疗3个月时,仅PD的差异有统计学意义(SMD=-0.57,95%CI为-0.91~-0.23,P=0.001);治疗6个月时,CAL和PD的差异有统计学意义(CAL:SMD=-0.46,95%CI为-0.88~-0.03,P=0.04;PD:SMD=-0.57,95%CI为-1.04~-0.11,P=0.02);试验组均低于对照组。结论PDT辅助SRP可在短期(6个月)内改善CAL,减少PD,但尚无证据显示在改善PI和BOP方面,PDT辅助SRP优于单纯SRP。Objective This study aimed to evaluate the clinical efficacy of photodynamic therapy(PDT)adjunctive to scaling and root planning(SRP)in patients with chronic periodontitis.Methods Published literature on PubMed,Embase,Web of Science/SCI,Wanfang,CNKI,and VIP was searched by Boolean algorithm combined with medical subject words and free words.The time was also searched from their inception until December 2020,and the language type was Chinese or English.Then,a manual search was performed to obtain a randomized controlled trial of PDT adjunctive to SRP in the treatment of periodontitis.Literature was screened out on the basis of the inclusion and exclusion criteria.The Cochrane bias risk assessment tool was used to evaluate literature quality.Revman 5.3 software was used for meta-analysis.Outcome indicators included clinical attachment loss,probing depth,plaque index,and bleeding on probing.Results A total of 21 articles were included.Meta-analysis showed that at 1 month after SRP+PDT treatment,PD and BOP differences were statistically significant(PD:SMD=−0.81,95%CI was−1.40 to−0.21,P=0.008;BOP:SMD=−0.61,95%CI was−1.05 to−0.16,P=0.008).At 3 months after treatment,only PD difference was statistically significant(SMD=−0.57,95%CI was−0.91 to−0.23,P=0.001).At 6 months after treatment,CAL and PD differences were statistically significant(CAL:SMD=−0.46,95%CI was−0.88 to−0.03,P=0.04;PD:SMD=−0.57,95%CI was−1.04 to−0.11,P=0.02).The experimental group was lower than the control group.Con⁃clusion PDT adjunctive to SRP improved CAL and reduced PD in the short term(6 months),but no evidence that PDT adjunctive to SRP was superior to pure SRP in improving PI and BOP was found.

关 键 词：光动力疗法 龈下刮治和根面平整术 牙周炎 META分析 

分 类 号：R783[医药卫生—口腔医学]