半导体激光辅助机械清创治疗种植体周围疾病临床疗效的Meta分析

Clinical Efficacy of Diode Laser in Treatment of Peri-implant Disease: A Meta-analysis

目的:系统评价半导体激光(DL)联合机械清创(MD)用于治疗种植体周围疾病的疗效,为半导体激光在种植体周围疾病治疗中的作用提供循证医学证据。方法:检索数据库:PubMed、Embase、Cochrane Library、中国知网、万方、维普、中国生物医学文献数据库等,收集关于半导体激光应用于种植体周围黏膜炎和种植体周围炎治疗的临床随机对照研究,试验组采用MD+DL,对照组仅采用MD。检索时限为建库至2020年5月9日。由2位研究者独立筛选、分析、评估相关文献后使用Revman5.3进行数据分析。结果:最终纳入6个随机对照实验,共包含371个种植体,其中试验组为187个种植体,对照组为184个种植体。Meta分析数据表明,与单纯MD组相比,DL联合MD在治疗3个月后的探诊深度(PD)、菌斑指数(PI)和出血指数(BI)减少更多,差异有统计学意义[MD=-0.44,95%CI:(-0.77,-0.11),P=0.008]、[MD=-0.17,95%CI:(-0.27,-0.08),P=0.0006]、[MD=-0.60,95%CI:(-1.15,-0.05),P=0.03];而治疗1个月时的PD虽较基线有明显减少,但试验组与对照组之间的差异没有统计学意义[MD=-0.31,95%CI:(-1.11,0.48),P=0.44]。结论:DL辅助MD治疗对于种植体周围疾病的PD、PI、BI及感染控制方面有明显的效果,但仍需更多更大样本量的RCT进一步论证。

Objective:to evaluate the efficacy of diode laser(DL)in combination with mechanical debridement(MD)compared to mechanical debridement alone for patients with peri-implant disease.Methods:bibliographic databases including PubMed、Embase、Cochrane Library、CNKI、Wanfang Data、VIP and CBM from inception to May 9 st,2020 were searched for the literature about the diode laser assisted mechanical debridement for peri-implant mucositis and peri-implantitis.MD+DL was used in the experimental group and only MD was used in the control group.Two researchers independently screened,analysed and evaluated of relevant literature.Then,meta-analysis was performed by using RevMan 5.3 software.Results:finally,six randomized controlled trials were selected,including 371 implants.Meta-analysis showed that compared with the mechanical debridement group,probing depth(PD)[MD=-0.44,95%CI:(-0.77,-0.11),P=0.008],plaque index(PI)[MD=-0.17,95%CI:(-0.27,-0.08),P=0.0006]and bleeding index(BI)[MD=-0.60,95%CI:(-1.15,-0.05),P=0.03]of the DL combined with mechanical debridement group decreased more after 3 months of treatment,the difference was statistically significant.However,PD at 1 month after treatment was significantly lower than that at baseline,but there was no significant difference between the test group and the control group[MD=-0.31,95%CI:(-1.11,0.48),P=0.44].Conclusion:DL combined with mechanical debridement therapy has obvious effect on PD,PI,BI and infection control of peri-implant disease.However,more RCTs with larger sample size are needed for further demonstration.