Khan Ahsen, Goyal Ankit, Currell Scott D, Sharma Dileep
College of Medicine and Dentistry, James Cook University, 14-88 McGregor Road, Smithfield, QLD 4878, Australia.
Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, QLD 4878, Australia.
Dent J (Basel). 2020 Sep 14;8(3):106. doi: 10.3390/dj8030106.
This systematic review aims to assess the current evidence on the efficacy of surgical and non-surgical debridement techniques in the treatment of peri-implantitis lesions without the use of any antimicrobials.
Five electronic databases (MEDLINE, Pubmed, Scopus, CINAHL and Cochrane) were used, alongside hand searches, to find relevant articles. Full-text articles that were randomised controlled trials, published in the English language from 2011 onwards without pre-operative, peri-operative and post-operative antibiotic usage were included. The study was conducted according to the latest Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-P protocols, the latest Cochrane Risk of Bias tool and each investigated intervention was evaluated using the grading of recommendation, assessment, development and evaluation (GRADE) system.
The search yielded 2718 results. After initial screening, 38 full-text articles were assessed for eligibility. From these, 11 studies satisfied all inclusion criteria. These 11 articles described six non-surgical and five surgical debridement therapies. Most articles were classified as having either a high risk of bias or presenting with some concerns. Small sample sizes, in combination with this risk of bias, meant that all interventions were adjudged to be of either low or very low quality of evidence.
While all investigated modalities displayed some sort of efficacy, this review suggests that a surgical approach may be best suited to treating peri-implantitis lesions in the absence of antibiotic therapy. Despite this weak indication, further research is required in this field.
本系统评价旨在评估在不使用任何抗菌药物的情况下，手术清创术和非手术清创术治疗种植体周围炎病变的现有疗效证据。
使用五个电子数据库（MEDLINE、PubMed、Scopus、CINAHL和Cochrane），并结合手工检索来查找相关文章。纳入2011年起发表的、未使用术前、术中和术后抗生素的英文随机对照试验全文文章。本研究按照最新的系统评价和Meta分析优先报告项目（PRISMA）-P方案、最新的Cochrane偏倚风险工具进行，并使用推荐分级、评估、制定和评价（GRADE）系统对每项研究干预措施进行评估。
检索共获得2718条结果。初步筛选后，对38篇全文文章进行了资格评估。其中，11项研究符合所有纳入标准。这11篇文章描述了六种非手术清创疗法和五种手术清创疗法。大多数文章被归类为存在高偏倚风险或存在一些问题。样本量小，再加上这种偏倚风险，意味着所有干预措施的证据质量均被判定为低或极低。
虽然所有研究的治疗方式都显示出某种疗效，但本评价表明，在不使用抗生素治疗的情况下，手术方法可能最适合治疗种植体周围炎病变。尽管这一迹象不明显，但该领域仍需进一步研究。
