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牙周治疗策略对妊娠围产期结局的影响差异:系统评价和荟萃分析。

DIFFERENTIAL IMPACT OF PERIODONTAL TREATMENT STRATEGIES DURING PREGNANCY ON PERINATAL OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS.

机构信息

School of Dentistry and the Charles Perkins Center, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; School of Odonto-Stomatology, Hanoi Medical University, Hanoi, Vietnam.

The Whiteley-Martin Research Centre, Discipline of Surgery, The University of Sydney, New South Wales, Australia.

出版信息

J Evid Based Dent Pract. 2022 Mar;22(1):101666. doi: 10.1016/j.jebdp.2021.101666. Epub 2021 Nov 12.

Abstract

OBJECTIVES

This study aimed to evaluate the impact of different periodontal treatment strategies during pregnancy on perinatal outcomes.

STUDY SELECTION

This systematic review and meta-analysis of clinical trials was conducted according to PRISMA guidelines to assess the effect of mouthwash in addition to scaling and root planning (SRPM) on pregnancy outcomes, including preterm birth, low birth weight, gestational age, and birth weight. Pooled risk ratios (RR), mean differences (MD), and 95% confidence intervals (CI) were calculated using the random effect model.

RESULTS

Twenty trials involving 5938 participants, including thirteen trials comparing scaling and root planning (SRP) and seven trials comparing SRPM with control groups. SRPM was associated with reduced risk of preterm birth (RR = 0.37; 95%CI = 0.16-0.84; P = .017; I=93.26%; P < .001; number needed to treat (NNT): 3), low birth weight (RR = 0.54; 95%CI = 0.40-0.74; P < .0001; I = 0%; P = .46; NNT: 13), increased gestational age (MD = 0.78; 95%CI: 0.19-1.37; P = .009; I = 87.15%; P < .001), and birth weight (MD = 121.77; 95%CI = 3.19-240.34; P = .044; I = 80.68%; P < .001). There were no statistically significant differences in the analysis of SRP group, except for the increased birth weight (MD = 93.85; 95% CI = 3.27-184.42; P = .042; I = 84.11%; P < .001).

CONCLUSION

Using mouthwash in addition to scaling and root planning (SRPM) for the treatment of periodontal disease during pregnancy significantly improves perinatal outcomes.

摘要

目的

本研究旨在评估孕期采用不同牙周治疗策略对围产期结局的影响。

研究选择

本系统评价和荟萃分析按照 PRISMA 指南进行,以评估在牙周治疗中使用漱口水(附加于刮治和根面平整术(SRPM))对早产、低出生体重、胎龄和出生体重等妊娠结局的影响。采用随机效应模型计算汇总风险比(RR)、均数差值(MD)和 95%置信区间(CI)。

结果

共纳入 20 项试验,涉及 5938 名参与者,其中 13 项试验比较了刮治和根面平整术(SRP),7 项试验比较了 SRPM 与对照组。SRPM 与早产风险降低相关(RR=0.37;95%CI=0.16-0.84;P=0.017;I=93.26%;P<.001;需要治疗人数(NNT):3)、低出生体重(RR=0.54;95%CI=0.40-0.74;P<.0001;I=0%;P=0.46;NNT:13)、胎龄增加(MD=0.78;95%CI:0.19-1.37;P=0.009;I=87.15%;P<.001)和出生体重增加(MD=121.77;95%CI=3.19-240.34;P=0.044;I=80.68%;P<.001)。SRP 组分析中,除出生体重增加(MD=93.85;95%CI=3.27-184.42;P=0.042;I=84.11%;P<.001)外,无统计学显著差异。

结论

在牙周病的治疗中,在刮治和根面平整术(SRPM)基础上使用漱口水可显著改善围产期结局。

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