Department of Periodontology, Oral Medicine and Oral Surgery, Dentistry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Department of Periodontology, Facultad de Odontología, Universitat Internacional de Catalunya, Barcelona, Spain.
J Clin Periodontol. 2023 Jun;50 Suppl 26:146-160. doi: 10.1111/jcpe.13747. Epub 2022 Dec 16.
To evaluate the efficacy of professionally administered chemical agents as an adjunctive treatment to sub-marginal instrumentation (SMI) in the therapy of peri-implant mucositis.
The primary outcome criteria were reduction in bleeding on probing (BOP), whereas resolution of disease, elimination of suppuration, including suppuration on probing, reduction of peri-implant probing pocket depth, reduction of plaque, and patient-reported outcome measures were considered as secondary outcome parameters. A literature search was performed on three electronic databases (01/1980 to 05/2022) focused on clinical studies with at least 3 months of follow-up, and meta-analyses were performed when appropriate.
From a total of 139 publications, 40 articles were identified for full-text reading, and 5 randomized controlled clinical trials (RCTs) on antimicrobial photodynamic therapy (aPDT), 1 RCT on chlorhexidine (CHX), and 1 RCT on sodium hypochlorite (NaOCl) were included. Three studies had a low risk of bias and four had a mid-level (some concerns) risk of bias. The application of aPDT, 0.95% NaOCl, or 0.12% CHX as an adjunctive treatment to SMI showed no difference in changes in BOP and PD compared with SMI alone (p > .05).
Within the limitations of this review and based on a low level of evidence from seven RCTs, it is concluded that the professional adjunctive topical application of aPDT, 0.95% NaOCl, and 0.12% CHX may not be effective to improve changes for BOP and PD when compared with SMI alone.
评估专业化学药剂作为辅助治疗对边缘下器械（SMI）的疗效，用于治疗种植体周围黏膜炎。
主要结局标准是探测出血（BOP）减少，而疾病缓解、化脓消除，包括探测时化脓、种植体周围探测袋深度减少、菌斑减少和患者报告的结果测量被视为次要结局参数。在三个电子数据库（1980 年 1 月至 2022 年 5 月）上进行了文献检索，重点是至少有 3 个月随访的临床研究，并且在适当的情况下进行了荟萃分析。
从总共 139 篇出版物中，确定了 40 篇文章进行全文阅读，包括 5 项关于抗菌光动力疗法（aPDT）的随机对照临床试验（RCT）、1 项关于洗必泰（CHX）的 RCT 和 1 项关于次氯酸钠（NaOCl）的 RCT。三项研究的偏倚风险低，四项研究的偏倚风险为中等级（存在一些关注）。与单独 SMI 相比，将 aPDT、0.95% NaOCl 或 0.12% CHX 作为 SMI 的辅助治疗应用在 BOP 和 PD 的变化方面没有差异（p>.05）。
在本综述的限制内，并基于来自 7 项 RCT 的低水平证据，结论是与单独 SMI 相比，专业辅助应用 aPDT、0.95% NaOCl 和 0.12% CHX 可能无法有效改善 BOP 和 PD 的变化。
