对智障儿童和青少年牙菌斑控制的系统评价与荟萃分析。
A systematic review and meta-analysis of dental plaque control among children and adolescents with intellectual disabilities.
作者信息
McGrath Colman, Zhou Ni, Wong Hai Ming
机构信息
Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
School of Stomatology, Kunming Medical University, Yunnan, China.
出版信息
J Appl Res Intellect Disabil. 2019 May;32(3):522-532. doi: 10.1111/jar.12561. Epub 2019 Feb 8.
BACKGROUND
People with intellectual disabilities (ID) typically have poorer oral health. Oral diseases have a microbiological origin, and thus, dental plaque control (DPC) is key to safeguard their oral health.
METHODS
A structured search strategy was applied to screen oral health promotion initiatives for DPC among children and adolescents with ID following PRISMA statements. Qualitative and quantitative analyses were performed.
RESULTS
From 1,455 citations, 22 studies informed this review. Seven studies related to mechanical interventions and 13 to chemical interventions. Qualitative analyses found conventional toothbrushes were less effective than modified toothbrushes but quantitative analyses were conflicting. Of the nine studies that compared chlorhexidine to placebos, seven reported chlorhexidine was more effective than placebos. Meta-analysis favoured chlorhexidine to placebos (p < 0.0001, 95% CI 0.34-0.63).
CONCLUSIONS
Both mechanical and chemical interventions are effective for DPC. It is unclear whether they are alternative means for DPC or whether they are best employed together.
背景
智力残疾（ID）患者通常口腔健康状况较差。口腔疾病起源于微生物，因此，控制牙菌斑（DPC）是保障其口腔健康的关键。
方法
采用结构化检索策略，按照PRISMA声明筛选针对ID儿童和青少年进行DPC的口腔健康促进举措。进行了定性和定量分析。
结果
从1455篇文献中，22项研究为本次综述提供了信息。7项研究与机械干预有关，13项与化学干预有关。定性分析发现传统牙刷不如改良牙刷有效，但定量分析结果相互矛盾。在9项将氯己定与安慰剂进行比较的研究中，7项报告氯己定比安慰剂更有效。荟萃分析支持氯己定优于安慰剂（p < 0.0001，95% CI 0.34 - 0.63）。
结论
机械和化学干预对DPC均有效。尚不清楚它们是DPC的替代方法，还是最好联合使用。
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