Er:YAG激光治疗慢性牙周炎的临床疗效:随机对照试验的Meta分析

The Effects of Er:YAG Laser Therapy in Patients with Periodon-titis:A Meta-Analysis of Randomized Controlled Trials

目的:比较并评价在慢性牙周炎治疗中,Er:YAG激光的疗效是否优于根面平整术(Scaling and Root Planing,SRP)。方法:检索外文数据库Springerlink、OVID、Embase、Pubmed和中文数据库万方、维普、中国知网、中国生物医学文献数据库,收集自建库到2013年l2月公开发表的关于Er:YAG治疗慢性牙周炎随机对照试验的文献,随访时间不得少于三个月。采用Jadad法对文章质量进行评价,并使用Stata12.0对治疗三个月、六个月及十二个月后两组牙周探诊深度和临床附着水平的改变值进行Meta分析。采用I2检验检测不同研究间的异质性。结果:共有8篇文献符合纳入和排除标准,Meta分析结果显示三个月、六个月及十二个月后,Er:YAG组与SPR组相比,牙周探诊深度差异无统计学意义,附着水平的差值也无统计学意义。结论:Er:YAG激光治疗牙周炎的短中期临床疗效好,可作为SPR的辅助疗法甚至替代疗法,但目前尚无足够的证据证明Er:YAG激光的临床疗效优于SPR。由于纳入研究的数量有限,且只有2篇文献为高质量研究,因此,上述结论仍需更多高质量的研究进一步证实。

Objective：To assess the effects of Er：YAG laser therapy versus scaling and root planing（SPR） on the clinical outcomes in patients with periodontitis.Methods：We searched foreign language electronic databases including springerlink、OVID、Embase、Pubmed and Chinese electronic databases including Wan-fang、VIP、CNKI、CBM from establishment to December 2013.Randomized controlled trials（RCTs）that investigated the use of Er：YAGlaser in comparison with SRP alone for at least three months were identified.The methodological quality of included trials was assessed by the Jadad methods.Stata12.0 software was used to analyze PD changes and CAL changes after 3 months,6 months and 12 months.Heterogeneity was assessed using I 2 measurement.Results：Eight trails in accordance with inclusion and exclusion criteria were included.No significant difference in probing depth changes and clinical attachment level changes was observed after 3,6 and 12 months between the group Er：YAG and group SRP.Conclusions：This study show short-term efficacy of Er：YAG laser.Nevertheless,there is no evidence of superior effectiveness for the use of Er：YAG laser compared to SPR.The findings of this review should be verified by more high quality studies given the small number and low quality of included studies.