Department of Restorative Dentistry, Periodontology, Endodontology, Preventive and Pediatric Dentistry, University Medicine Greifswald, Fleischmannstr. 42, 17475, Greifswald, Germany.
Department of Orthodontics, University Medicine Greifswald, Greifswald, Germany.
Clin Oral Investig. 2023 Dec 26;28(1):21. doi: 10.1007/s00784-023-05392-6.
To conduct a systematic review of the published scientific evidence to evaluate the efficacy of nonsurgical periodontal therapy (NSPT) in treating periodontitis in patients with concurrent systemic conditions (diabetes, CVD, erectile dysfunction, chronic kidney disease, rheumatoid arthritis, polycystic ovarian syndrome, obesity, pregnancy). We hypothesised that NSPT results in better periodontal outcomes when compared to untreated controls after follow-up.
A systematic search (PUBMED/EMBASE) was conducted from 1995 to 2023 to identify randomised controlled trials (RCTs) with a minimum follow-up of 3 months. The primary outcome was the difference in mean probing depth (PD), and the secondary outcomes were mean clinical attachment loss (CAL), percentage of sites with PD ≤ 3 mm (%PD ≤ 3 mm) and percentage of sites with bleeding on probing (%BOP) between the treated and untreated control group in patients with comorbidities.
The electronic search resulted in 2,403 hits. After removing duplicates, 1,565 titles and abstracts were screened according to the eligibility criteria, resulting in 126 articles for full-text screening. Following this, 44 studies were analysed. Restricting to studies with low bias or some concerns, NSPT group demonstrated a 0.55 mm lower mean PD (95%CI: -0.69; -0.41) after 3 months compared to the control group.
Compared to the untreated controls, NSPT notably reduced mean PD, mean CAL, and %BOP while increasing %PD ≤ 3 mm in patients with concurrent systemic conditions. These findings suggest that NSPT is also an effective procedure in managing periodontitis in patients with concurrent systemic conditions.
This systematic review was registered under the protocol registration number CRD42021241517/PROSPERO.
系统评价已发表的科学证据，评估非手术牙周治疗（NSPT）在治疗合并系统性疾病（糖尿病、心血管疾病、勃起功能障碍、慢性肾脏病、类风湿关节炎、多囊卵巢综合征、肥胖症、妊娠）患者牙周炎的疗效。我们假设与未治疗的对照组相比，NSPT 在随访后会产生更好的牙周结果。
从 1995 年到 2023 年，进行了系统检索（PUBMED/EMBASE），以确定至少随访 3 个月的随机对照试验（RCT）。主要结局是治疗组和未治疗对照组之间的平均探诊深度（PD）差异，次要结局是合并症患者的平均临床附着丧失（CAL）、PD≤3mm 的位点百分比（%PD≤3mm）和探诊出血位点百分比（%BOP）。
电子检索产生了 2403 个结果。去除重复项后，根据纳入标准筛选了 1565 个标题和摘要，最终对 44 篇文章进行了全文筛选。在此之后，分析了 44 项研究。限制为低偏倚或存在一些关注的研究，NSPT 组在 3 个月后 PD 的平均差值为-0.55mm（95%CI：-0.69；-0.41），低于对照组。
与未治疗的对照组相比，NSPT 显著降低了合并系统性疾病患者的平均 PD、CAL 和 %BOP，同时增加了 %PD≤3mm。这些发现表明，NSPT 也是治疗合并系统性疾病患者牙周炎的有效方法。
本系统评价根据注册号 CRD42021241517/PROSPERO 进行了注册。
