Kopp Svenja L, Ramseier Christoph A, Ratka-Krüger Petra, Woelber Johan P
Department of Operative Dentistry and Periodontology. University Freiburg Medical Center Freiburg im Breisgau, Germany.
Department of Periodontology and Fixed Prosthodontics, University of Bern, School of Dental Medicine Bern, Switzerland.
Front Psychol. 2017 Feb 28;8:279. doi: 10.3389/fpsyg.2017.00279. eCollection 2017.
Periodontal therapy is highly dependent on a patient's long-term adherence with regard to oral hygiene, diet, and regular check-ups at the dentist. Motivational Interviewing (MI) is a client-centered, directive method for encouraging a patients' behavioral health change. The aim of this systematic review was to reveal the effects of MI as an adjunct to periodontal therapy. Three databases (PubMed, Cochrane Library, and Web of Science) were reviewed for randomized controlled clinical trials. Articles were included when using MI as an adjunct to periodontal therapy and presenting clinical periodontal and oral hygiene related parameters. Two authors independently coded the relevant articles. The search yielded 496 articles. After analysis and exclusion, a total of five papers could be included. The quality of the articles ranged between 72-88%. The two independent raters showed a high inter-rater reliability (Cohens-Kappa = 0.89). In two studies MI showed a significant positive effect on bleeding on probing and plaque values. One study showed improvement of self-efficacy in interdental cleaning. Two studies showed no influence of MI on periodontal parameters of the patients. The use of MI as an adjunct to periodontal therapy might have a positive influence on clinical periodontal parameters (plaque values, gingival, and periodontal inflammation) and psychological factors related to oral hygiene (self-efficacy). Due to the low body of evidence further studies are needed. Future studies should include fidelity measures of the applied MI, a high number of counselors, several MI sessions, and long-term study follow-up to show potential effects.
牙周治疗高度依赖患者在口腔卫生、饮食以及定期看牙医方面的长期坚持。动机性访谈（MI）是以患者为中心的指导性方法，用于鼓励患者改变行为健康。本系统评价的目的是揭示MI作为牙周治疗辅助手段的效果。对三个数据库（PubMed、Cochrane图书馆和科学网）进行了随机对照临床试验的综述。当使用MI作为牙周治疗的辅助手段并呈现临床牙周和口腔卫生相关参数时，文章被纳入。两位作者独立对相关文章进行编码。检索共得到496篇文章。经过分析和排除，总共纳入了五篇论文。文章质量在72%-88%之间。两位独立评分者显示出较高的评分者间信度（科恩斯-卡帕系数=0.89）。在两项研究中，MI对探诊出血和菌斑值显示出显著的积极影响。一项研究显示牙间隙清洁的自我效能有所提高。两项研究显示MI对患者的牙周参数没有影响。将MI作为牙周治疗的辅助手段可能会对临床牙周参数（菌斑值、牙龈和牙周炎症）以及与口腔卫生相关的心理因素（自我效能）产生积极影响。由于证据不足，需要进一步研究。未来的研究应包括所应用MI的保真度测量、大量的咨询人员、多次MI疗程以及长期的研究随访，以显示潜在效果。
