Slot Dagmar Else, Van der Weijden Fridus
Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands.
Evid Based Dent. 2014 Sep;15(3):74-5. doi: 10.1038/sj.ebd.6401039.
The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, the metaRegister of Controlled Trials and the US National Institutes of Health Clinical Trials Register.
Randomised controlled trials (excluding split mouth) of routine scale and polish treatments with and without OHI in healthy dentate adults without severe periodontitis.
Study assessment, data extraction and risk of bias assessment were carried out independently by two reviewers. Mean and standardised mean differences were calculated when different scales were reported. Fixed effects models were used as there were only a small number of studies.
Three studies involving a total of 837 patients, and all considered to be at unclear risk of bias were included. No studies reported any adverse effects. Only one trial (conducted in general practice) provided data comparing scale and polish versus no scale and polish. It found no evidence to claim or refute benefit for scale and polish treatments for the outcomes of gingivitis, calculus and plaque. Two studies, both at unclear risk of bias, compared routine scale and polish provided at different time intervals. When comparing six with 12 months there was insufficient evidence to determine a difference for gingivitis at 24 months. There were some statistically significant differences in favour of scaling and polishing provided at more frequent intervals, in particular between three and 12 months for the outcome of gingivitis at 24 months, with OHI, MD -0.14 (95% CI -0.23 to -0.05; P value = 0.003) and without OHI MD -0.21 (95% CI -0.30 to -0.12; P value < 0.001) (mean per patient measured on 0-3 scale), based on one study. There was some evidence of a reduction in calculus. This body of evidence was assessed as of low quality.One study provided data for the comparison of scale and polish treatment with and without OHI. There was a reduction in gingivitis for the 12-month scale and polish treatment when assessed at 24 months MD -0.14 (95% CI -0.22 to -0.06) in favour of including OHI. There were also significant reductions in plaque for both three and 12-month scale and polish treatments when OHI was included. The body of evidence was once again assessed as of low quality.
There is insufficient evidence to determine the effects of routine scale and polish treatments. High quality trials conducted in general dental practice settings with sufficiently long follow-up periods (five years or more) are required to address the objectives of this review.
考科蓝口腔健康小组试验注册库、考科蓝对照试验中央注册库（CENTRAL）、医学索引数据库（Medline）、荷兰医学文摘数据库（Embase）、对照试验元注册库以及美国国立卫生研究院临床试验注册库。
针对无严重牙周炎的健康有牙成年人，进行常规洁治和抛光治疗（无论有无口腔卫生指导）的随机对照试验（不包括半口对照试验）。
两名评价员独立进行研究评估、数据提取及偏倚风险评估。当报告采用不同量表时，计算均值差和标准化均值差。由于研究数量较少，采用固定效应模型。
纳入三项研究，共837例患者，所有研究的偏倚风险均不明确。没有研究报告任何不良反应。仅有一项试验（在全科医疗中开展）提供了比较洁治和抛光与未进行洁治和抛光的数据。该试验未发现证据支持或反驳洁治和抛光治疗对牙龈炎、牙石和牙菌斑疗效的有益性。两项偏倚风险不明确的研究比较了在不同时间间隔进行的常规洁治和抛光。比较6个月和12个月时，没有足够证据确定24个月时牙龈炎的差异。在更频繁的时间间隔进行洁治和抛光有一些统计学上的显著差异，特别是在3个月至12个月之间进行洁治和抛光，对于24个月时的牙龈炎结局，有口腔卫生指导时，平均差为-0.14（95%可信区间-0.23至-0.05；P值=0.003），无口腔卫生指导时平均差为-0.21（95%可信区间-0.30至-0.12；P值<0.001）（基于一项研究，每位患者按0-3量表测量）。有一些牙石减少的证据。这组证据被评估为低质量。一项研究提供了比较有和无口腔卫生指导的洁治和抛光治疗的数据。在24个月评估时，12个月的洁治和抛光治疗使牙龈炎有所减轻，平均差为-0.14（95%可信区间-0.22至-0.06），支持采用口腔卫生指导。当采用口腔卫生指导时，3个月和12个月的洁治和抛光治疗也使牙菌斑显著减少。这组证据再次被评估为低质量。
没有足够证据确定常规洁治和抛光治疗的效果。需要在普通牙科诊疗环境中开展高质量试验，并进行足够长时间（五年或更长）的随访，以实现本综述的目标。
