Xue Dong, Tang Lu, Bai Yuhao, Ding Qian, Wang Pengcheng, Zhao Ying
Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China.
Department of Stomatology, Capital Medical University Xuanwu Hospital,No. 45 Changchun Street, West District, Beijing, China.
Photodiagnosis Photodyn Ther. 2017 Jun;18:119-127. doi: 10.1016/j.pdpdt.2017.01.183. Epub 2017 Feb 8.
To evaluate the clinical efficacy of photodynamic therapy (PDT) adjunctive to scaling and root planing (SRP) in patients with untreated chronic periodontitis based on up-to-date evidence.
MEDLINE and the Cochrane Library were systematically searched to identify eligible randomized controlled trials (RCTs), supplemented by a manual literature search. Mean differences (MD) and the corresponding 95% confidence intervals (CI) of probing depth (PD) reduction and clinical attachment level (CAL) gain were synthesized. The I test and Q statistics were used to determine the inter-study heterogeneity. Subgroup analysis based on smoking status was performed.
Eleven RCTs with a total of 243 subjects were included. Significant improvement in PD reduction (MD=0.13, CI:0.02-0.24, p=0.02) and marginal significant improvement in CAL gain (MD=0.18, CI:-0.005-0.363, p=0.056) were observed in favor of SRP+PDT at 3months. When evaluated at 6months after baseline, the association of PDT with SRP resulted in a significant benefit in PD reduction (MD=0.40, CI:0.05-0.74, p=0.03), but not in CAL gain (MD=0.37, CI:-0.18-0.93, p=0.18). Subgroup analysis revealed that the combined therapy produced no significant improvements in PD and CAL at neither 3months nor 6months for studies with smokers. No treatment-related adverse events or side effects had been reported by the included studies.
Pooled analysis suggests a short-term benefit of PDT as an adjunct to SRP in clinical outcome variables. However, evidence regarding its long-term efficacy is still insufficient and no significant effect has been confirmed in terms of CAL gain at 6months. Future clinical trials of high methodological quality are needed to establish the optimal combination of photosensitizer and laser configuration.
基于最新证据评估光动力疗法（PDT）辅助龈下刮治和根面平整（SRP）治疗未经治疗的慢性牙周炎患者的临床疗效。
系统检索MEDLINE和Cochrane图书馆以识别符合条件的随机对照试验（RCT），并辅以手动文献检索。综合探诊深度（PD）减少和临床附着水平（CAL）增加的平均差异（MD）及相应的95%置信区间（CI）。采用I检验和Q统计量确定研究间的异质性。基于吸烟状况进行亚组分析。
纳入11项RCT，共243名受试者。在3个月时，观察到支持SRP+PDT的PD减少有显著改善（MD=0.13，CI：0.02-0.24，p=0.02），CAL增加有边缘显著改善（MD=0.18，CI：-0.005-0.363，p=0.056）。在基线后6个月评估时，PDT与SRP联合使用在PD减少方面产生显著益处（MD=0.40，CI：0.05-0.74，p=0.03），但在CAL增加方面无显著益处（MD=0.37，CI：-0.18-0.93，p=0.18）。亚组分析显示，对于吸烟者的研究，联合治疗在3个月和6个月时PD和CAL均未产生显著改善。纳入的研究均未报告与治疗相关的不良事件或副作用。
汇总分析表明，PDT作为SRP的辅助治疗在临床结局变量方面有短期益处。然而，关于其长期疗效的证据仍然不足，且在6个月时CAL增加方面未确认有显著效果。需要未来高质量的临床试验来确定光敏剂和激光配置的最佳组合。
