上海口腔医学

上海口腔医学 ›› 2016, Vol. 25 ›› Issue (2): 248-253.

• 口腔循证医学 • 上一篇    下一篇

Nd:YAG激光联合牙周基础治疗对牙周炎疗效的评价

赵溪达1*，刘静波1*，张翀2，潘亚萍1   

  1. 1.中国医科大学口腔医学院 牙周病科,
    2.种植中心,辽宁省口腔医学研究所,辽宁省口腔疾病转化医学研究中心,辽宁 沈阳 110002
  • 收稿日期:2015-11-05 修回日期:2016-02-25 出版日期:2016-03-25 发布日期:2016-05-06
  • 作者简介:赵溪达(1982-),男,硕士,讲师,主治医师,E-mail: zhaoxida@163.com 潘亚萍,E-mail: yppan@mail.cmu.edu.cn
  • 基金资助:
    牙周病诊疗能力提高项目(LNCCC-C08-2015);辽宁省自然科学基金(2013021030)

Effectiveness of Nd:YAG laser with non-surgical periodontal therapy on improvement of periodontitis: meta analysis

ZHAO Xi-da1, LIU Jing-bo1, ZHANG Chong2, PAN Ya-ping1   

  1. 1.Department of Periodontology,
    2.Center of Implant Dentistry, School of Stomatology, China Medical University, Liaoning Institute of Dental Research; Liaoning Provincial Translational Medical Research Center of Oral Diseases. Shenyang 110002, Liaoning Province, China
  • Received:2015-11-05 Revised:2016-02-25 Online:2016-03-25 Published:2016-05-06

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摘要： 目的:通过meta分析,系统评价掺钕钇铝石榴石晶体激光(neodymium-doped yttrium aluminium garnet, Nd:YAG)联合牙周基础治疗对牙周炎的改善效果。方法:通过电子检索PubMed、Web of Science、Cochrane、中国知网、万方数据库、维普期刊数据库和中国生物医学文献数据库发表的期刊文献、会议论文和学位论文,检索年限为建库至2015年9月30号,收集Nd:YAG激光联合牙周基础治疗和单纯牙周基础治疗比较的临床随机对照研究。根据NOS国际量表,对纳入的文献进行质量评价、数据提取,进行异质性检验和meta分析,对得出的结果进行发表偏倚检验。文献中研究的实验室观察指标为白细胞介素1β(Interleukin-1β, IL-1β)和龈沟液(gingival crevicular fluid, GCF),临床观察指标为菌斑指数(plaque index, PI)、牙龈指数(gingival index, GI)、牙周探诊深度(probing depth, PD)和附着丧失(attachment loss, AL),各效应量均以95%可信区间表示。结果:经检索评估,共12篇文献纳入本研究,英文9篇,中文3篇。Meta分析发现,Nd:YAG激光联合牙周基础治疗在治疗后12周时对GCF(I2=0.0%,P=0.000)、GI(I2=0.0%,P=0.000)和PD(I2=85.8%,P=0.032)改善效果显著,其余统计结果未见显著差异,所有结果未见发表偏倚。结论:Nd:YAG激光联合牙周基础治疗在治疗后12周能显著改善牙周炎症,但不能证明促进组织获得新的牙周附着。Nd:YAG激光的操作标准和时间间隔有待进一步研究。

关键词: Nd:YAG激光, 牙周基础治疗, 牙周炎, Meta分析

Abstract: PURPOSE: The aim of the present meta analysis was to systemically evaluate the scientific evidence for the effectiveness of neodymium-doped yttrium aluminium garnet(Nd:YAG) laser in combination with non-surgical periodontal therapy compared to non-surgical periodontal therapy alone for patients with periodontitis. METHODS: Electronic database searches of MEDLINE-PubMed, ISI Web of Science, Cochrane Controlled Clinical Trial Register, Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure(CNKI), Wanfang Data Knowledge Service Platform, CQVIP Company Profile, and China Biology Medicine disc were performed to identify appropriate studies for clinical randomized controlled trials, as well as hand-searching of relevant journals, conference paper and thesis of master and Ph. D from the earliest records to September 30, 2015. Quality assessment was made according to Newcastle-Ottawa Quality Assessment Scale(NOS), and the datum were extracted. Then heterogeneity test and meta analysis were performed on the outcomes, and the publication biases of the outcome by meta analysis were assessed. Meta analysis of interleukin-1β(IL-1β), gingival crevicular fluid(GCF), plaque index(PI), gingival index(GI), probing depth(PD) and attachment loss(AL) were performed using weighted mean differences for continuous data with 95% confidence intervals. RESULTS: A total of 12 articles met the eligibility criteria and entered into the study. When compared to non-surgical periodontal therapy alone, Nd:YAG laser in combination with non-surgical periodontal therapy showed significant differences in GCF(I2=0.0%,P=0.000), GI(I2=0.0%,P=0.000) and PD(I2=85.8%,P=0.032) at 12 weeks post-therapy. No significant publication biases were found. CONCLUSIONS: The findings of this meta analysis suggest that use of Nd:YAG laser as an adjunctive therapy to non-surgical periodontal therapy could potentially provide an effect at 12 weeks post-therapy. However, the evidence is insufficient that Nd:YAG could yield more AL gain than non-surgical periodontal therapy alone. Further research will focus on the operating standard and interval of Nd:YAG laser in periodontal therapy.

Key words: Nd:YAG laser, Non-surgical periodontal therapy, Periodontitis, Meta analysis

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