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Er,Cr:YSGG 激光在慢性牙周炎非手术治疗中的临床疗效:一项随机对照试验的荟萃分析。

Clinical effectiveness of Er,Cr:YSGG lasers in non-surgical treatment of chronic periodontitis: a meta-analysis of randomized controlled trials.

机构信息

Department of Pediatric Dentistry, School and Hospital of Stomatology & Hebei Key Laboratory of Stomatology, Hebei Medical University, Shijiazhuang, 050017, People's Republic of China.

Outpatient Clinic, Hebei Medical University, Shijiazhuang, 050017, People's Republic of China.

出版信息

Lasers Med Sci. 2021 Jun;36(4):889-901. doi: 10.1007/s10103-020-03156-2. Epub 2020 Oct 9.

Abstract

The meta-analysis aimed to systematically evaluate all the available pieces of evidence concerning the clinical effectiveness of Er,Cr:YSGG lasers (erbium, chromium, yttrium scandium gallium garnet laser) in the non-surgical treatment of patients with chronic periodontitis, and provide guidance for clinicians about the application of Er,Cr:YSGG lasers during the process of non-surgical periodontal treatments. The meta-analysis was conducted with data extracted from 16 randomized controlled clinical trials (RCTs) that compare Er,Cr:YSGG lasers adjunct/substitute to scaling and root planing (SRP) with SRP alone for the treatment of chronic periodontitis published in English or Chinese from January 2000 to January 2020. The weighted mean differences (WMDs) and 95% confidence intervals (CIs) were counted for probing depth (PD) reduction, clinical attachment level (CAL) gain, and visual analogue scale (VAS) score. Heterogeneity of each study was evaluated with the Q test. The publication bias was measured using Begg's adjusted rank correlation test. Sixteen RCTs with 606 patients were included in the meta-analysis. There were statistically significant differences between Er,Cr:YSGG lasers adjunct/substitute to SRP and SRP alone in the PD reduction at 1-month follow-up (WMD = ‑ 0.35, 95% CI [- 0.63, ‑ 0.07], P = 0.013), 3-month follow-up (WMD = - 0.342, 95% CI [- 0.552, - 0.132], P = 0.001), CAL gain at 3-month follow-up (WMD = - 0.17, 95% CI [- 0.31, 0.03], P = 0.017), and VAS score (WMD = - 2.395, 95% CI [- 3.327, - 1.464], P = 0.000) immediately after treatment. There were no significant differences of PD reduction and CAL change at 6-month follow-up. The present meta-analysis indicated that Er,Cr:YSGG lasers provided additional effectiveness in PD reduction and CAL gain at short-term follow-ups and there was less pain compared with SRP alone.

摘要

本荟萃分析旨在系统评估所有关于 Er,Cr:YSGG 激光(掺铒、铬、钇、钪、石榴石激光)在慢性牙周炎非手术治疗中的临床疗效的现有证据,并为临床医生在非手术牙周治疗过程中应用 Er,Cr:YSGG 激光提供指导。该荟萃分析使用了 2000 年 1 月至 2020 年 1 月期间以英文或中文发表的 16 项比较 Er,Cr:YSGG 激光辅助/替代与单独牙周刮治和根面平整(SRP)治疗慢性牙周炎的随机对照临床试验(RCT)的数据进行。计算了探诊深度(PD)减少、临床附着水平(CAL)增加和视觉模拟评分(VAS)的加权均数差值(WMD)和 95%置信区间(CI)。采用 Q 检验评估每项研究的异质性。采用贝格调整等级相关检验测量发表偏倚。荟萃分析纳入了 16 项 RCT,共 606 名患者。在 1 个月随访时,Er,Cr:YSGG 激光辅助/替代 SRP 与单独 SRP 相比,PD 减少的差异具有统计学意义(WMD=‑0.35,95%CI[-0.63,-0.07],P=0.013),3 个月随访时(WMD=‑0.342,95%CI[-0.552,-0.132],P=0.001),CAL 增加的差异具有统计学意义(WMD=‑0.17,95%CI[-0.31,0.03],P=0.017),治疗后即刻 VAS 评分(WMD=‑2.395,95%CI[-3.327,-1.464],P=0.000)。6 个月随访时 PD 减少和 CAL 变化无显著差异。本荟萃分析表明,Er,Cr:YSGG 激光在短期随访时在 PD 减少和 CAL 增加方面提供了额外的疗效,并且与单独 SRP 相比疼痛更少。

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