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激光治疗牙本质敏感症脱敏效果的网状Meta 分析

Network meta-analysis of the desensitizing effects of lasers in patients with dentine hypersensitivity.

机构信息

Department of Stomatology, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, China.

Dental Medical Devices Testing Center, Dental Materials Laboratory, Peking University School and Hospital of Stomatology, Beijing, 100081, China.

出版信息

Clin Oral Investig. 2020 Jun;24(6):1917-1928. doi: 10.1007/s00784-019-03051-3. Epub 2019 Sep 2.

Abstract

OBJECTIVES

This network meta-analysis compares different lasers, placebo, and no treatment in terms of their effects on dentine hypersensitivity (DH) immediately after treatment and over the long term (1 month).

METHODS

A systematic electronic literature search of four databases and a manual search were performed to identify randomized controlled trials (RCTs) examining different laser treatments for the treatment of DH. Pairwise and network meta-analyses were performed to analyze the desensitization effect immediately after treatment and over the long term. The risk of bias was assessed based on the Cochrane guidelines and funnel plots. The quality of the evidence, statistical heterogeneity, inconsistencies, and ranking probability were also evaluated.

RESULTS

A total of 11 RCTs were included in the network meta-analysis; 11 and 9 of these studies analyzed immediate and long-term effects, respectively. All four types of laser had a better desensitizing effect than controls immediately after treatment and over the long term, but there were no significant differences among the four different lasers. There was a significant placebo effect immediately after treatment. The laser with the highest probability of being the most effective treatment for DH was Er,Cr:YSGG immediately after treatment and over the long term (73% and 47%, respectively).

CONCLUSIONS

All four types of laser had significantly better effects than no treatment on DH immediately after treatment and in the long term, but there were no significant differences among the four lasers. In addition, there was a significant placebo effect, supporting the importance of including a placebo group in future studies. Furthermore, Er,Cr:YSGG may be the most effective laser for the treatment of DH immediately and over the long term.

CLINICAL RELEVANCE

This study used network meta-analyses to compare different lasers, placebo, and no treatment over different time periods, which is to provide guidance for selecting an appropriate laser treatment in patients with DH.

摘要

目的

本网络荟萃分析比较了不同激光、安慰剂和不治疗在即刻治疗和长期(1 个月)治疗后对牙本质敏感(DH)的疗效。

方法

系统检索了四个数据库中的电子文献,并进行了手动检索,以确定评估不同激光治疗 DH 的随机对照试验(RCT)。进行了配对和网络荟萃分析,以分析即刻治疗和长期治疗的脱敏效果。根据 Cochrane 指南和漏斗图评估偏倚风险。还评估了证据质量、统计异质性、不一致性和排序概率。

结果

共有 11 项 RCT 纳入网络荟萃分析,其中 11 项和 9 项研究分别分析了即刻和长期效果。即刻治疗和长期治疗后,四种激光均比对照组具有更好的脱敏效果,但四种不同激光之间无显著差异。即刻治疗时存在显著的安慰剂效应。Er,Cr:YSGG 激光即刻治疗和长期治疗 DH 的可能性最大(分别为 73%和 47%)。

结论

即刻治疗和长期治疗后,四种激光均比不治疗对 DH 具有显著更好的效果,但四种激光之间无显著差异。此外,存在显著的安慰剂效应,支持在未来研究中纳入安慰剂组的重要性。此外,即刻和长期治疗时,Er,Cr:YSGG 激光可能是治疗 DH 最有效的激光。

临床相关性

本研究使用网络荟萃分析比较了不同激光、安慰剂和不治疗在不同时间段的效果,为 DH 患者选择合适的激光治疗提供了指导。

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