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自体富血小板浓缩物作为非手术牙周治疗辅助手段的有效性:一项随机对照试验的系统评价和荟萃分析

The effectiveness of autologous platelet-rich concentrates as an adjunct during nonsurgical periodontal therapy: a systematic review and meta-analysis of randomized controlled trials.

作者信息

Nik Eezammuddeen Nazurah, Johari Nurina Nasuha, Demius Olevia, Al-Bayaty Fouad Hussain

机构信息

Periodontology Centre of Studies, Faculty of Dentistry, Universiti Teknologi MARA, Jalan Hospital, 47000, Sungai Buloh, Malaysia.

Faculty of Dentistry, MAHSA University, Jalan SP 2, Bandar Saujana Putra, 42610, Jenjarom, Malaysia.

出版信息

Evid Based Dent. 2025 Mar;26(1):68. doi: 10.1038/s41432-024-01060-0. Epub 2024 Aug 29.

Abstract

OBJECTIVES

To evaluate the efficacy of autologous platelet concentrates (APC) on periodontal outcomes in nonsurgical therapy of periodontitis patients.

METHOD

Electronic search via Web of Science, MEDLINE via PubMed, Scopus, and Cochrane CENTRAL registry as well as manual search were done from June 2024 to July 2024 for relevant publication from inception until June 2024. The articles were assessed by 2 independent reviewers and deemed relevant when the interventional studies reported on periodontal outcomes after adjunctive APC were used in NSPT. The studies were excluded if it was not in English or unpublished. The risk of bias for each study was assessed using the Cochrane risk-of-bias tool (RoB 2). Fixed effect meta-analysis was conducted to measure the summary effect for change of periodontal pocket depth (PPD) and Clinical Attachment Level (CAL). The statistical heterogeneity between studies was also calculated using I test.

RESULT

A total of 607 records were found in the four electronic databases. Following the removal of duplicates and initial title screening, 16 full text articles from electronic search and 7 articles from manual search were assessed resulting in 13 studies included in the systematic review. The overall risk of bias showed most studies have moderate to high risk of bias. The fixed-effect meta-analysis showed summary effects favored the adjunctive use of APC in nonsurgical periodontal therapy but with high heterogeneity between the studies, particularly for CAL.

CONCLUSION

The evidence on APC as adjunct in NSPT is limited by the small number of studies, moderate to high risk of bias in most studies and significant heterogeneity in the results.

摘要

目的

评估自体血小板浓缩物(APC)在牙周炎患者非手术治疗中对牙周结局的疗效。

方法

于2024年6月至2024年7月通过Web of Science、PubMed的MEDLINE、Scopus和Cochrane CENTRAL注册库进行电子检索,并进行手工检索,以查找从创刊至2024年6月的相关出版物。文章由2名独立审稿人进行评估,当干预性研究报告了在非手术牙周治疗(NSPT)中使用辅助性APC后的牙周结局时,该文章被视为相关。如果文章不是英文或未发表,则将其排除。使用Cochrane偏倚风险工具(RoB 2)评估每项研究的偏倚风险。进行固定效应荟萃分析以测量牙周袋深度(PPD)和临床附着水平(CAL)变化的汇总效应。还使用I检验计算研究之间的统计异质性。

结果

在四个电子数据库中共找到607条记录。在去除重复记录和初步标题筛选后,对电子检索的16篇全文文章和手工检索的7篇文章进行了评估,最终有13项研究纳入系统评价。总体偏倚风险显示,大多数研究具有中度至高偏倚风险。固定效应荟萃分析显示,汇总效应支持在非手术牙周治疗中辅助使用APC,但研究之间存在高度异质性,尤其是对于CAL。

结论

关于APC作为NSPT辅助手段的证据受到研究数量少、大多数研究存在中度至高偏倚风险以及结果存在显著异质性的限制。

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