甲硝唑局部应用对龈下刮治和根面平整影响的Meta分析

Effect of Local Application of Metronidazole with Scaling and Root Planing:A Meta-Analysis

目的比较并评价在牙周炎治疗中,牙周袋内局部应用甲硝唑辅助用于龈下刮治和根面平整(scaling and root planing,SRP)的临床效果是否优于单纯SRP。方法检索中国期刊网、PubMed、EBSCO、OVID、ScienceDirect、Springrlink等数据库,收集从建库至2009年5月公开发表的中英文牙周局部应用甲硝唑辅助用于龈下刮治和根面平整的随机对照试验,随访时间至少一个月。采用Cochrane协作网提供的方法评价纳入研究质量,并用Stata10.0对纳入研究进行定量分析。结果最终纳入7个研究。Meta分析结果显示:牙周局部应用甲硝唑辅助SRP与单纯SRP相比,可使术后牙周探诊深度指标显著降低[WMD=–0.43,95%CI(–0.72,–0.13),P=0.004],但两组临床附着水平差异无统计学意义[WMD=–0.23,95%CI(–0.53,0.06),P=0.118]。结论在慢性牙周炎的治疗过程中,牙周局部应用甲硝唑辅助SRP可以使牙周探诊深度显著降低。

Objective To assess the effectiveness of local delivery of metronidazole as an adjunct to scaling anu root planing （SRP） versus SRP alone in patients with chronic periodontitis. Methods We searched six major electronic databases including CNKI, PubMed, EBSCO, OVID, ScienceDirect, and Springrlink from establishment to May 2009. Randomized controlled trials （RCTs） comparing metronidazole plus SRP with SRP alone for at least 1 month of follow-up were included, The methodological quality of included trials was assessed by the method recommended by the Cochrane Collaboration and pooled analysis was conducted using Stata 10.0 software. Results Seven RCTs met the inclusion and exclusion criteria. A significant mean reduction in probing depth with WMD -0.43 and 95%CI -0.72 to -0.13 for the combined metronidazole and SRP was observed, but there were no statistical significant differences at the clinical attachment level between the two treatments with WMD -0.23 and 95%CI -0.53 to 0.06. Conclusion Metronidazole as an adjunct to SRP could reduce probing depth in the treatment of chronic adult periodontitis.