Sánchez-Martos Rebeca, Samman Andrea, Priami Mattia, Arias-Herrera Santiago
Universidad Europea de Valencia. Faculty of Health Sciences. Department of Dentistry.
J Clin Exp Dent. 2020 Dec 1;12(12):e1171-e1182. doi: 10.4317/jced.57630. eCollection 2020 Dec.
The present study systematically reviewed randomized controlled trials (RCT) to investigate the effect of diode laser therapy in the management of peri-implant mucositis.
The electronic databases were searched until January 2020. Outcome measures were bleeding on probing (BOP), plaque index (PI) and probing depth (PD). The addressed PICO question was: Is the diode laser therapy effective reducing the signs of inflammation as an adjunctive element in the non-surgical treatment of peri-implant mucositis?.
Eight randomized clinical trials (RCTs) were included in the systematic review for qualitative synthesis and three in the meta-analysis for quantitative synthesis. All studies included in the quantitative synthesis have low risk of bias according to the Cochrane collaborations' tool. Diode laser as coadyuvant therapy significantly reduced plaque index (SMD: -1.24; -0.47/-1.53) but not in bleeding on probing (SMD: -0.84; -0.31/-1.53) or probing pocket depth (SMD: -1.36; -0.28/-1.69). Non-statistically significant reductions in peri-implant bleeding on probing and in probing pocket depth were also observed in the test groups of most studies included in the meta-analysis.
The results should be interpreted cautiously due to the great heterogeneity in the methodology of the studies included in the systematic review. However the meta-analysis suggests that the use of diode lasers, as an adjunct in conventional non-surgical treatment of peri-implant mucositis, is promising in reducing the clinical signs of peri-implant mucositis, especially reducing the perii-implant plaque index. Peri-implant diseases, peri-implant mucositis, laser therapy, diode laser.
本研究系统回顾了随机对照试验（RCT），以调查二极管激光治疗在种植体周围黏膜炎管理中的效果。
检索电子数据库直至2020年1月。观察指标为探诊出血（BOP）、菌斑指数（PI）和探诊深度（PD）。所提出的PICO问题是：二极管激光治疗作为种植体周围黏膜炎非手术治疗的辅助手段，在减轻炎症迹象方面是否有效？
八项随机临床试验（RCT）纳入定性综合的系统评价，三项纳入定量综合的荟萃分析。根据Cochrane协作组的工具，定量综合中纳入的所有研究偏倚风险低。二极管激光作为辅助治疗可显著降低菌斑指数（标准化均数差：-1.24；-0.47/-1.53），但探诊出血（标准化均数差：-0.84；-0.31/-1.53）或探诊袋深度（标准化均数差：-1.36；-0.28/-1.69）无明显降低。荟萃分析中纳入的大多数研究的试验组在种植体周围探诊出血和探诊袋深度方面也观察到非统计学意义的降低。
由于系统评价中纳入的研究方法存在很大异质性，结果应谨慎解释。然而，荟萃分析表明，在传统的种植体周围黏膜炎非手术治疗中使用二极管激光作为辅助手段，在减少种植体周围黏膜炎的临床症状，尤其是降低种植体周围菌斑指数方面具有前景。种植体周围疾病、种植体周围黏膜炎、激光治疗、二极管激光。
