Dederich Douglas N
School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
Evid Based Dent. 2015 Mar;16(1):16. doi: 10.1038/sj.ebd.6401078.
Medline, PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL) and Embase databases.
Randomised controlled trials (RCTs) using thermal diode lasers as an adjunct to non-surgical conventional periodontal initial therapy conducted in patients ≥18 years old written in English or Dutch were considered.
Study assessment data extraction and quality assessment was carried out independently by two reviewers. The main outcome variables were probing pocket depth (PPD) and clinical attachment loss (CAL), but plaque scores (PS), bleeding scores (BS) and the Gingival Index (GI) were also considered. Meta-analysis was carried out using a random effects model.
Nine studies involving 247 patients were included. Seven studies were of split mouth design and two were parallel group studies. The study designs showed considerable heterogeneity and follow up ranged from six weeks to six months. Meta-analysis found no significant effect on PPD, CAL and PS. There was however a significant effect for GI and BS favouring adjunctive use of the diode laser.
The collective evidence regarding adjunctive use of the diode laser with SRP indicates that the combined treatment provides an effect comparable to that of SRP alone. With respect to BS the results showed a small but significant effect favouring the diode laser, however, the clinical relevance of this difference remains uncertainStandard . This systematic review questions the adjunctive use of diode laser with traditional mechanical modalities of periodontal therapy in patients with periodontitis. The strength of the recommendation for the adjunctive use of the diode laser is considered to be 'moderate' for changes in PPD and CAL.
医学索引数据库（Medline）、医学期刊数据库（PubMed）、考克兰对照试验中心注册库（CENTRAL）和荷兰医学文摘数据库（Embase）。
纳入≥18岁患者使用热二极管激光作为非手术常规牙周初始治疗辅助手段的随机对照试验（RCT），文献语言为英语或荷兰语。
由两名评价者独立进行研究评估、数据提取和质量评估。主要结局变量为探诊深度（PPD）和临床附着丧失（CAL），但也考虑菌斑评分（PS）、出血评分（BS）和牙龈指数（GI）。采用随机效应模型进行荟萃分析。
纳入9项研究，共247例患者。7项研究为口内对照设计，2项为平行组研究。研究设计显示出相当大的异质性，随访时间从6周至6个月不等。荟萃分析发现，对PPD、CAL和PS无显著影响。然而，对于GI和BS，二极管激光辅助使用有显著效果。
关于二极管激光与龈下刮治术（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。关于BS，结果显示对二极管激光有小但显著的效果，然而，这种差异的临床相关性仍不确定。本系统评价对二极管激光与传统机械性牙周治疗方法联合用于牙周炎患者提出质疑。对于PPD和CAL的改变，二极管激光辅助使用的推荐强度被认为是“中等”。
