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系统评价和荟萃分析:全身性抗生素治疗在种植体周围炎治疗中的应用。

A Systematic Review and Meta-Analysis of Systemic Antibiotic Therapy in the Treatment of Peri-Implantitis.

机构信息

Department of Stomatology, Faculty of Dentistry, University of Granada, Colegio Máximo de Cartuja s/n, 18071 Granada, Spain.

Independent Researcher, 18071 Granada, Spain.

出版信息

Int J Environ Res Public Health. 2022 May 26;19(11):6502. doi: 10.3390/ijerph19116502.

Abstract

Research has been conducted into the advantages of the systemic administration of antibiotics. The aim of this systematic review and meta-analysis was to assess the efficacy of systemic antibiotic administration in the treatment of peri-implantitis in terms of bleeding on probing (BoP) and probing pocket depth (PPD). Literature searches were performed across PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) to identify randomized controlled trials and observational clinical studies. After peri-implantitis treatment, PPD was reduced by 0.1 mm ( = 0.58; IC 95% [-0.24, 0.47]), indicating a non-significant effect of antibiotic administration on PPD. The BoP odds ratio value was 1.15 ( = 0.5; IC 95% [0.75, 1.75]), indicating that the likelihood of bleeding is almost similar between the test and control groups. Secondary outcomes were found, such as reduced clinical attachment level, lower suppuration and recession, less bone loss, and a reduction in total bacterial counts. In the treatment of peri-implantitis, the systemic antibiotic application reduces neither PPD nor BoP. Therefore, the systemic administration of antibiotics, in the case of peri-implantitis, should be rethought in light of the present results, contributing to address the problem of increasing antibiotic resistance.

摘要

已经对全身应用抗生素的优势进行了研究。本系统评价和荟萃分析的目的是评估全身使用抗生素治疗种植体周围炎时在探诊出血(BoP)和探诊牙周袋深度(PPD)方面的疗效。通过在 PubMed、EMBASE 和 Cochrane 中心对照试验注册库(CENTRAL)进行文献检索,确定了随机对照试验和观察性临床研究。在种植体周围炎治疗后,PPD 减少了 0.1mm(=0.58;95%CI [-0.24, 0.47]),表明抗生素治疗对 PPD 没有显著影响。BoP 的优势比为 1.15(=0.5;95%CI [0.75, 1.75]),表明试验组和对照组的出血可能性几乎相似。还发现了一些次要结果,如临床附着水平降低、排脓和退缩减少、骨丢失减少以及总细菌计数减少。在种植体周围炎的治疗中,全身应用抗生素既不能减少 PPD 也不能减少 BoP。因此,鉴于目前的结果,应重新考虑全身使用抗生素治疗种植体周围炎,有助于解决抗生素耐药性日益增加的问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce8b/9180155/672fa2cd65e8/ijerph-19-06502-g001.jpg

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