Slot Dagmar E, Jorritsma Kirsten H, Cobb Charles M, Van der Weijden Fridus A
Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
J Clin Periodontol. 2014 Jul;41(7):681-92. doi: 10.1111/jcpe.12233. Epub 2014 Jun 2.
What is the adjunctive effect of a diode laser (DL) following non-surgical periodontal debridement (SRP) during the initial phase of periodontal therapy on the clinical parameters of periodontal inflammation.
The MEDLINE-PubMed, Cochrane-Central Register of Controlled Trials and EMBASE databases were searched up to September 2013. Probing pocket depth (PPD) and clinical attachment loss (CAL) were selected as outcome variables. Also plaque scores (PS), bleeding scores (BS) and the Gingival Index (GI) were considered outcome measures. Data were extracted and a meta-analysis (MA) was performed where appropriate.
Independent screening of 416 unique papers resulted in nine eligible publications. The MA evaluating PPD, CAL and PS showed no significant effect. The only significance favouring adjunctive use of the DL was observed for the outcome parameters GI and BS.
The collective evidence regarding adjunctive use of the DL with SRP indicates that the combined treatment provides an effect comparable to that of SRP alone. That is for PPD and CAL. The body of evidence considering the adjunctive use of the DL is judged to be "moderate" for changes in PPD and CAL. With respect to BS, the results showed a small but significant effect favouring the DL, however, the clinical relevance of this difference remains a question. This systematic review questions the adjunctive use of DL with traditional mechanical modalities of periodontal therapy in patients with periodontitis.
在牙周治疗的初始阶段,非手术牙周清创术(SRP)后使用二极管激光(DL)对牙周炎症临床参数的辅助作用是什么?
检索截至2013年9月的MEDLINE-PubMed、Cochrane对照试验中央注册库和EMBASE数据库。选择探诊深度(PPD)和临床附着丧失(CAL)作为结局变量。还将菌斑评分(PS)、出血评分(BS)和牙龈指数(GI)视为结局指标。提取数据并在适当情况下进行荟萃分析(MA)。
对416篇独立论文进行筛选后,有9篇符合条件的出版物。评估PPD、CAL和PS的荟萃分析未显示显著效果。在结局参数GI和BS方面,仅观察到支持辅助使用DL的显著差异。
关于DL与SRP联合使用的综合证据表明,联合治疗的效果与单独使用SRP相当。这是针对PPD和CAL而言。对于PPD和CAL的变化,考虑DL辅助使用的证据等级被判定为“中等”。关于BS,结果显示支持DL的效果虽小但显著,然而,这种差异的临床相关性仍是一个问题。本系统评价对DL在牙周炎患者中与传统牙周治疗机械方法联合使用提出质疑。