Department of Periodontics, Faculty of Dentistry, Sabzevar University of Medical Sciences, Sabzevar, Iran.
Department of Oral Medicine, Firoozgar Hospital, Iran University of Medical Sciences,Tehran, Iran.
Bosn J Basic Med Sci. 2022 Oct 23;22(6):843-861. doi: 10.17305/bjbms.2022.7157.
This systematic review and meta-analysis aimed to assess the extent of clinical attachment loss (CAL) as a clinical parameter in the efficacy of antimicrobial photodynamic therapy (aPDT) in non-surgical management of stage II-IV grade C molar-incisor pattern Periodontitis. This review protocol was conducted in accordance with PRISMA statements and is registered in PROSPERO (CRD42022321211). An electronic and manual search was conducted for relevant articles comparing the efficacy of aPDT versus scaling and root planning (SRP) alone or with amoxicillin/metronidazole (AMX/MET) published up until December 2021. The mean clinical attachment loss (CAL), probing depth (PD) reduction, and bleeding on probing (BOP) with a 95% confidence interval (CI) were pooled and compared between the two groups with CAL < and > 7 mm using a random-effect model after 3 and 6 months. To assess the heterogeneity of the findings, the I2 test was applied and Publication bias was evaluated by visual examination of the funnel plot symmetry. Analysis of 9 studies indicated a significant difference in clinical attachment gain in patients with CAL > 7 mm between the aPDT group and the SRP alone (mean difference=0.92, 95% CI=0.01-1.84, P=0.05) and SRP + AMX/MET (mean difference=0.91, 95% CI=-0.14-1.68, P=0.02) control groups. However, this difference was not significant in patients with CAL < 7 mm. Despite the limitations of the included studies, aPDT can be suggested for the improvement of clinical parameters in grade C molar-incisor pattern Periodontitis with CAL > 7 mm. However, its application in milder cases requires further investigation.
本系统评价和荟萃分析旨在评估临床附着丧失（CAL）作为非手术治疗 II-IV 期 C 级磨牙-切牙模式牙周炎中抗菌光动力疗法（aPDT）疗效的临床参数的程度。本综述方案按照 PRISMA 声明进行，并在 PROSPERO（CRD42022321211）中注册。对截至 2021 年 12 月比较 aPDT 与单独刮治和根面平整（SRP）或与阿莫西林/甲硝唑（AMX/MET）联合治疗效果的相关文章进行了电子和手动检索。使用随机效应模型，在 3 个月和 6 个月后，对 CAL<7mm 和 CAL>7mm 的两组患者进行 CAL、探诊深度（PD）减少和探诊出血（BOP）的平均临床附着丧失（CAL）、探诊深度（PD）减少和探诊出血（BOP）的均值和 95%置信区间（CI）进行汇总和比较。为了评估结果的异质性，应用了 I2 检验，并通过漏斗图对称性的视觉检查评估发表偏倚。对 9 项研究的分析表明，在 CAL>7mm 的患者中，aPDT 组与单独 SRP（平均差异=0.92，95%CI=0.01-1.84，P=0.05）和 SRP+AMX/MET（平均差异=0.91，95%CI=-0.14-1.68，P=0.02）对照组之间，临床附着体获得存在显著差异。然而，在 CAL<7mm 的患者中，这种差异并不显著。尽管纳入研究存在局限性，但对于 CAL>7mm 的 C 级磨牙-切牙模式牙周炎，aPDT 可用于改善临床参数。然而，其在轻度病例中的应用需要进一步研究。
