Serrano Jorge, Escribano Marta, Roldán Silvia, Martín Conchita, Herrera David
ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain.
J Clin Periodontol. 2015 Apr;42 Suppl 16:S106-38. doi: 10.1111/jcpe.12331.
The aim of this systematic review was to evaluate the efficacy of anti-plaque chemical formulations for managing gingivitis, in 6-month, home-use, randomised clinical trials (RCTs).
A protocol was designed, including inclusion and exclusion criteria to identify RCTs assessing gingival and/or bleeding indices. Electronic and hand-searches identified relevant papers, which were screened and evaluated for inclusion. Full-papers were retrieved and relevant information was extracted (also plaque indices), including quality and risk of bias. Mean treatment effects were calculated to obtain weighted mean differences (WMD) and 95% confidence intervals.
After the process of screening and selection, 87 articles with 133 comparisons, were included in the review. The additional effects of the tested products were statistically significant in terms of Löe & Silness gingival index (46 comparisons, WMD -0.217), modified gingival index (n = 23, -0.415), gingivitis severity index (n = 26, -14.939%) or bleeding index (n = 23, -7.626%), with significant heterogeneity. For plaque, additional effects were found for Turesky (66 studies, WMD -0.475), Silness & Löe (n = 26, -0.109), and plaque severity (n = 12, -23.4%) indices, with significant heterogeneity.
Within the limitations of the present study, formulations with specific agents for chemical plaque control provide statistically significant improvements in terms of gingival, bleeding and plaque indices.
本系统评价旨在通过为期6个月的家庭使用随机临床试验(RCT),评估抗牙菌斑化学制剂治疗牙龈炎的疗效。
设计了一项方案,包括纳入和排除标准,以识别评估牙龈和/或出血指数的RCT。通过电子检索和手工检索确定相关论文,并对其进行筛选和评估以确定是否纳入。检索全文并提取相关信息(包括菌斑指数),包括质量和偏倚风险。计算平均治疗效果以获得加权平均差(WMD)和95%置信区间。
经过筛选和选择过程,本评价纳入了87篇文章,共133项比较。在Löe & Silness牙龈指数(46项比较,WMD -0.217)、改良牙龈指数(n = 23,-0.415)、牙龈炎严重程度指数(n = 26,-14.939%)或出血指数(n = 23,-7.626%)方面,受试产品的额外效果具有统计学意义,但存在显著异质性。对于菌斑,在Turesky指数(66项研究,WMD -0.475)、Silness & Löe指数(n = 26,-0.109)和菌斑严重程度指数(n = 12,-23.4%)方面发现了额外效果,存在显著异质性。
在本研究的局限性范围内,含有特定化学菌斑控制剂的制剂在牙龈、出血和菌斑指数方面具有统计学意义的改善。