2型糖尿病合并牙周炎患者龈下刮治和根面平整术中全身应用抗生素佐剂:网状Meta分析的系统评价
Systemic antibiotics adjuvants to scaling and root planing in type 2 diabetic and periodontitis individuals: Systematic review with network meta-analysis.
作者信息
Wu Shih-Yun, Wu Ching-Yi, Lin Liang-Yu, Chen Yu-Hsuan, Huang Hsin-Yi, Lai Yu-Lin, Lee Shyh-Yuan
机构信息
Department of Stomatology, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.
出版信息
Jpn Dent Sci Rev. 2023 Dec;59:167-178. doi: 10.1016/j.jdsr.2023.06.001. Epub 2023 Jun 18.
Targeting inflammatory pathways is considered a common strategy to control type 2 diabetes (T2D) and periodontitis. This overview was to validate systemic antibiotics as an adjuvant to scaling and root planing (SRP) for the treatments of periodontal patients with T2D. Literature searches were conducted using Web of Science, PubMed, Cochrane, and EMBASE. Randomized trials comparing SRP and systemic antibiotics on glycated hemoglobin (HbA1c) and probing pocket depth (PPD) in adults with T2D and periodontitis were analyzed using network meta-analysis and meta-regression. At 3-month postintervention, meta-analyses of 16 studies revealed that SRP and SRP plus systemic antibiotics (SRPa) had similar significant effects in reducing HbA1c levels of - 0.72% and - 0.96% respectively. While SRP and SRPa also, respectively, reduced PPD of - 0.67 and - 0.89 mm, SRPa showed a better reduction than SRP. At 6-month postintervention, meta-analyses of 7 trials revealed that only SRP was effective in reducing HbA1c levels (-0.29%) but not SRPa. Although both SRP and SRPa still significantly reduced PPD by - 0.56 and - 0.81 mm, respectively, there was no difference between them. The current overview suggested that routine SRP alone is highly recommended for patients with T2D and periodontitis, since systemic antibiotics as an adjuvant provide a rather short-term effect.
针对炎症通路被认为是控制2型糖尿病(T2D)和牙周炎的常用策略。本综述旨在验证全身使用抗生素作为龈下刮治术和根面平整术(SRP)的辅助手段,用于治疗患有T2D的牙周炎患者。使用科学网、PubMed、Cochrane和EMBASE进行文献检索。采用网络荟萃分析和荟萃回归分析比较SRP和全身使用抗生素对患有T2D和牙周炎的成年人糖化血红蛋白(HbA1c)和探诊深度(PPD)的随机试验。干预后3个月,对16项研究的荟萃分析显示,SRP和SRP联合全身使用抗生素(SRPa)在降低HbA1c水平方面分别有相似的显著效果,分别降低了-0.72%和-0.96%。虽然SRP和SRPa也分别使PPD降低了-0.67和-0.89毫米,但SRPa的降低效果优于SRP。干预后6个月,对7项试验的荟萃分析显示,只有SRP在降低HbA1c水平方面有效(-0.29%),而SRPa无效。尽管SRP和SRPa仍分别使PPD显著降低了-0.56和-0.81毫米,但两者之间没有差异。当前综述表明,对于患有T2D和牙周炎的患者,强烈建议仅进行常规SRP治疗,因为全身使用抗生素作为辅助手段的效果相当短暂。